Ventricular (Broad Complex) Tachycardia****

Question 1

Where does it arise from? - not the AV node

It usually occurs in a structurally abnormal heart!

When is it classed as sustained tachycardia?

What is ventricular fibrillation?

What would ventricular fibrillation cause?

What features would you see on ECG?

Answer 1

Ventricular ectopic focus

Structurally abnormal heart

> 30 SECONDS

Irregular chaotic ventricular activity

Ineffective cardiac output
No identifiable P wave, QRS or T waves on ECG

Question 2

ECG findings:

What rate would you find?

Why do they get broad QRS complexes?

Signs of AV dissociation?

Answer 2

150-250

Spread of depolarisation through ventricular myocardium is slower than through conduction pathways

P waves and QRS different rates and fusion beats (P wave fused with broad QRS)

Question 3

Management:

In cardiac arrest?

What drug can be given IV if there is a pulse?

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Answer 3

VF and pulseless VT are shockable rhythms - cardioversion

Synchronised DC shocks (defib) if unstable and amiodarone IV

Amiodarone IV if stable