Rhythm diagnosis in regular wide complex tachycardia: Difference between revisions

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==Brugada's Criteria==
== Brugada's Criteria ==
 
#Lack of precordial RS complex. yes=VT
#Lack of precordial RS complex. yes=VT
#R onset to S nadir > 100ms of 2.5 sm boxes in one precordial lead. yes=VT
#R onset to S nadir > 100ms of 2.5 sm boxes in one precordial lead. yes=VT
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#Morphology criteria for VT present both in precordial leads v1-2 and v6. yes-VT
#Morphology criteria for VT present both in precordial leads v1-2 and v6. yes-VT


==VTach vs. SVT ==
== VTach vs. SVT ==
===V TACH===
 
#age >50
{| border="1" cellspacing="1" cellpadding="1" style="width: 500px; "
#h/o MI, CHF, CABG, ASHD, mitral valve prolapse, prev v tach
|-
#cannon A waves
| <br/>
#variation in arterial pulse
| V Tach
#variable first heat sound
| SVT w/ Aberrancy
#fusion beats
|-
#AV dissociation
| Age
#QRS > 0.14sec
| >50
#extreme LAD <-30degree
| <35
#no response to vagal maneuvers
|-
#specific QRS pattern- V1- R, qR or RS, V6- S, rS or qR
| History
#concordance
| MI, CHF, CABG, MVR
| MVR, WPW
|-
| Cannon A Waves
| Present
| Absent
|-
| Arterial Pulse
| Variation
| No variation
|-
| First heart sound
| Variable
| Not variable
|-
| Fusion Beats
| Present
| Absent
|-
| AV dissociation
| Present
| Absent
|-
| QRS
| >0.14sec
| <0.14sec
|-
| Axis
| Extreme LAD (< -30)
| Normal or slightly abnl
|-
| Vagal Maneuvers
| No response
| Slows or terminates
|-
| If RBBB present
|
V1 - R or qR
 
V6 - rS
 
|
V1 - RSR'
 
V6 - Rs
 
|-
| If LBBB present
|
V1/V2 - Broad R wave (>40msec)
 
V6 - Any Q or QS


===SVT With Aberrancy===
|
#age <35
V1/V2 - Small R
#mitral valve prolapse, esp c h/o WPW
 
#prev SVT
V6 - no Q
#no cannon A waves
 
#no variability in arterial pulse
|}
#no variability of first heart sound
 
#no fusion beats
=== <br/> ===
#p waves preceding qrs cmplx
 
#QRS usually <0.14 sec
=== <br/> ===
#axis normal or slightly abnormal
 
#slow or terminate with vagal maneuver
#<span class="Apple-style-span" style="font-size: 14px;" />
#specific QRS pattern- V1-rsR', V6qRs (R wave in V1 or V2 < 1 box wide)
 
#In Peds SVT w/ Aberrancy = #1 cause of wide tachycardia
== See Also ==


==See Also==
[[Tachycardia (Wide)]]
[[Tachycardia (Wide)]]




==Source ==
7/2/09 Pani
4/2/10 Niemann


[[Category:Cards]]
== Source ==
 
7/2/09 Pani 4/2/10 Niemann
 
<br/>[[Category:Cards]] <br/><br/>

Revision as of 02:10, 8 April 2011

Brugada's Criteria

  1. Lack of precordial RS complex. yes=VT
  2. R onset to S nadir > 100ms of 2.5 sm boxes in one precordial lead. yes=VT
  3. AV dissociation. yes=VT
  4. Morphology criteria for VT present both in precordial leads v1-2 and v6. yes-VT

VTach vs. SVT


 V Tach SVT w/ Aberrancy
Age >50 <35
History MI, CHF, CABG, MVR MVR, WPW
Cannon A Waves Present Absent
Arterial Pulse Variation No variation
First heart sound Variable Not variable
Fusion Beats Present Absent
AV dissociation Present Absent
QRS >0.14sec <0.14sec
Axis Extreme LAD (< -30) Normal or slightly abnl
Vagal Maneuvers No response Slows or terminates
If RBBB present

V1 - R or qR

V6 - rS

V1 - RSR'

V6 - Rs

If LBBB present

V1/V2 - Broad R wave (>40msec)

V6 - Any Q or QS

V1/V2 - Small R

V6 - no Q



See Also

Tachycardia (Wide)


Source

7/2/09 Pani 4/2/10 Niemann




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