Cardiology, internal medicine

1. Domina Petric, MD
Broad complex tachycardia

2. Definition

3. Concordance
Concordance means
that all QRS
complexes are
positive or negative.

4. A fusion beat
Fusion beat is when a
normal beat fuses with a
ventricular tachycardia
complex to create an
unusual complex.

5. Fusion beat
Image source: ecgwaves.com

6. Capture beat
It is a normal
QRS between
abnormal beats.

7. Capture beat
Image source: lifeinthefastlane.com

8. Stable VT
 High flow oxygen by face mask!
 Iv. access!
 Urea, electrolytes, kreatinine,
cardiac enzymes, Ca, Mg:
correct hypokalemia,
hypomagnesemia.
 12-lead ECG!

9. Stable VT
 Arterial blood gas in cases
of pulmonary oedema,
reduced conscious level and
sepsis.
 Amiodarone iv. or lidocaine
instead!

10. Torsade de pointes
It can happen as side
effect of antiarrhythmics.
It is due to prolonged QT
interval.

11. Torsade de pointes
Image source: heartpearls.com

12. Ventricular extrasystole
(ectopics)
 VES are the commonest post-MI arrhythmia, but
may also be seen in healthy heart (less than
10% of all rhythm).
 Ventricular bigeminy, trigeminy, VES that come
in pairs are always sign of heart pathology.
Ventricular trigeminy (Google sites)

13. Ventricular fibrillation and ventricular
tachycardia without pulse
VF and pulseless VT are
emergency states that
are treated with
asynchronized DC shock
during reanimation!

14. VF (Lifeinthefastlane.com)

15. Literature
 Oxford Handbook of Clinical
Medicine. Longmore M. Wilkinson I.
B. Baldwin A. Elizabeth W. Ninth
edition.
 Lifeinthefastlane.com
 Ecgwaves.com
 Heartpearls.com