Tachycardia

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Introduction

Tachycardia's are arranged as follows;

Supra-ventricular tachycardia

AV node arrhythmias

Ventricular tachycardia

Differentiation between SVT and VT

Differentiation between supraventricular tachycardias (SVT) and ventricular tachycardias (VT) can be challenging, especially in acute emergency settings. SVT's are rhythm disturbances in the atria or AV-nodal ring or rhythm disorders in which these structures are involved. VT's are rhythm disorders that only involve the ventricles. It can both take place in the myocardium and the conduction system tissue.

Definitions: Tachycardia: heartrate above 100 bpm

Small complex tachycardia: QRS duration < 120 ms. A small complex tachycardia is most likely to be a SVT. However, also a septal VT or His-tachycardia can appear as a small complex tachycardia. (Figure 1, small complex tachy algorithm)

Broad complex tachycardia: QRS duration > 120 ms. A broad complex tachycardia can be due to a SVT with aberration, pre-exited tachycardia (eg antidrome re-entry tachycardia) or VT. (Figure 2, broad complex tachy algorithm)