Rhythm diagnosis in regular wide complex tachycardia: Difference between revisions

Revision as of 18:11, 12 March 2011

Brugada's Criteria

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

VTach vs. SVT

V TACH

age >50
h/o MI, CHF, CABG, ASHD, mitral valve prolapse, prev v tach
cannon A waves
variation in arterial pulse
variable first heat sound
fusion beats
AV dissociation
QRS > 0.14sec
extreme LAD <-30degree
no response to vagal maneuvers
specific QRS pattern- V1- R, qR or RS, V6- S, rS or qR
concordance

SVT With Aberrancy

age <35
mitral valve prolapse, esp c h/o WPW
prev SVT
no cannon A waves
no variability in arterial pulse
no variability of first heart sound
no fusion beats
p waves preceding qrs cmplx
QRS usually <0.14 sec
axis normal or slightly abnormal
slow or terminate with vagal maneuver
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

Source

7/2/09 Pani

4/2/10 Niemann

Authors:

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 ==See Also==
 Cards: Tachycardia (Wide)
 ==Brugada's Criteria==
+#Lack of precordial RS complex. yes=VT
+#R onset to S nadir > 100ms of 2.5 sm boxes in one precordial lead. yes=VT
-- Lack of precordial RS complex. yes=VT
+#AV dissociation. yes=VT
+#Morphology criteria for VT present both in precordial leads v1-2 and v6. yes-VT
-- R onset to S nadir > 100ms of 2.5 sm boxes in one precordial lead. yes=VT
-- AV dissociation. yes=VT
-- Morphology criteria for VT present both in precordial leads v1-2 and v6. yes-VT
 ==VTach vs. SVT ==
 ===V TACH===
+#age >50
+#h/o MI, CHF, CABG, ASHD, mitral valve prolapse, prev v tach
-- age >50
+#cannon A waves
+#variation in arterial pulse
-- h/o MI, CHF, CABG, ASHD, mitral valve prolapse, prev v tach
+#variable first heat sound
+#fusion beats
-- cannon A waves
+#AV dissociation
+#QRS > 0.14sec
-- variation in arterial pulse
+#extreme LAD <-30degree
+#no response to vagal maneuvers
-- variable first heat sound
+#specific QRS pattern- V1- R, qR or RS, V6- S, rS or qR
+#concordance
-- fusion beats
-- AV dissociation
-- QRS > 0.14sec
-- extreme LAD <-30degree
-- no response to vagal maneuvers
-- specific QRS pattern- V1- R, qR or RS
-                                     V6- S, rS or qR
-- concordance
 ===SVT With Aberrancy===
+#age <35
+#mitral valve prolapse, esp c h/o WPW
-- age <35
+#prev SVT
+#no cannon A waves
-- mitral valve prolapse, esp c h/o WPW
+#no variability in arterial pulse
+#no variability of first heart sound
-- prev SVT
+#no fusion beats
+#p waves preceding qrs cmplx
-- no cannon A waves
+#QRS usually <0.14 sec
+#axis normal or slightly abnormal
-- no variability in arterial pulse
+#slow or terminate with vagal maneuver
+#specific QRS pattern- V1-rsR', V6qRs (R wave in V1 or V2 < 1 box wide)
-- no variability of first heart sound
+#In Peds SVT w/ Aberrancy = #1 cause of wide tachycardia
-- no fusion beats
-- p waves preceding qrs cmplx
-- QRS usually <0.14 sec
-- axis normal or slightly abnormal
-- slow or terminate with vagal maneuver
-- 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
 ==Source ==
 /2/09 Pani
 /2/10 Niemann
 [[Category:Cards]]