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Wide Complex TachycardiaOsama DiabAssistant prof. of CardiologyAin Shams UniversityWhat make the complex narrow ?1- The impulse originates above the ventricles2- The impulse conducts to the ventricle centrally (through the AVN-His)3- The LBB and RBB are intact(Simultaneous LV and RV activation)What make the complex wide ?1- The impulse originates from the ventricles2- The impulse conducts to the ventricle eccentrically (through acces pathway)3- LBBB or RBBBWide complex tachycardias1- PVCs2- Ventricular tachycardia3- Antidromic AVRT4- SVT with BBB5- AF or flutter with antegrade accessory pathway conduction6- AF or flutter with BBB 7- PM mediated tachycardia

The ACC algorithm

the most commonly used algorithm. SN 89%, SP 59.2%.1234V2V3V4V1V5V6Why absence of RS indicates VT ?V1V2V3V4V5V6Why absence of RS indicates VT ?V1V2V3V4V5V6Why absence of RS indicates VT ?However, presence of RS does not preclude VT

the most commonly used algorithm. SN 89%, SP 59.2%.1234Why RS interval 100 ms indicates VT ? Normally ventricular activation speed up by the virtue of Purkinje fibers100 msAgain.. RS