Contributor: Travis Barlock MD
Educational Pearls:
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Wide-complex tachycardia is defined as a heart rate > 100 BPM with a QRS width > 120 milliseconds
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Wide-complex tachycardia of supraventricular origin is known as SVT with aberrancy
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Aberrancy is due to bundle branch blocks
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Mostly benign
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Treated with adenosine or diltiazem
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Wide-complex tachycardia of ventricular origin is also known as VTach
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Originates from ventricular myocytes, which are poor inherent pacemakers
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Dangerous rhythm that can lead to death
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Treated with amiodarone or lidocaine
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80% of wide-complex tachycardias are VTach
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90% likelihood for patients with a history of coronary artery disease
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In assessing a wide-complex tachycardia, it is best to treat it as a presumed ventricular tachycardia
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Treating SVT with amiodarone or lidocaine does no harm
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However, treating VTach with adenosine or diltiazem may worsen the condition
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