Tachyarrhythmia
Results:
Torsade de Pointes (TdP)
Key Points Definition: TdP is a specific subtype of polymorphic ventricular tachycardia associated with a prolonged QTc interval. It often presents with a “twisting” pattern on ECG but can be…
Ventricular Tachycardia (VT): Core Overview
Key Points VT is a ventricular-origin rhythm: ≥3 consecutive ventricular beats, QRS >120 ms, rate usually 120–250 bpm. Types include monomorphic VT, polymorphic VT, torsades (PMVT with long QT), ventricular…
Ventricular Tachycardia (VT) Mimics
Key Points: Initial Assumption: Any wide (QRS >120 ms), regular tachycardia should be considered ventricular tachycardia (VT) until clearly proven otherwise. VT Characteristics: VT generally has a ventricular rate of…
Pulseless Ventricular Tachycardia (pVT) Arrest
Key Points Defibrillation First, Minimal Pauses: pVT is rapidly fatal without immediate shocks and high‑quality CPR. Charge defibrillator during compressions and resume compressions immediately after each shock. pVT is a…
Electrical Storm
Key Points Definition: Electrical storm is defined as three or more episodes of sustained ventricular tachycardia (VT), ventricular fibrillation (VF), or appropriate implantable cardioverter-defibrillator (ICD) shocks within 24 hours. Some…
Ventricular Fibrillation (VF) Arrest
Key Points Defibrillation First, Minimal Pauses: VF is rapidly fatal without immediate shocks and high‑quality CPR. Charge during compressions and resume compressions immediately after each shock. Chaotic Electrical Activity: VF…
Ventricular Flutter (V-Flutter)
Key Points Definition: A malignant ventricular tachyarrhythmia with a regular, sine-wave–like waveform at ~250–350 bpm, no isoelectric baseline, and no discernible P/QRS/T distinction. Clinical importance: Rapidly degenerates into ventricular fibrillation…
Unstable Tachyarrhythmias
Key Points: Intervene Immediately: Unstable tachyarrhythmias pose significant risk for rapid clinical deterioration that may lead to irreversible end-organ damage or cardiac arrest. Clinical Indicators of Instability: Altered Mental Status:…
Atrioventricular Reciprocating Tachycardia (AVRT)
Key Points AVRT is a macroreentrant SVT that uses both the AV node and an accessory pathway. Orthodromic AVRT conducts down the AV node and up the pathway and is…
Atrioventricular Nodal Reentry Tachycardia (AVNRT)
Key Points AVNRT is a paroxysmal, regular, usually narrow-complex SVT caused by a reentry circuit within or adjacent to the AV node. Dual-pathway physiology is typical. Bedside hallmark is a…
Wide & Regular Tachydysrhythmia DDx
Key Points Definition: Wide complex tachycardia (WCT) = QRS >120 ms with a steady R-R interval. This section focuses on regular WCT (RWCT). Wide & irregular rhythms are covered separately…
Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT)
Key Points Rare, inherited ventricular arrhythmia triggered by adrenergic stress during exertion or emotion. Classically presents in children or adolescents with syncope or cardiac arrest despite a normal resting ECG…
Monomorphic Ventricular Tachycardia
Key Points Monomorphic ventricular tachycardia (MMVT) is the most common sustained VT. It shows a single, uniform QRS morphology throughout. Classified as sustained if lasting > 30 seconds or associated…
VT vs SVT with Aberrancy: DDx
Key Points ECG alone cannot reliably distinguish VT from SVT-aberrancy in many cases. Use ECG features to rule in VT, not to exclude it. Default: treat regular WCT as VT…
Bidirectional Ventricular Tachycardia (BiVT)
Key Points BiVT is a regular wide-complex VT with beat-to-beat alternation of QRS axis and/or bundle-branch pattern (often alternating RBBB/LBBB or 180° frontal-plane axis shift). Most common cause is severe…
RV Outflow Tract Tachycardia (RVOT VT)
Key Points Idiopathic monomorphic VT arising from the right ventricular outflow tract. Most patients have no structural heart disease; catecholamine and cAMP-mediated triggers are common. Classic ECG pattern: LBBB morphology…
Fascicular Ventricular Tachycardia (Idiopathic Left Fascicular VT)
Key Points Idiopathic reentrant VT arising within the left Purkinje system, most often the left posterior fascicle. Patients are usually young and lack structural heart disease. Signature ECG: RBBB-like morphology…
Slow Ventricular Tachycardia (VT)
Key Points Definition: Slow ventricular tachycardia is defined as a wide complex tachycardia with a ventricular rate between 100–120 bpm. Distinction: Typical sustained VT usually exceeds 120 bpm. When encountering…
R-on-T Phenomenon
Key Points Definition: The R on T phenomenon occurs when an ectopic impulse (often a PVC or cardioversion shock) falls on the T wave of the preceding beat. Mechanism: Interrupting…
Multifocal Atrial Tachycardia (MAT)
Key Points Definition: Multifocal Atrial Tachycardia (MAT) is a rare type of irregularly irregular supraventricular tachycardia (SVT) characterized by the presence of at least three or more different P wave…
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