Differential Diagnosis of Wide QRS Tachycardias

Katritsis, Demosthenes G.; Brugada, Josép

doi:10.15420/aer.2020.20

Cited by 15 publications

(9 citation statements)

References 28 publications

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“…There are several algorithms that are currently used to help distinguish Supraventricular Tachycardia (SVT) with aberrancy and Ventricular Tachycardia (VT) (Table 3). Many of these algorithms and criteria have limitations [44][45][46][47][48][49][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71].…”

Section: Ecg Criteria Favoring Ventricular Rather Than Supra-ventricu...mentioning

confidence: 99%

“…[RBBB morphology, LBBB morphology] Precordial concordance = VT. A QRS, which is predominantly positive or predominantly negative in every precordial lead, overwhelmingly favors VT with specificity of 95-100% and a PPV of 89-100% [44][45][46][47][48][49][50][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71].…”

Section: Sandler and Marriott Criteria (1965)mentioning

confidence: 99%

“…[RBBB morphology] Rsr' ('Rabbit ears') = VT. In an unusual triphasic V1, with the left R wave taller than the right, and the S wave not crossing the baseline, favors VT with PPV of 100% [44][45][46][47][48][49][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71].…”

Section: Wellens Criteria Of Right Bundle Branch Blockmentioning

confidence: 99%

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Electrocardiographic Differential Diagnosis of Narrow QRS and Wide QRS Complex Tachycardias

Song¹

2023

Clinical Use of Electrocardiogram

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Narrow QRS complex tachycardias or Wide QRS complex tachycardias are common problems encountered in clinical practices. Although such tachycardias often occur in patients with a normal anatomy and/or function of heart and rarely represent life-threatening conditions, they are common sources of morbidity and/or mortality. Narrow QRS complex tachycardias are fast cardiac rhythms with QRS duration of 120 ms or less while wide QRS complex tachycardias are fast cardiac rhythms with QRS duration of 120 ms or more. Origins of narrow QRS complex tachycardias are above or within the His bundle. Wide QRS complex tachycardias can be ventricular tachycardias, supra-ventricular tachycardias with bundle branch block or accessory pathway. The purpose of this chapter is to present the differential diagnosis of narrow and wide QRS complex tachycardias.

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Section: Ecg Criteria Favoring Ventricular Rather Than Supra-ventricu...mentioning

confidence: 99%

Section: Sandler and Marriott Criteria (1965)mentioning

confidence: 99%

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Electrocardiographic Differential Diagnosis of Narrow QRS and Wide QRS Complex Tachycardias

Song¹

2023

Clinical Use of Electrocardiogram

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“…But you need to keep in mind that all of these futures are suggestive and not confirmatory as they may occur in SVT under specific scenarios. Other ECG components that could also be assessed to help in the differentiation include RS intervals and the morphological appearance of QRS and BBB in specific leads (Katritsis & Brugada, 2020).…”

Section: Other Forms Of Wctmentioning

confidence: 99%

Tachycardia Evaluation and its Management Approach, Literature Review

Almuhanna¹,

Alanazi²,

Ghamdi³

et al. 2022

World Journal of Environmental Biosciences

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Tachycardia is a term used to describe any abnormally elevated heart rate exceeding or equal to 100 beats per minute (bpm), it can occur as the result of a wide array of pathologies. The majority of patients are symptomatic and typically present complaining of palpitations or chest discomfort. Patients may also have more dreadful presentations such as shock, hypotension, dyspnea, altered conscious level, myocardial infarction, and heart failure. Tachycardias are classically classified into narrow complex tachycardia (NCT) and wide complex tachycardia (WCT) based on the width of the QRS complex on Electrocardiography (ECG). Our objective was to look into the literature concerning the different types of tachycardia and their diagnosis along with their management. PubMed database was used for articles selection, papers afterward were obtained and reviewed accordingly. Clinical presentations of tachycardia can vary from simple palpitations or lightheadedness to severe shock or even sudden death. Diagnosis is mainly through the use of ECG or Holter monitor. The first step in the management of any type of tachycardia is assessing the hemodynamic stability of the patient, where if they were found to be unstable prompt use of cardioversion is warranted to prevent progression into cardiac arrest. In cases of stable NCT vagal maneuvers and IV, adenosine is considered to be the initial line of the therapy, other treatment options include radiofrequency or catheter ablation.

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“…PR prolongation was de ned as a PR interval of ≥ 200 ms [16]. In patients with myocardial infarction or cardiomyopathy, the presence of heart scar tissue may slow down the electrical conduction between myocardial cells, resulting in widening of the QRS complexes [17]. QRS complex widening was de ned as a QRS interval of ≥ 120 ms [17].…”

Section: Data Collectionmentioning

confidence: 99%

Role of electrocardiogram findings in predicting 48-h mortality in patients with traumatic brain injury

Lee

et al. 2022

Preprint

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Objective: Electrocardiogram (ECG) patterns can change, especially in patients with central nervous system disorders such as spontaneous subarachnoid hemorrhage. However, the association between the prognosis of traumatic brain injury (TBI) and ECG findings is unknown. Therefore, this study aimed to compare and to analyze ECG findings to predict early mortality in patients with TBI.Methods: This retrospective observational study included patients with severe trauma and TBI who were admitted to the emergency department (ED) between January 2018 and December 2020. TBI was defined as an abbreviated injury scale score of the head of ≥ 3. We examined ECG findings, including PR prolongation (≥ 200 ms), QRS complex widening (≥ 120 ms), corrected QT interval prolongation (QTP, ≥ 480 ms), ST-segment elevation, and ST-segment depression (STD) at ED arrival. The primary outcome was 48-h mortality.Results: Of the total patients with TBI, 1024 patients were included in this study and 48-h mortality occurred in 89 patients (8.7%). In multivariate analysis, QTP (odds ratio [OR], 2.017; confidence interval [CI], 1.203–3.382) and STD (OR, 8.428; 95% CI, 5.019–14.152) were independently associated with 48-h mortality in patients with TBI. The areas under the curve (AUCs) of the revised trauma score (RTS), injury severity score (ISS), QTP, STD, and the combination of QTP and STD were 0.790 (95% CI, 0.764–0.815), 0.632 (95% CI, 0.602–0.662), 0.605 (95% CI, 0.574–0.635), 0.723 (95% CI, 0.695–0.750), and 0.786 (95% CI, 0.759–0.811), respectively. The AUC of the combination of QTP and STD significantly differed from that of ISS, QTP, and STD, but not RTS.Conclusion: Based on the ECG findings, QTP and STD were associated with 48-h mortality in patients with TBI.

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Differential Diagnosis of Wide QRS Tachycardias

Cited by 15 publications

References 28 publications

Electrocardiographic Differential Diagnosis of Narrow QRS and Wide QRS Complex Tachycardias

Electrocardiographic Differential Diagnosis of Narrow QRS and Wide QRS Complex Tachycardias

Tachycardia Evaluation and its Management Approach, Literature Review

Role of electrocardiogram findings in predicting 48-h mortality in patients with traumatic brain injury

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