View source for Approach to the Wide Complex Tachycardia

During wide complex tachycardia (heart rate > 100/min, QRS > 0.12 sec) the differentiation between supraventricular and ventricular origin of the arrhythmia is important to guide therapy. Several algorithms have been developed to aid in this differentiation (below). It is important to keep in mind that a good estimate of VT ''versus'' SVT can be made based on the clinical vignette:
* 'Horizontal entrance' into the ER. Older patient with previous myocardial infarction = most likely VT
* Younger patient with known paroxysmal tachycardias and who is hemodynamically stable = most like SVT