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Most have a narrow QRS complex, although, occasionally, electrical conduction abnormalities may produce a wide QRS complex that may mimic ventricular tachycardia (VT). In the clinical setting, the distinction between narrow and wide complex tachycardia (supraventricular vs. ventricular) is fundamental since they are treated differently.
A narrow complex tachycardia with an accessory conduction pathway, often termed "supraventricular tachycardia with pre-excitation" (e.g. Wolff–Parkinson–White syndrome) Pacemaker-tracked or pacemaker-mediated tachycardia; Tachycardias may be classified as either narrow complex tachycardias (supraventricular tachycardias) or wide complex ...
Diagram showing how the polarity of the QRS complex in leads I, II, and III can be used to estimate the heart's electrical axis in the frontal plane. The QRS complex is the combination of three of the graphical deflections seen on a typical electrocardiogram (ECG or EKG). It is usually the central and most visually obvious part of the tracing.
WPW pattern with hemodynamically stability and orthodromic AVRT leading to a regular narrow complex tachycardia may be managed similarly to other regular narrow complex supraventricular tachycardias: first with vagal maneuvers followed by a trial of adenosine (first-line therapy). The 2015 ACC/AHA/HRS guidelines recommend beta-blockers or ...
Ventricular tachycardia is a regular rhythm with a rate of 140-250 bpm, there are no P waves and the main feature is a wide QRS complex (0.12 and greater) Ventricular fibrillation has no p waves or QRS complexes, there are only wavy irregular deflections throughout the heart rhythm, at this point the heart would have a rate of 0 and be ...
Premature ventricular contractions (PVCs) – Normal beats are conducted through the AV node to the ventricles resulting in a narrow QRS complex. With PVCs, the extra beat originates within the ventricles and results in a wide QRS complex. Like PACs, they can be found in healthy hearts but are more likely to be found in bigeminy than PACs.
Synchronized electrical cardioversion is used to treat hemodynamically unstable supraventricular (or narrow complex) tachycardias, including atrial fibrillation and atrial flutter. It is also used in the emergent treatment of wide complex tachycardias, including ventricular tachycardia, when a pulse is present.
This effect can sometimes be seen in the setting of a faster heart rate (tachycardia) and so is termed "rate-related aberrancy." After the first aberrant complex, subsequent complexes may be wide due to concealed conduction rather than aberrancy.
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