Wide-complex tachycardia: beyond the traditional differential diagnosis of ventricular tachycardia vs supraventricular tachycardia with aberrant conduction.
Wide-complex tachycardia (WCT) is defined as a rhythm disturbance with a rate greater than 100 beats/min and a QRS complex duration of 0.12 seconds or more in the adult patient; in the pediatric patient, both rate and QRS complex width are age related. In evaluating this type of tachycardia, there are 2 broad categories usually discussed in the medical literature: ventricular and supraventricular with aberrant intraventricular conduction. There are several other important causes of a WCT encountered in clinical practice, which are less often discussed; these tachycardias often require specific therapies differing from the standard approach to WCT. These tachycardias are diverse; as such, the pathophysiology behind each form of WCT includes toxic, metabolic, and conduction system dysfunction mechanisms.
Hollowell
Heather
H
Department of Emergency Medicine, University of Virginia, Charlottesville, VA 22908, USA.
Mattu
Amal
A
Perron
Andrew D
AD
Holstege
Christopher
C
Brady
William J
WJ
D000328:Adult; D003937:Diagnosis, Differential; D004554:Electric Countershock / Q000009:adverse effects; D004562:Electrocardiography; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000150:complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D026941:Sodium Channel Blockers / Q000009:adverse effects; D013617:Tachycardia, Supraventricular / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D017180:Tachycardia, Ventricular / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*
D026941:Sodium Channel Blockers