Approach to the Wide Complex Tachycardia: Difference between revisions

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Approach to the Wide Complex Tachycardia (view source)

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== Brugada criteria ==
== Brugada criteria ==
{| class="wikitable" width="500px"
{| class="wikitable" width="500px"
! colspan="3" |Brugada criteria ter differentiatie van [[supraventriculaire ritmestoornissen]] (SVT's) van [[ventriculaire ritmestoornissen]] (VT's)<cite>Brug1</cite>
! colspan="3" |Brugada criteria to differentiate [[SVT]] from [[VT]] <cite>Brug1</cite>
|-
|-
| Zijn er fusie of capture beats? (dit item komt niet uit de Brugada criteria, maar is wel heel specifiek)|| Ja? => VT || specificiteit=100% [[image:fusionbeat.png|thumb|100px]]
| Are there fusion or capture beats? (this is not an item from Brugada, it is however very specific|| Yes? => VT || specificy=100% [[image:fusionbeat.png|thumb|100px]]
|-
|-
| RS complexen afwezig over de voorwand? || Ja? => [[VT]] || sensitiviteit=21% specifiteit=100%
| RS complexen missing in the chest leads? || Yes? => [[VT]] || sensitivity=21% specificity=100%
|-  
|-  
| RS-interval in één van de precordiale afleidingen > 100 msec (bij patient zonder anti-arritmetica)? || Ja? => VT || sensitiviteit=66% specifiteit=98%
| RS-interval in one of the cheast leads > 100 msec (in the absence of anti-arrhythmics)? || Yes? => VT || sensitivity=66% specificity=98%
|-
|-
| Is er [[AV-dissociatie]]? || Ja? => waarschijnlijk [[VT]] (NB [[AVNRT|AV nodale re-entry]] kan ook AV-dissociatie geven!)|| sensitiviteit=82% specifiteit=98%
| [[AV-dissociation]]? || Yes? => probably [[VT]] (Note [[AVNRT]] can also present with AV dissociation!)|| sensitivity=82% specifity=98%
|-
|-
! colspan="3" | Morfologische criteria (als bovenstaande criteria geen uitkomst bieden)
! colspan="3" | Morphological criteria (if the above criteria are inconclusive)
|-
|-
!colspan="3" |[[LBTB]] patroon
!colspan="3" |[[LBBB]] pattern
|-
|-
| Initiële R breder dan 40ms? ||Ja => VT || [[Image:Rhythm_RSratio.png|thumb|100px]]
| Initial R more than 40ms? ||Yes => VT || [[Image:Rhythm_RSratio.png|thumb|100px]]
|-
|-
| Slurred of notched neergaand been van S golf in afleiding V1 of V2 || Ja => [[VT]] ||
| Slurred or notched downwards leg of S wave in leads V1 or V2 || Yes => [[VT]] ||
|-
|-
| Begin Q tot nadir QS >60 ms in V1 of V2? || Ja => [[VT]] || LR >50:1
| Beginning of Q to nadir QS >60 ms in V1 or V2? || Yes => [[VT]] || LR >50:1
|-
|-
| Q of QS in V6? || Ja => [[VT]] || LR >50:1
| Q or QS in V6? || Yes => [[VT]] || LR >50:1
|-
|-
| colspan="3" |[[Image:Rhythm_LBTBmorph_en.png|thumb|300px]]
| colspan="3" |[[Image:Rhythm_LBTBmorph_en.png|thumb|300px]]
|-
|-
! colspan="3" |[[RBTB]] patroon
! colspan="3" |[[RBBB]] pattern
|-
|-
| Monofasische R of qR in V1? ||Ja => [[VT]] ||
| Monofasic R or qR in V1? ||Yes => [[VT]] ||
|-
|-
| R hoger dan R' (rabbit-ear sign)?|| Ja => [[VT]] || LR >50:1
| R taller than R' (rabbit-ear sign)?||Yes => [[VT]] || LR >50:1
|-
|-
| rS in V6? || Ja => VT || LR >50:1
| rS in V6? || Yes => VT || LR >50:1
|-
|-
| colspan="3" |[[Image:Rhythm_RBTBmorph_en.png|thumb|300px]]
| colspan="3" |[[Image:Rhythm_RBTBmorph_en.png|thumb|300px]]
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{{clr}}
{{clr}}


==Voorbeelden==
==Examples==
<gallery>
<gallery>
Image:wide_qrs_tachy_AAM1.jpg|Breedcomplextachycardie. Geen AV dissociatie. RBTB. Lijkt op complex bij SR van zelfde patient. Conclusie: [[SVT met aberrantie]]
Image:wide_qrs_tachy_AAM1.jpg|Wide complex tachycardia. No AV dissociation. RBBB. Resembles sinus rhythm from the same patient. Conclusio  SVT with [[RBBB]]
Image:wide_qrs_tachy_AAM2.jpg|ECG van zelfde patient als eerste voorbeeld, maar nu in [[sinusritme]]. Het QRS complex is nauwelijks gewijzigd
Image:wide_qrs_tachy_AAM2.jpg|ECG from the same patient in sinus rhythm. The QRS complex is very similiar.
Image:wide_qrs_tachy_AAM3.png|Breedcomplextachycardie. LBTB configuratie. Afwezigheid RS over voorwand. [[AV-dissociatie]]: de pijlen wijzen de p-toppen aan. Conclusie: [[ventrikeltachycardie]]
Image:wide_qrs_tachy_AAM3.png|Wide complex tachycardia. LBBB configuration. Absence of RS in the chest leads. [[AV dissociation]] is present. Conclusion: [[VT]]
Image:wide_qrs_tachy_AAM4.png|Breedcomplextachycardie. [[LBTB]] configuratie. Afwezigheid RS over vorwand. [[AV-dissociatie]]: de pijlen wijzen de p-toppen aan. Conclusie: [[ventrikeltachycardie]]
Image:wide_qrs_tachy_AAM4.png|Wide complex tachycardia. LBBB configuration. Absence of RS in the chest leads. [[AV dissociation]] is present. Conclusion: [[VT]]`ß
</gallery>
</gallery>
== Referenties ==
== Referenties ==
Retrieved from "https://en.ecgpedia.org/index.php?title=Special:MobileDiff/9722"

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