Wide-Complex Tachycardia: Criteria
Objectives
At the end of this chapter, the student should be able to:
- Define and discuss the nonurgent period of the clinical evaluation of patients with wide-complex tachycardia (WCT). (pp 566–567)
- Discuss the following concept: When approaching a WCT, we need to focus primarily on identifying the presence of a ventricular tachycardia (VTach) and not on whether it is an SVT with aberrancy. (p 567)
- List the factor(s) in the history and physical examination that points us in the direction that a WCT is VTach. (p 567)
- Predict how evaluating the QRS interval width can help increase your chance of diagnosing a VTach. (pp 568–570)
- Discuss how the warm-up period can lead to an erroneous diagnosis when evaluating a WCT. (p 570)
- List some of the morphologic features present in leads V1-2 and V6 in a WCT that can assist you in isolating the correct causative arrhythmia. (pp 572–576)
- Describe how the presence of premature ventricular contractions with morphology similar to that found in the WCT rhythm will help you isolate the correct causative rhythm. (pp 576–577)
- Define atrioventricular (AV) dissociation, and discuss the clinical and diagnostic importance of this finding. (pp 577–579)
- Discuss why AV dissociation can never occur in an SVT-A. (pp 577, 579)
- Compare the direct and indirect evidence of AV dissociation. (p 579)
- Define the concept of concordance of the QRS complexes in the precordial leads. (p 581)
- Discuss the hemodynamic status and compromise that can occur as a result of a rapid VTach. (p 583)
- Defend the position that you could or could not predict the probability that a VTach is the culprit arrhythmia in a WCT using only the hemodynamic status of the patient. (p 583)
ADVANCED
- Exhibit proficiency in the use of the Brugada algorithm in performing your differential diagnosis of a WCT. (pp 584–586)
- Exhibit proficiency in the use of the Vereckei aVR algorithm in performing your differential diagnosis of a WCT. (pp 587–588)
