Broad complex tachycardia

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Updated March 2006: D. Tucker, RPh, BCPS

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Presentation transcript:

Broad complex tachycardia Domina Petric, MD

Definition Heart rate >100 bpm. QRS complexes >120 ms. If there are no clear QRS complexes, it is ventricular fibrillation or asystole.

Concordance means that all QRS complexes are positive or negative.

A fusion beat Fusion beat is when a normal beat fuses with a ventricular tachycardia complex to create an unusual complex.

Fusion beat Image source: ecgwaves.com

It is a normal QRS between abnormal beats. Capture beat It is a normal QRS between abnormal beats.

Capture beat Image source: lifeinthefastlane.com

Stable VT High flow oxygen by face mask! Iv. access! Urea, electrolytes, kreatinine, cardiac enzymes, Ca, Mg: correct hypokalemia, hypomagnesemia. 12-lead ECG!

Stable VT Arterial blood gas in cases of pulmonary oedema, reduced conscious level and sepsis. Amiodarone iv. or lidocaine instead!

It can happen as side effect of antiarrhythmics. Torsade de pointes It can happen as side effect of antiarrhythmics. It is due to prolonged QT interval.

Torsade de pointes Image source: heartpearls.com

Ventricular extrasystole (ectopics) VES are the commonest post-MI arrhythmia, but may also be seen in healthy heart (less than 10% of all rhythm). Ventricular bigeminy, trigeminy, VES that come in pairs are always sign of heart pathology. Ventricular trigeminy (Google sites)

Ventricular fibrillation and ventricular tachycardia without pulse VF and pulseless VT are emergency states that are treated with asynchronized DC shock during reanimation!

VF (Lifeinthefastlane.com)

Literature Oxford Handbook of Clinical Medicine. Longmore M. Wilkinson I. B. Baldwin A. Elizabeth W. Ninth edition. Lifeinthefastlane.com Ecgwaves.com Heartpearls.com