Table of Contents
What does wide complex tachycardia indicate?
Two ECG features define wide-complex tachycardia: a QRS complex >120 ms and a heart rate of >100 beats per minute [1]. Patients with wide-complex tachycardia can present at the emergency department (ED) haemodynamically stable or unstable.
Can Rbbb cause SVT?
Figure 1 Episode of a wide complex tachycardia with a right bundle branch block (RBBB) configuration, which spontaneously changes to a narrow complex SVT in the presence of a slight decrease in cycle length.
Is Right bundle branch block a tachycardia?
The Brugada Criteria can be helpful in distinguishing these two entities. Lastly, VT itself can sometimes have a RBBB pattern if it arises from the left ventricle. If tachycardia is present — that is, heart rate greater than 100 beats per minute — in a RBBB pattern, VT should be considered.
Is wide complex tachycardia shockable?
Assuming that the victim has no pulse (which is a condition for using the AED algorithm), VT may be treated with unsynchronized shocks. Wide QRS tachycardia of unknown origin with a rate greater than 150 bpm and sustained for six seconds is also shockable.
Is wide complex tachycardia the same as V tach?
Ventricular tachycardia refers to a wide QRS complex heart rhythm — that is, a QRS duration beyond 120 milliseconds — originating in the ventricles at a rate of greater than 100 beats per minute.
Is RBBB serious?
How serious is a right bundle branch block? If you have no symptoms and no heart disease, a right bundle branch block is not serious. But if you’ve already had heart failure or a heart attack along with right bundle branch block, it puts you at a higher risk of death.
What does wide complex mean?
A “wide QRS complex” refers to a QRS complex duration ≥120 ms. Widening of the QRS complex is related to slower spread of ventricular depolarization, either due to disease of the His-Purkinje network and/or reliance on slower, muscle-to-muscle spread of depolarization.
What is wide complex tachycardia with aberrancy?
Most often it refers to a patient with a bundle branch block (BBB). If a patient has a BBB at baseline and they develop tachycardia, then this BBB will persist, and it will present as a wide complex tachycardia. SVT with Aberrancy is one example of this.
What is the differential diagnosis of wide-complex tachycardia?
Besides ventricular tachycardia, the differential diagnosis of wide-complex tachycardia includes supraventricular tachycardia with aberrant conduction due to bundle branch block or Wolff-Parkinson-White syndrome if the QRS complex is regular.
How is wide complex tachycardia treated in atrial fibrillation?
In atrial fibrillation with bundle branch block causing irregular wide-complex tachycardia, the same treatment as for small complex tachycardia is recommended. For a stable and regular wide-complex tachycardia, if ventricular, amiodarone 2 × 150 mg intravenously over 20–60 minutes is a safe treatment of choice.
What ECG features define wide-complex tachycardia?
Two ECG features define wide-complex tachycardia: a QRS complex >120 ms and a heart rate of >100 beats per minute. Patients with wide-complex tachycardia can present at the emergency department (ED) haemodynamically stable or unstable.