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Intraventricular Conduction Delay (QRS widening)

Definition of QRS widening

QRS duration > 100 ms in the presence of a supraventricular rhythm. Most commonly due to bundle branch block or left ventricular hypertrophy.

The most important life-threatening causes of QRS widening are:


Causes of Intraventricular Conduction Delay
Fascicular and bundle-branch blocks
Ventricular hypertrophy and dilatation
Electrolyte abnormalities
Toxins
Pre-excitation
Arrhythmogenic cardiac conditions
“Non-specific” IVCD
  • Not due to any of the causes above — Before making this diagnosis, be sure to check the serum potassium level and scrutinise the ECG for any signs of TCA toxicity.

Differential Diagnosis
Ventricular Rhythms

References

Advanced Reading

Online

Textbooks


LITFL Further Reading

ECG LIBRARY

Emergency Physician in Prehospital and Retrieval Medicine in Sydney, Australia. He has a passion for ECG interpretation and medical education | ECG Library |

Adult/Paediatric Emergency Medicine Advanced Trainee in Melbourne, Australia. Special interests in diagnostic and procedural ultrasound, medical education, and ECG interpretation. Co-creator of the LITFL ECG Library. Twitter: @rob_buttner

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