🍺Noonbeeee🍀臨床工学技士🛠

ECG MASTERCLASS: A SYSTEMATIC APPROACH TO TACHYCARDIA Not every tachycardia is the same. Correct rhythm identification begins with a systematic ECG assessment. This flowchart provides a practical approach to differentiating narrow- and wide-complex tachycardias. Start with 5 key questions: 1️⃣ Is the QRS narrow or wide? 2️⃣ Is the rhythm regular, regularly irregular or irregularly irregular? 3️⃣ Are P waves visible? 4️⃣ What is the relationship between P waves and QRS complexes? 5️⃣ What is the RP interval? Important rhythms to distinguish: - AVNRT - AVRT - Atrial tachycardia (AT) - Atrial flutter - Atrial fibrillation (AF) - Sinoatrial nodal re-entrant tachycardia (SANRT) - Ventricular tachycardia (VT) Clinical pearls: - An irregularly irregular narrow-complex tachycardia strongly suggests AF. - A regular narrow-complex tachycardia with a short RP interval often suggests AVNRT. - A pseudo-R′ in V1 or pseudo-S waves in the inferior leads may support AVNRT. - A wide-complex tachycardia should be treated as VT until proven otherwise in an appropriate clinical context. - Adenosine may help diagnose selected regular tachycardias, but it is not appropriate for every rhythm. Remember: ECG interpretation is not simply about calculating heart rate. It is about understanding the electrical mechanism behind the rhythm.