Wide Complex Tachycardia
TYPES
- Ventricular Tachycardia (VT)
- Wide complex SVT
- Accelerated idioventricular rhythm
- Ventricular Fibrillation (VF)
VENTRICULAR TACHYCARDIA
- see separate document
WIDE COMPLEX SVT
- see VT document for Brugada algorithm
ACCELERATED IDIOVENTRICULAR RHYTHM (AIVR)
- encountered in an inferior AMI
- often causes haemodynamic compromise c/o loss of atrial systole
ECG
- wide QRS with a rate of 60-110/min
- sinus rhythm is often only slightly slower than the arrhythmia so the dominant rhythm may be intermittent AIVR and sinus
- fusion beats are therefore common
Management
- overdrive pacing
- atropine
VENTRICULAR FIBRILLATION
- always causes cardiac arrest
- often have IHD or are having an MI
- consider: cardiomyopathy, anti-arrhythmics, severe hypoxia and non-synchronised DC cardiovertion
ECG
- irregular waves of varying morphology and amplitude
Management
- immediate cardioversion
- amiodarone
References and Links
- ECG Library – QRS Morphology
- ECG Library – Ventricular Fibrillation
- ECG Library – Ventricular Tachycardia
- ECG Library – Supraventricular Tachycardia (SVT)
- ECG Library – Accelerated Idioventricular Rhythm (AIVR)
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC