Rhythm diagnosis in regular wide complex tachycardia: Difference between revisions
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*Only for regular rhythms | *Only for regular rhythms | ||
*Only for treatment decision if pt is stable | *Only for treatment decision if pt is stable | ||
*Assume V-tach until proven otherwise | |||
#Absence of an RS complex in all precordial leads? | #Absence of an RS complex in all precordial leads? | ||
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#Morphology criteria for VT present both in V1-2 and V6? | #Morphology criteria for VT present both in V1-2 and V6? | ||
##If yes then VT | ##If yes then VT | ||
##If no then SVT | ##If no then possibly SVT | ||
== VTach vs. SVT == | == VTach vs. SVT == | ||
Revision as of 17:43, 9 May 2011
Brugada Criteria
- Only for regular rhythms
- Only for treatment decision if pt is stable
- Assume V-tach until proven otherwise
- Absence of an RS complex in all precordial leads?
- If yes then VT
- If no then continue
- R to S interval >100ms in one precordial lead?
- If yes then VT
- If no then continue
- AV dissociation
- If yes then VT
- If no then continue
- Morphology criteria for VT present both in V1-2 and V6?
- If yes then VT
- If no then possibly SVT
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 |
|
QRS morphology V1 positive pattern |
V1 - R or qR V6 - rS |
V1 - RSR' V6 - Rs |
|
QRS morphology V1 negative pattern |
V1/V2 - Broad R wave (>40msec) V6 - Any Q or QS |
V1/V2 - Small R V6 - no Q |
See Also
Source
7/2/09 Pani 4/2/10 Niemann