EKG Criteria for Ventricular Tachycardia Advertising Whenever we have a wide QRS complex tachycardia on an electrocardiogram, we must assume by default that it is a ventricular tachycardia , although this is not always true. In certain cardiac alterations, wide QRS complex tachycardias of another etiology can be observed. For example, supraventricular tachycardia with a bundle branch block or aberrant conduction, or antidromic tachycardia secondary to accessory pathway. As you can imagine, the rapid and accurate diagnosis of an electrocardiogram with ventricular tachycardia is vital.
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Ventricular tachycardia is a highly nuanced arrhythmia which originates in the ventricles. A wide range of conditions may cause ventricular tachycardia and the ECG is as nuanced as are those conditions. Regardless of etiology and ECG, ventricular tachycardia is always a potentially life-threatening arrhythmia which requires immediate attention. This results in electrical instability which explains why ventricular tachycardia may progress to ventricular fibrillation.
Left untreated, ventricular fibrillation leads to asystole and cardiac arrest. All health care providers, regardless of profession, must be able to diagnose ventricular tachycardia. Causes of ventricular tachycardia Patients with ventricular tachycardia almost invariably have significant underlying heart disease. Individuals with reduced left ventricular function e. Idiopathic ventricular tachycardia IVT Ventricular tachycardia may be classified as idiopathic if no cause can be identified.
All types of myocardial cells may be engaged in initiation and maintenance of this arrhythmia. As mentioned above VT causes hemodynamic compromise. The rapid ventricular rate, which may be accompanied by already impaired ventricular function, does not allow for adequate filling of the ventricles, which results in reduced stroke volume and reduced cardiac output.
Most patients experience presyncope or syncope if the arrhythmia is sustained. In its fulminant course, VT degenerates to ventricular fibrillation, which then degenerates into asystole and cardiac arrest. Importantly, the progress from VT to cardiac arrest may be aborted either spontaneously or by means of treatment. Interestingly, treatment of VT is considered one of the greatest advances in cardiology. It was believed that the mere presence of physicians and nurses caused harmful stress.
Animal studies conducted in the late s, and showed that VT could be terminated by delivering an electrical shock. This prompted physicians to construct coronary care units, in which all patients with acute myocardial infarction were monitored with continuous ECG and ventricular tachyarrhythmias were handled by means of immediate resuscitation and defibrillation.
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EKG Criteria for Ventricular Tachycardia