EDUCATION IN HEART
Electrophysiology
Approach to wide complex tachycardias in patients without structural heart disease
Medizinische Klinik und Poliklinik C, Universitätsklinikum Münster, Münster, Germany
Correspondence to:
Correspondence to:
Priv.-Doz. Dr Lars Eckardt
Medizinische Klinik und Poliklinik C, Universitätsklinikum Münster, Albert-Schweitzer-Str. 33, D-48149 Münster, Germany; l.eckardt@uni-muenster.de
Keywords: Brugada syndrome; supraventricular tachycardia; ventricular tachycardia; wide complex tachycardias; Wolff-Parkinson-White
| The first 150 words of the full text of this article appear below. |
The correct diagnosis of a wide complex tachycardia (WCT)—QRS duration > 120 ms—remains a challenge despite numerous established criteria for the differentiation of ventricular from supraventricular tachycardia (SVT) with aberrant conduction. Making the correct diagnosis is important for the acute as well as long term management of patients with WCT. The objective of the present review is to discuss the major causes as well as clinical and electrophysiologic criteria of WCT (table 1
) in patients without structural heart disease.
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View this table: [in a new window] Table 1 Causes of wide complex tachycardias (WCTs) in patients without structural heart disease |
Broad categories of WCTs include ventricular tachycardia (VT), SVT with abnormal intraventricular conduction, and ventricular paced rhythms. A lack of underlying structural heart disease does neither exclude a VT nor imply a benign prognosis. However, if a patient has had similar episodes during previous years, SVT is more likely than VT. Termination of a tachycardia by the
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