title: [Tachycardias. What must the emergency physician know?].
abstract: Clinical characteristics and the surface electrocardiogram (ECG) are important diagnostic tools for patients with tachycardias. Tachycardias are characterized by a ventricular heart rate > 100/min and have been divided into those with narrow (QRS width < 0.12 s) or wide QRS complex tachycardias (QRS width ≥ 0.12 s). In broad complex tachycardias, AV dissociation, negative or positive concordant pattern in V(1)-V(6), a notch in V(1) and qR complexes in V(6) in tachycardias with left bundle-branch block morphologies are findings indicating ventricular tachycardia (VT). In addition, an R/S relation <1 in V(6) favors VT when right bundle-branch block tachycardia morphologies are present. By analyzing the surface ECG in the right way with a systematic approach, the specificity and sensitivity of correctly identifying supraventricular tachycardia or VT can be > 95%. Therapeutic options in supraventricular or ventricular tachyarrhythmias are preferentially adenosine, ajmaline, amiodarone, and adrenaline. If antiarrhythmic drugs fail, electric cardioversion using short-acting anesthesia is recommended.
authors.affiliation: Medizinische Klinik II (Schwerpunkte Kardiologie und Angiologie), Ruhr-Universität Bochum, Hölkeskampring 40, 44625, Herne, Deutschland. hans-joachim.trappe@ruhr-uni-bochum.de
authors.forename: H-J
authors.initials: HJ
authors.lastname: Trappe
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D002037:Bundle-Branch Block / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D003937:Diagnosis, Differential; D004554:Electric Countershock; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D006327:Heart Block / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D011379:Prognosis; D012815:Signal Processing, Computer-Assisted; D013610:Tachycardia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D013617:Tachycardia, Supraventricular / Q000175:diagnosis / Q000209:etiology / Q000628:therapy
chemical_list: D000889:Anti-Arrhythmia Agents