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Dysrhythmias, also known as arrhythmias, are irregular heart rhythms that result from abnormal electrical activity in the heart, affecting its ability to circulate blood efficiently. Tachyarrhythmias, a subset of dysrhythmias, are characterized by abnormally fast heart rates exceeding 100 beats per minute. Here are some types of tachyarrhythmias with their distinct ECG features:Sinus Tachycardia:Sinus tachycardia presents a regular heart rhythm with an increased rate of 101-180 beats per...

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An electrocardiogram (ECG)graphically represents the heart's electrical activity on ECG paper or a monitor.
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Wide-QRS Complex Tachycardia.

Elias B Hanna¹, Colleen J Johnson², D Luke Glancy¹

¹Section of Cardiology, Department of Medicine, Louisiana State University Health Sciences Center and University Medical Center, New Orleans, Louisiana.

The American Journal of Cardiology

|November 15, 2017

Summary

This case study highlights how specific patient factors, including wide-QRS tachycardia and left ventricular scar, confirm ventricular tachycardia. It differentiates this from supraventricular tachycardia, aiding accurate diagnosis and treatment.

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Area of Science:

Cardiology
Electrophysiology
Medical Diagnostics

Background:

Wide-QRS complex tachycardia presents a diagnostic challenge.
Distinguishing between supraventricular tachycardia (SVT) with aberrant conduction and ventricular tachycardia (VT) is critical for patient management.
Left ventricular scars can influence tachycardia mechanisms.

Observation:

The patient presented with wide-QRS complex tachycardia.
A history of an inferior left ventricular scar was noted.
Atrioventricular dissociation was observed during the tachycardia.
The QRS morphology was inconsistent with typical right or left bundle branch block patterns.

Findings:

The combination of wide-QRS tachycardia, inferior left ventricular scar, atrioventricular dissociation, and atypical QRS morphology strongly supports a diagnosis of ventricular tachycardia.
These findings allowed the exclusion of supraventricular tachycardia with aberrant ventricular conduction or ventricular preexcitation.

Implications:

Accurate diagnosis of ventricular tachycardia is essential for appropriate therapeutic strategies, potentially including antiarrhythmic drugs or ablation.
Understanding the diagnostic criteria for VT in the presence of specific patient histories and electrocardiographic findings improves clinical decision-making.
This case underscores the importance of a comprehensive diagnostic approach in complex tachycardia cases.