Introduction to Arrhythmias: Difference between revisions

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Introduction to Arrhythmias (view source)

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[[Image:VT_SVT_LBBB_WCT.svg|thumb|300px|Morphologic criteria to differentiate between SVT vs. VT in a wide complex tachycardia. This is part of the [[media:wideQRS_tachycardia_flow.png|wide complex tachycardia flowchart]]]]
[[Image:VT_SVT_LBBB_WCT.svg|thumb|300px|Morphologic criteria to differentiate between SVT vs. VT in a wide complex tachycardia. This is part of the [[media:wideQRS_tachycardia_flow.png|wide complex tachycardia flowchart]]]]
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 understand, but with a systematic approach, diagnosis is often less difficult than it may appear at first.  


A good stepwise approach to interprete the heart rhythm is to follow these steps:
A good stepwise approach to interpret the heart rhythm is to follow these steps:
*What is the '''ventricular [[Rate|heart rate]]'''?
*What is the '''ventricular [[Rate|heart rate]]'''?
**>100 bpm = tachycardia
**>100 bpm = tachycardia
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** If the heart axis turns significantly when compared to the heart axis during sinus rhythm a ventricular origin of the rhythm is more likely.
** If the heart axis turns significantly when compared to the heart axis during sinus rhythm a ventricular origin of the rhythm is more likely.
* What is the '''clinical setting'''?
* What is the '''clinical setting'''?
** A wide complex tachycardia in a hemodynamically instable 70 year old man with previous myocardial infarction should be concidered a [[ventricular tachycardia]] until proven otherwise
** A wide complex tachycardia in a hemodynamically unstable 70-year-old man with previous myocardial infarction should be considered a [[ventricular tachycardia]] until proven otherwise
** A wide complex tachycardia in a 24 year old women with recurrent spells of tachycardia the respond to vagal manouevres is most likely an [[AVNRT]] with aberrant conduction.
** A wide complex tachycardia in a 24-year-old woman with recurrent spells of tachycardia that respond to vagal maneuvers is most likely an [[AVNRT]] with aberrant conduction.


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