Wide Complex Tachycardia

TYPES

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

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