What does widening of the QRS complex indicate?
What does widening of the QRS complex indicate?
A “wide QRS complex” refers to a QRS complex duration ≥120 ms. Widening of the QRS complex is related to slower spread of ventricular depolarization, either due to disease of the His-Purkinje network and/or reliance on slower, muscle-to-muscle spread of depolarization.
What type of arrhythmia has a widened QRS complex?
Wide QRS complex tachycardia can be originated by 3 main mechanisms1: Ventricular tachycardia (VT). Supraventricular tachycardia (SVT) with an aberrant conduction attributable to a preexisting bundle-branch block or functional bundle-branch block induced by the fast heart rate.
What is sinus rhythm with SVE?
Kardia Advanced Determination “Sinus with Supraventricular Ectopy (SVE)” indicates sinus rhythm with occasional irregular beats originating from the top of the heart. A common reason for this is premature atrial contractions (PACs).
How do you treat QRS widening?
Sodium bicarbonate is a well-known antidote for tricyclic antidepressant (TCA) poisoning. It has been used for over half a century to treat toxin-induced sodium channel blockade as evidenced by QRS widening on the electrocardiogram (ECG).
How do you treat a wide QRS complex?
Treatment / Management
- SVT will typically be managed with adenosine, Afib with WPWS will be treated with amiodarone, and Afib with aberrancy with either diltiazem or a beta-blocker.
- Typically, amiodarone will be the first-line drug of choice for all ventricular arrhythmias (VT, polymorphic VT, Vfib, etc.)
What causes wide complex ventricular tachycardia?
Most commonly, wide-complex tachycardia or ventricular tachycardia originates from coronary artery disease. The presence of cardiomyopathies with or without left ventricular dysfunction are often already known.
What are the wide complex tachycardia?
Wide complex tachycardia is a cardiac rhythm with more than 100 ventricular beats per minute and a QRS complex of 120 ms or greater.
What drugs cause wide QRS?
Permanent transvenous pacemaker results in wide QRS complexes. Tricyclic antidepressant (TCA) overdose causes a WCT due to the quinidine-like effects of these drugs. The class IA sodium channel blocking activity widens the QRS complex, with tachycardia being part of the toxidrome caused by these agents.
What drugs should be avoided with wide complex tachycardia?
It is so very critical to choose the right kind of medication once the decision is made to treat a patient with wide complex tachycardia. Calcium channel blockers (Diltiazem and verapamil) are strongly advised not to be used for fear of hemodynamic collapse, hypotension and cardiac arrest [4].
What is cardiac SVE?
What does QRS widening mean?
Definition of QRS widening. QRS duration > 100 ms in the presence of a supraventricular rhythm. Most commonly due to bundle branch block or left ventricular hypertrophy. The most important life-threatening causes of QRS widening are Hyperkalaemia. Tricyclic antidepressant poisoning.
What causes wide QRS complex?
A broad QRS complex is either caused by the ventricular conducting system not working (bundle branch block) or the electrical circuit not involving the atrioventricular (AV) node correctly. Broad complex tachycardias may be ventricular or supraventricular in origin. Ventricular tachycardias (VTs).
What are the reasons for low QRS amplitude in ECG?
Similarly, a person with chronic obstructive pulmonary disease often display diminished QRS amplitudes due to hyperinflation of thorax (increased distance to electrodes). Low amplitudes may also be caused by hypothyreosis . In the setting of circulatory collapse, low amplitudes should raise suspicion of cardiac tamponade.
What is considered wide QRS?
A wide complex tachycardia (WCT) is defined as a cardiac rhythm with a rate ≥ 100 bpm and QRS width/duration ≥120 ms or 0.12 sec. Other terms used aside from WCT is wide QRS tachycardia or WQRST.
