Introduction to Arrhythmias: Difference between revisions
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Secondly it is important to assess the '''origin of the arrhythmia''': | Secondly it is important to assess the '''origin of the arrhythmia''': | ||
*If the QRS < 120ms (i.e. a narrow complex), then it is either a [[Sinus node rhythms and arrhythmias|sinus arrhythmia]], [[Supraventricular Rhythms|supraventricular rhythm]] or a [[Junctional Tachycardias|junctional tachycardia]]. In tachycardias, this [[Media:narrow_tachycardia_flow.png|'''flowchart''']] will lead to the right diagnosis.<cite>ESCnarrowQRS</cite> | *If the QRS < 120ms (i.e. a narrow complex), then it is either a [[Sinus node rhythms and arrhythmias|sinus arrhythmia]], [[Supraventricular Rhythms|supraventricular rhythm]] or a [[Junctional Tachycardias|junctional tachycardia]]. In tachycardias, this [[Media:narrow_tachycardia_flow.png|'''flowchart''']] will lead to the right diagnosis.<cite>ESCnarrowQRS</cite> | ||
*If the QRS > 120ms it is either a [[Ventricular Arrhythmias|ventricular tachycardia]] or a [[Supraventricular Rhythms|supraventricular rhythm]] with additional [[Intraventricular Conduction|bundle branch block]]. This is a challenging difficulty in arrhythmia diagnosis, therefore a [[media:wideQRS_tachycardia_flow.png|'''flowchart''']] has been | *If the QRS > 120ms it is either a [[Ventricular Arrhythmias|ventricular tachycardia]] or a [[Supraventricular Rhythms|supraventricular rhythm]] with additional [[Intraventricular Conduction|bundle branch block]]. This is a challenging difficulty in arrhythmia diagnosis, therefore a [[media:wideQRS_tachycardia_flow.png|'''flowchart''']] might help, which incoporates the Brugada criteria for VT.<cite>brugada</cite> Another method to discriminate VT from SVT has been proposed by Vereckei et al.<cite>vereckei</cite> In the editorial on that paper an excellent review is given on the subject by Dendi and Josephson.<cite>dendi</cite> | ||
==References== | ==References== | ||
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#ESCnarrowQRS pmid=14563598 | #ESCnarrowQRS pmid=14563598 | ||
#Brugada pmid=2022022 | #Brugada pmid=2022022 | ||
#vereckei pmid=17272358 | |||
#dendi pmid=17317697 | |||
</biblio> | </biblio> | ||
Revision as of 10:13, 17 January 2008
| Author(s) | J.S.S.G. de Jong | |
| Moderator | J.S.S.G. de jong | |
| Supervisor | ||
| some notes about authorship | ||
Arrhythmias (non-normal heart rhythms) can be a challenge to the person who tries to understand them. But with a systematical approach, diagnosis is often less difficult than it seems at the beginning.
First look at the heart rate:
- >100 bpm = tachycardia
- <60 bpm = bradycardia
- are there extra beats? -> Ectopic Beats
Secondly it is important to assess the origin of the arrhythmia:
- If the QRS < 120ms (i.e. a narrow complex), then it is either a sinus arrhythmia, supraventricular rhythm or a junctional tachycardia. In tachycardias, this flowchart will lead to the right diagnosis.ESCnarrowQRS
- If the QRS > 120ms it is either a ventricular tachycardia or a supraventricular rhythm with additional bundle branch block. This is a challenging difficulty in arrhythmia diagnosis, therefore a flowchart might help, which incoporates the Brugada criteria for VT.brugada Another method to discriminate VT from SVT has been proposed by Vereckei et al.vereckei In the editorial on that paper an excellent review is given on the subject by Dendi and Josephson.dendi
References
<biblio>
- ESCnarrowQRS pmid=14563598
- Brugada pmid=2022022
- vereckei pmid=17272358
- dendi pmid=17317697
</biblio>