Tachycardia: Difference between revisions

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===Definitions===
===Definitions===
*'''Narrow complex tachycardia:''' QRS duration < 120 ms.
A narrow complex tachycardia is most likely to be a SVT. However, also a septal VT or His-tachycardia can appear as a narrow complex tachycardia.


*'''Wide complex tachycardia:''' QRS duration > 120 ms.
'''Small complex tachycardia:''' QRS duration < 120 ms.
A wide complex tachycardia can be due to a SVT with aberration, pre-exited tachycardia (eg antidrome re-entry tachycardia) or VT.  
 
A small complex tachycardia is most likely to be a SVT. However, also a septal VT or His-tachycardia can appear as a small complex tachycardia.
 
'''Broad complex tachycardia:''' QRS duration > 120 ms.
 
A broad complex tachycardia can be due to a SVT with aberration, pre-exited tachycardia (eg antidrome re-entry tachycardia) or VT.  


===Differentiation===
===Differentiation===
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===Treatment===
===Treatment===
*'''Haemodynamical instable (systolic blood pressure less than 100 mmHg):'''
'''Haemodynamical instability (systolic blood pressure less than 100 mmHg):'''  
**Electrical cardioversion (with anesthesia when concious)
*electrical cardioversion  
 
'''Haemodynamical stability in a regular small complex tachycardia:'''  
*'''Haemodynamically stable regular narrow complex tachycardia:'''
*Carotid massage (after palpation and ausculatation of carotid arteries for exclusion of carotid occlusion/stenosis)  
**Carotid massage (after palpation and ausculatation of carotid arteries for exclusion of carotid occlusion/stenosis)  
*Vasalva manoeuvre  
**Vasalva manoeuvre  
*Adenosine bolus (if patient is not asthmatic or having COPD)  
**Adenosine bolus (if patient is not asthmatic or having COPD)  
*Verapamil (if patient is not having systolic heart failure)  
**Verapamil (if patient is not having systolic heart failure)  
*Beta-blocker (if patient is not having systolic heart failure)
**Beta-blocker (if patient is not having systolic heart failure)  


==References==
==References==