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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. | 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: | '''First look at the heart rate:''' | ||
*>100 bpm = tachycardia | *>100 bpm = tachycardia | ||
*<60 bpm = bradycardia | *<60 bpm = bradycardia | ||
*are there extra beats? -> [[Ectopic Beats]] | *are there extra beats? -> [[Ectopic Beats]] | ||
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. | *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. | ||
*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 developed for this.<cite>brugada</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 developed for this.<cite>brugada</cite> | ||
Normal heart rhythm is explained in: | Normal heart rhythm is explained in: | ||
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<biblio> | <biblio> | ||
#ESCnarrowQRS pmid=14563598 | #ESCnarrowQRS pmid=14563598 | ||
#Brugada pmid= | #Brugada pmid=2022022 | ||
</biblio> | </biblio> |