Dos años más tarde presentó episodios recurrentes de taquicardia a lat/min no revertió con verapamilo i.v. Tras la cardioversión eléctrica de la taquicardia, Diagnosis and cure of Wolff-Parkinson-White or paroxysmal supraventricular. Request PDF on ResearchGate | Actualización en taquicardia ventricular | La Una taquicardia mal tolerada requiere cardioversión eléctrica, mientras que una . El registro de la tira de ritmo (tras amiodarona intravenosa) corrobora un diagnóstico de taquicardia ventricular. 4. La cardioversión eléctrica resulta efectiva.

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In ARVD there are three predilection sites in the right ventricle: It arises on or near to the septum near the left posterior fascicle. They are often amenable to cure by radiofrequency ablation.


We recently reported an ECG algorithm for differential diagnosis of regular wide QRS complex tachycardias that was superior to the Brugada algorithm. Los botones se encuentran debajo. Al mismo tiempo, perfusion: The QRS complex will be smaller when the VT has its origin in or close to the interventricular septum. A diagnosis of myocardial ischemia or surpaventricular cannot be made with certainty in the presence of a left intraventricular conduction delay. Cardiac arrhythmias are common complications during pregnancy, and it appears that the incidence of arrhythmias has been increasing in patients with and without structural cardiac disease.

SVT not associated with structural cardiac disease or drug presence, for example, would be expected to show rapid initial forces and delayed mid-terminal forces. Pregnancy; Arrhythmia; Supraventricular tachycardia; Ablation.

Idiopathic outflow tract tachycardias are usually exertion or stress related arrhythmias. The first occurrence of the tachycardia after an MI strongly implies VT [7]. The most common supravenfricular is shown in panel A.


When the arrhythmia arises in the lateral free wall of the ventricle sequential activation of the ventricles occurs resulting in a very wide QRS. When in doubt, do not give verapamil or adenosine; procainamide should be used instead. Desencadenadas con esfuerzo Bien toleradas.

When the rate is approximately beats per minute, atrial flutter with aberrant conduction should be considered, although this diagnosis should not be accepted without other supporting evidence. The rationale for these criteria is eminently reasonable.

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Regularity — VT is generally regular, although slight variation in the RR intervals is sometimes seen. In the discussions that follow, patients are categorized as follows: Note the prominent broad R wave in leads V1 and V2.

Sudden narrowing of a QRS complex during VT may also be the result of a premature ventricular depolarisation arising in the ventricle in which the tachycardia originates, or it may occur when retrograde conduction during VT produces a ventricular echo beat leading to fusion with the VT QRS complex.

If all precordial leads are predominantly positive, the differential diagnosis is an antidromic tachycardia using a left sided accessory pathway or supraventriculae VT. The rhythm is more likely originating in ventricular tissue. If they are P waves, they occur in 1: See “Pharmacologic interventions” below and see “Uncertain diagnosis” below [3,4]. Also the presence of AV conduction disturbances during sinus rhythm make it very unlikely that a broad QRS tachycardia in that patient has a supraventricular origin and, as already shown in fig 11, a QRS width during tachycardia more narrow that during sinus rhythm points to a VT.

When in V6 the R: SVT is more likely in younger patients positive predictive value 70 percent. In the setting of AMI, the suprafentricular is more likely. The origin of the QRS rhythm may be in the AV junction, with associated intraventricular aberration, or in fascicular or ventricular tissue. Cardioveraion P waves are not evident on the surface ECG, direct recordings of atrial activity eg, with an esophageal lead or an intracardiac catheter can reveal AV dissociation [22].


See “General principles of the implantable cardioverter-defibrillator”. This type of re-entry may occur in patients with anteroseptal myocardial infarction, idiopathic dilated cardiomyopathy, myotonic dystrophy, after aortic valve surgery, and cardioverssion severe frontal chest trauma.

ECG, April 2018

Notches in the T waves, signifying atrial depolarizations, are present in 1: Fn — This term refers to a patient with evidence of hemodynamic compromise, but who remains awake with a discernible pulse. In this study, wide QRS complex tachycardias [ ventricular tachycardias VTssupraventricular tachycardias SVTs20 preexcited tachycardias] from patients with proven diagnoses were prospectively analyzed by two of the authors blinded to the diagnosis.

As described in the text, lead V1 during LBBB clearly shows signs pointing to a supraventricular origin of the tachycardia. On the tasuicardia sinus rhythm is present with a very wide QRS because of anterolateral myocardial infarction and pronounced delay in left ventricular activation. History of heart disease — The presence of taquciardia heart disease, especially coronary heart disease and a previous MI, strongly suggests VT as an etiology [4,7].

When any of criteria 1 to 3 was present, VT was diagnosed; when absent, the next criterion was analyzed.