Initial evaluation and management of wide-complex tachycardia: A simplified and practical approach

Laszlo Littmann; Elizabeth G Olson; Michael A Gibbs

doi:10.1016/j.ajem.2019.04.027

Initial evaluation and management of wide-complex tachycardia: A simplified and practical approach

Am J Emerg Med. 2019 Jul;37(7):1340-1345. doi: 10.1016/j.ajem.2019.04.027. Epub 2019 Apr 12.

Authors

Laszlo Littmann¹, Elizabeth G Olson², Michael A Gibbs²

Affiliations

¹ Department of Internal Medicine, Carolinas Medical Center, Charlotte, NC, United States. Electronic address: Laszlo.Littmann@atriumhealth.org.
² Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC, United States.

PMID: 31027937
DOI: 10.1016/j.ajem.2019.04.027

Abstract

The evaluation and treatment of wide QRS-complex tachycardia remains a challenge, and mismanagement is quite common. Diagnostic aids such as wide-complex tachycardia algorithms perform poorly in the real-life setting. The purpose of this review is to offer a simple clinical-electrocardiographic approach for the initial evaluation and management of the adult patient with stable wide-complex tachycardia that does not require recollection of complex guidelines or algorithms.

Keywords: Atrial fibrillation; Electrocardiogram; Supraventricular tachycardia; Ventricular tachycardia; Wide-complex tachycardia; Wolff-Parkinson-White syndrome.

Publication types

Review

MeSH terms

Administration, Intravenous
Anti-Arrhythmia Agents / administration & dosage
Atrial Fibrillation / complications
Atrial Fibrillation / diagnosis*
Diagnosis, Differential
Electrocardiography*
Humans
Randomized Controlled Trials as Topic
Tachycardia / complications
Tachycardia / diagnosis*
Tachycardia / drug therapy*
Wolff-Parkinson-White Syndrome / complications
Wolff-Parkinson-White Syndrome / diagnosis*

Substances

Anti-Arrhythmia Agents