![]() The signal does not usually enter the ventricles on every lap due to the long refractory period of the atrioventricular node. The atrial rate is usually around 300 beats per minute. The signal goes round and round the atrium without interruption. The electrical signal re-circulates in a self-perpetuating loop due to an extra electrical pathway in the atria. Atrial flutter is caused by a re-entrant rhythm in either atrium. Normally the electrical signal passes through the atria once, stimulating a contraction, then disappears through the atrioventricular node into the ventricles. Supraventricular tachycardia with bundle branch block (treated as SVT).Atrial fibrillation with bundle branch block (treated as AF).Polymorphic ventricular tachycardia, such as torsades de pointes (treated with IV magnesium).Ventricular tachycardia or unclear cause (treated with IV amiodarone).The resuscitation guidelines break down broad complex tachycardia into: Intravenous amiodarone is added if initial DC shocks are unsuccessful.īroad complex tachycardia refers to a fast heart rate with a QRS complex duration of more than 0.12 seconds or 3 small squares on an ECG. Patients with life-threatening features, such as loss of consciousness (syncope), heart muscle ischaemia (e.g., chest pain), shock or severe heart failure, are treated with synchronised DC cardioversion under sedation or general anaesthesia. Atrial flutter (treated with rate control or rhythm control, similar to atrial fibrillation).Atrial fibrillation (treated with rate control or rhythm control).Supraventricular tachycardia (treated with vagal manoeuvres and adenosine).Sinus tachycardia (treatment focuses on the underlying cause).There are four main differentials of a narrow complex tachycardia: Therefore, the QRS complex will fit within 3 small squares in narrow complex tachycardia. On a normal 25 mm/sec ECG, 0.12 seconds equals 3 small squares. Narrow complex tachycardia refers to a fast heart rate with a QRS complex duration of less than 0.12 seconds. Asystole (no significant electrical activity). ![]()
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