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[Solved] #3 Interpret the ECG rhythm below: PRI: | Course Hero All rights reserved. The QRS complex in lead V1 shows an Rr morphology (first rabbit ear is taller than the second), favoring VT (Table IV). The Q wave in aVR is >40 ms, favoring VT. ECG with Wide QRS - YouTube - Conference Coverage The presence of antiarrhythmic drugs (especially class Ic or class III antiarrhythmic drugs) or electrolyte abnormalities (such as hyperkalemia) can slow intra-myocardial conduction velocity and widen the QRS complex. Approach to Wide QRS Complex Tachycardias | Musculoskeletal Key For example, VTs that arise within scar tissue located in the crest of the interventricular septum may break into (engage) the His bundle or proximal bundle branches early, and subsequent spread of electrical activation occurs via the His-Purkinje network, resulting in relatively narrower QRS complexes. That rhythm changes into a regular wide QRS tachycardia (rate 220 bpm), with QRS characteristics pointing to a ventricular origin (QRS width 180 ms, north-west frontal QRS axis, monophasic R in lead V 1, R/S ratio V 6 <1) 2. When it's not, you could have an irregular heartbeat called AFib . read more Dr. Das, MD In EKG results, nonrespiratory sinus arrhythmia can look like respiratory sinus arrhythmia. In adults, normal sinus rhythm usually accompanies a heart rate of 60 to 100 beats per minute. What would cause a wide qrs (sinus rhythm, normal heart rate - Quora Causes of wide QRS complex tachycardia in children - UpToDate N/A QRS Complex: wide and bizarre (>0.12 seconds) 13. Radcliffe Cardiology is part of Radcliffe Medical Media, an independent publisher and the Radcliffe Group Ltd. Wide Complex Tachycardia: Definition of Wide and Narrow. In 2007, Vereckei et al. Sinus arrhythmia is a kind of arrhythmia (abnormal heart rhythm). For the most common type of sinus arrhythmia, the time between heartbeats can be slightly shorter or longer depending on whether you're breathing in or out. Normal Sinus Rhythm i. Vijay Kunadian ECG results: 79 pbm, Pr interval 152 ms, Qrs duration 100 ms,QT/QTc 352/403 ms, p r t axes 21 20 17. The differentiation of wide QRS complex tachycardias presents a challenging diagnostic dilemma to many physicians despite multiple published algorithms and approaches.1 The differential diagnosis includes supraventricular tachycardia conducting over accessory pathways, supraventricular tachycardia with aberrant conduction, antidromic atrio-ventricular reentrant tachycardia, supraventricular tachycardia with QRS complex widening secondary to medication or electrolyte abnormalities, ventricular tachycardia (VT) or electrocardiographic artifacts. The wide QRS complexes follow some of the pacing spikes, and show varying degrees of QRS widening due to intramyocardial aberrancy. We recommend using a protocol that one is most familiar and comfortable with and supplementing it with the steps from other protocols to improve the accuracy of the diagnosis.
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