Urchaga a, gracia m, basterra n, sola t, garrido m, romero j. This initial distinction will guide the rest of the thinking needed to arrive at a final diagnosis. Accahaesc guidelines for the management of patients with. It is more common in women than men approximately 75% of cases occur in females. Diagnosis and management of narrow and wide complex. The qrs morphology in postmyocardial infarction ventricular tachycardia. As shown in fig 1, broad qrs tachycardia can be divided in three groups svt with bundle branch blockbundle branch block bbb may be preexisting or can occur when the refractory period of one of the bundle branches is reached because of the heart rate of the svt so called tachycardia related or phase 3 block. T he ancho is our topoftheline pianomation player piano system frontend controller. In the lla, ventricular tachycardia vt is diagnosed in the presence of at least 1 of the following. Julian andres duran residente 1 ano cardiologia instituto cardiovascular denton cooley. The differential diagnosis of wide qrs complex tachycardia. Taquicardias supraventriculares carlos rodriguez artuza, jose. We present the case of a patient who, after ophthalmologic examination and instillation of atropine eye drops, developed wide qrs complex tachycardia as the first manifestation of steinert disease.
Consider adenosine only if regular and monomorphic. Av nodal reentrant tachycardia is the most common regular supraventricular tachycardia. Clinical practice guideline 2015 accahahrs guideline for the management of adult patients with supraventricular tachycardia a report of the american college of cardiologyamerican heart association task force on clinical. Ante todo paciente con fibrilacion auricular con respuesta ventricular alta mayor a 220 lpm. We have noted a similar tachycardia in a patient with ischemic heart disease receiving digitalis during hypokalemia. An overview of the acute management of tachyarrhythmias, along with detailed discussions of specific narrow complex tachycardias eg, avnrt, avrt, and at and a broad discussion of wide complex. Joaquin velilla molliner, jose javier salazar gonzalez, antonio asso abadia, antonio gimenez valverde, m. Qrs complex depolarization of the ventricles 5 30mm amplitude 0. A new approach to the differential diagnosis of a regular tachycardia with a wide qrs complex. Wide complex tachycardia features for differentiation. Pulseless ventricular tachycardia is treated using the left branch of the heart attack arrest algorithm. Wide qrs complex tachycardia after atropine eye drop.
Ekg taquicardia qrs angosto by daniel espinoza on prezi. Avnodal reentrant tachycardia avnrt is a type of abnormal fast heart rhythm. Estimulacion vagal por ejemplo usualmente no afectan las taquicardia ventriculares pero pueden tener efectos. This topic will provide a broad overview of the different causes of narrow qrs complex tachycardia and an approach to their evaluation and diagnosis. The differential diagnosis of a regular, monomorphic wide qrs complex tachycardia wct mechanism represents a great diagnostic dilemma commonly encountered by the practicing physician, which has important implications for acute arrhythmia management, further workup, prognosis and chronic management as well. Using the acls tachycardia algorithm for managing stable tachycardia. Pdf the diagnosis and management of ventricular arrhythmias. A read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. When doubt exists in an emergency situation, it is safest to assume that a wide complex. Myotonic dystrophy type i, or steinert disease, is a multisystemic disease. Ecgelectrocardiograma taquicardia regular qrs ancho. Probable afvagal manoeuvres adenosine 6 mg rapid iv bolus if. Clasificacion rr regular rr irregular qrs ancho taquicardia ventricular taquicardia supraventricular con conduccion aberrante.
Adult tachycardia with pulse algorithm is qrs narrow qrs is rhythm regular. Pdf definition, diagnosis and management of tachycardia. Cardiologia pediatrica en atencion primaria capitulo 19. The key to managing a patient with any tachycardia is to assess if pulses are present, decide if the patient is stable or unstable, and then treat the patient based on the patients condition and rhythm. The differential diagnosis of wide qrs complex tachycardia william j. Three of the five patients were previously incorrectly diagnosed as having supraventricular tachycardia. Ekg taquicardia qrs ancho by daniel espinoza on prezi. Aug 28, 2016 qrs ancho con morfologia muy variable doble conduccion. Acls tachycardia algorithm for managing stable tachycardia.
A study of 100 tracings compared with 70 cases of idiopathic ventricular tachycardia. Ventricular tachycardia with narrow qrs complexes left. Accahaesc guidelines for the management of patients with supraventricular arrhythmiasm executive summary a report of the american college of cardiologyamerican heart. Narrow qrs ventricular tachycardia annals of internal. Classification of tachycardias with a broad qrs complex. The most common types of supraventricular tachycardia are caused by a reentry phenomenon producing acceler ated heart rates. Symptoms may include palpitations including possible pulsations in. Current algorithms for the diagnosis of wide qrs complex. Qrs ancho por trastorno electrolitico o drogas fig. Player piano control unit compactflash reader for easy player piano system software updates and large storage capacity. Intervalos rr irregulares fasciculo posterior izquierdo taquicardia ventricular fascicular. Taquicardias con qrs ancho authorstream presentation. Via accesoria av medir intervalo rr entre dos complejos preexcitados.