0071643192.pdf

ECG FINDINGS(SEEFIGURE1.16)

■ Regular wide complex tachycardia
■ Inappropriately concordant QRS complexes across the precordial leads
■ AV dissociation
■ Fusion complexes

DIFFERENTIAL

■ VT must be differentiated from SVT with aberrant conduction.
■ An approach using a combination of historical clues, general ECG char-
acteristics, and the Brugada ECG criteria (see Table 1.8) will diagnose VT
with reasonable accuracy.

TREATMENT

■ Pulseless→immediate cardioversion. See “Management of Cardiac Arrest.”
■ Unstable →cardioversion.
■ Synchronized
■ Start with 100J
■ Sedation, if possible

RESUSCITATION

FIGURE 1.15 Typical ECG for Brugada syndrome.

(Reproduced, with permission, from Fuster V, Walsh RA, O’Rourke RA, Poole-Wilson P.
Hurst’s The Heart,Vol.2, 12th ed. New York: McGraw-Hill, 2008:1661.)

FIGURE 1.16. Ventricular tachycardia.

In the patient with prior MI,

wide complex tachycardia is

nearly always VT.

When in doubt, treat any wide

complex tachycardia as

ventricular tachycardia!