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Medicine

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Cardiology

Question
47 out of 57
 

Broad complex tachycardia, due to ventricular a tachycardia is suggested by (PGI May 2009):



A Fusion Beats

B A V dissociation

C Capture Beats

D Termination of tachycardia by carotid massage

E Triphasic QRS in VI

Ans. A

Fusion Beats, B. A V dissociation, C. Capture Beats

1. Broad complex tachycardia

ECG shows rate of > 100 and QRS complexes> 120ms

If no clear QRS complexes, it is VF or asystole.

2. Differential diagnosis

a. VT b.. PSVT with aberrant conduction, eg AF, atrial flutter

3. Identification of the underlying rhythm ECG findings in favors of VT:

a. Positive QRS concordance Q in chest leads

b. Marked left axis deviation

c. AV dissociation (occurs in 25%) or 2:1 or 3:1 AV block

d. Fusion beats Q or capture beats Q

e. RSR complex in V1 (with positive QRS in V1)

f. QS complex in V 6 (with negative QRS in V6)

Extra Edge:

1. Concordance means QRS complexes are all +ve or -ve.

2. A fusion beat is when an 'normal beat' fuses with a VT complex to create an unusual complex,

3. Capture beat is a normal QRS between abnormal beats.

Cardiology Flashcard List

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