This document provides an overview of evaluating and treating different types of tachycardia, including: 1) It discusses evaluating the patient's hemodynamic stability, history, and ECG to determine the characteristics and cause of the tachycardia. 2) It describes differentiating between narrow and wide complex tachycardias, and the differential diagnoses for each including various types of supraventricular tachycardia and ventricular tachycardia. 3) It provides guidance on electrical and chemical therapies for terminating tachycardias, as well as long term treatment options like ablation.

1. TACHYARRHYTHMIA Dr Syed Raza

11. ATRIAL FLUTTER

17. ATRIAL FIBRILLATION WITH RAPID VENTRICULAR RESPONSE

21. ATRIO-VENTRICULAR NODAL RE ENTERANT TACHYCARDIA ( AVNRT)

23. “ pseudo-R’”

26. ATRIOVENTRICULAR RE ENTERANT TACHYCARDIA (AVRT)

44. SVT vs VT Clinical history Medication Drug-induced tachycardia -> Torsade de pointes Diuretics Digoxin-induced arrhythmia -> [digoxin] ≥2ng/l or normal if hypokalemia Age - ≥ 35 ys -> VT (positive predictive value of 85%) Underlying heart disease Previous MI -> 98% VT Pacemakers or ICD Increased risk of ventricular tachyarrhythmia

45. WIDE QRS

47. Step 4: LBBB - type wide QRS complex SVT VT small R wave notching of S wave R wave >40ms fast downslope of S wave no Q wave Q wave > 70ms V1 V6

49. Fusion beat and capture beat

50. Concordance and Northwest Axis

52. Previous MI

53. Previous RBBB

54. Wide complex SVT from bypass tract

56. Torsade de Pointes EKG Characteristics: Irregular wide-complex tachycardia The morphology, amplitude, and axis of the QRS complexes cycle through a sinusoidal pattern No discernable P waves

59. Tachycardia algorithm AHA Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Ciurculation 2005

60. Tachycardia algorithm