Ventricular tachycardia electrocardiogram: Difference between revisions
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{{Ventricular tachycardia}} | |||
{{CMG}}; '''Associate Editor-in Chief''': [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com] | |||
==Electrocardography(EKG)== | |||
===Overview=== | |||
The diagnosis of [[Ventricular tachycardia]] almost completely depends on EKG findings. The details are illustrated below. It is important to differentiate it from other wide complex tachycardias. | |||
===Electrocardiographic diagnostic findings=== | |||
[[Image:Lead II rhythm ventricular tachycardia Vtach VT.jpg|500 px|center|thumb|Ventricular tachycardia in Lead II (rhythm)]] | [[Image:Lead II rhythm ventricular tachycardia Vtach VT.jpg|500 px|center|thumb|Ventricular tachycardia in Lead II (rhythm)]] | ||
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==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
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Revision as of 12:08, 17 October 2011
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Ventricular tachycardia Microchapters |
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Differentiating Ventricular Tachycardia from other Disorders |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-in Chief: Avirup Guha, M.B.B.S.[2]
Electrocardography(EKG)
Overview
The diagnosis of Ventricular tachycardia almost completely depends on EKG findings. The details are illustrated below. It is important to differentiate it from other wide complex tachycardias.
Electrocardiographic diagnostic findings
- Abnormal and wide QRS complexes with secondary ST segment and T wave changes.
- Usual QRS duration is > 0.12 seconds, may be shorter if the ectopic focus is located in the ventricular septum.
- The secondary ST segment and T wave changes are in a direction that is opposite the major deflection of the QRS.
- A ventricular rate between 140 and 200 BPM.
- When the rate is >200 and has a sine wave appearance, it is called ventricular flutter.
- When the rate is <110 BPM it is called non-paroxysmal VT.
- A regular or slightly irregular (up to 0.03 seconds) rhythm.
- Abrupt onset and termination.
- AV dissociation.
- Atrial rate slower than ventricular rate.
- No relationship between atrial activity and ventricular activity.
- There can be VA conduction.
- The RP interval is >0.11 seconds.
- Occurs in about 50% of cases.
- Uncommon when the ventricular rate is rapid (only 1/7 when the rate was>200).
- Capture beats.
- Occurs when a supraventricular impulse is conducted and captures the ventricle.
- They are rare.
- Fusion beats.
Examples of Ventricular Tachycardia:
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12 lead EKG: Ventricular tachycardia.
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12 lead EKG: Ventricular tachycardia. Image courtesy of Dr Jose Ganseman
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12 lead EKG: Ventricular tachycardia. Image courtesy of Dr Jose Ganseman
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12 lead EKG: Ventricular tachycardia. Image courtesy of Dr Jose Ganseman
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12 lead EKG: Ventricular tachycardia. Image courtesy of Dr Jose Ganseman
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12 lead EKG: Ventricular tachycardia. Image courtesy of Dr Jose Ganseman
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Ventricular tachycardia of 140 bpm with a left bundle branch block pattern and left heart axis.
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Ventricular tachycardia of 250 bpm with a right bundle branch block pattern and right heart axis.
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Ventricular tachycardia of 150 bpm with a right bundle branch block pattern and right heart axis. Note the 5th and 6th complex from the right side. These are fusion complexes.
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Ventricular flutter on a 12 lead ECG
References
- ↑ Chou's Electrocardiography in Clinical Practice Third Edition, pp. 398-409.
- ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:194 ISBN 1591032016
- ↑ Hammill S. C. Electrocardiographic diagnoses: Criteria and definitions of abnormalities, Chapter 18, MAYO Clinic, Concise Textbook of Cardiology, 3rd edition, 2007 ISBN 0-8493-9057-5