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12-Lead and Rhythm Strip

Wide Complex Tachycardia, 12 Lead ECG and Rhythm Strip

Wed, 11/30/2011 - 13:22 -- Dawn

This is a good example of wide complex tachycardia that must be evaluated for V Tach vs supraventricular rhythm with left BBB.

There is an irregular rhythm.  When the rate is fast, it is important to look at a longer strip, as sometimes fast rates will cause the rhythm to look regular.  We know that monomorphic V Tach is not irregular, so that tells us that we are looking at atrial fibrillation.  

The ECG criteria for left bundle branch block is met here:  1) supraventricular rhythm (atrial fib), 2) wide QRS, and 3) negative QRS in V1 and positive QRS in Leads V6 and I.

With wide complex tachycardia, there is always a chance of ventricular tachycardia, and the patient should be treated as V tach until proven differently.  For more on determining whether a WCT is V tach or SVT with ventricular conduction delay, go to this LINK. 

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