• Rev Port Cardiol · Mar 2014

    Review

    The value of electrocardiography for differential diagnosis in wide QRS complex tachycardia.

    • Pedro A Sousa, Salomé Pereira, Rui Candeias, and Ilídio de Jesus.
    • Serviço de Cardiologia, Hospital de Faro, E.P.E., Faro, Portugal. Electronic address: Peter_senado2002@yahoo.com.
    • Rev Port Cardiol. 2014 Mar 1; 33 (3): 165-73.

    AbstractCorrect diagnosis in wide QRS complex tachycardia remains a challenge. Differential diagnosis between ventricular and supraventricular tachycardia has important therapeutic and prognostic implications, and although data from clinical history and physical examination may suggest a particular origin, it is the 12-lead surface electrocardiogram that usually enables this differentiation. Since 1978, various electrocardiographic criteria have been proposed for the differential diagnosis of wide complex tachycardias, particularly the presence of atrioventricular dissociation, and the axis, duration and morphology of QRS complexes. Despite the wide variety of criteria, diagnosis is still often difficult, and errors can have serious consequences. To reduce such errors, several differential diagnosis algorithms have been proposed since 1991. However, in a small percentage of wide QRS tachycardias the diagnosis remains uncertain and in these the wisest decision is to treat them as ventricular tachycardias. The authors' objective was to review the main electrocardiographic criteria and differential diagnosis algorithms of wide QRS tachycardia. Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

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