What does a widened QRS complex indicate?

A “wide QRS complex” refers to a QRS complex duration ≥120 ms. Widening of the QRS complex is related to slower spread of ventricular depolarization, either due to disease of the His-Purkinje network and/or reliance on slower, muscle-to-muscle spread of depolarization.

Which Tachycardic rhythm has a wide QRS complex?

Wide QRS complex tachycardia can be originated by 3 main mechanisms1: Ventricular tachycardia (VT). Supraventricular tachycardia (SVT) with an aberrant conduction attributable to a preexisting bundle-branch block or functional bundle-branch block induced by the fast heart rate.

What heart rhythm has a wide QRS?

A normal QRS should be less than 0.12 seconds (120 milliseconds), therefore a wide QRS will be greater than or equal to 0.12 seconds. To put it all together, a WCT is considered a cardiac dysrhythmia that is > 100 beats per minute, wide QRS (> 0.12 seconds), and can have either a regular or irregular rhythm.

Which ECG rhythm is commonly associated with bradycardia?

Definition of sinus bradycardia ECG criteria follows: Regular rhythm with ventricular rate slower than 50 beats per minute. P-waves with constant morphology preceding every QRS complex. P-wave is positiv in limb lead II.

What conditions are typically associated with wide QRS complexes?

Broad/Wide QRS Complexes

• Bundle branch block (RBBB or LBBB)
• Hyperkalaemia.
• Poisoning with sodium-channel blocking agents (e.g. tricyclic antidepressants)
• Pre-excitation (i.e. Wolff-Parkinson-White syndrome)
• Ventricular pacing.
• Hypothermia.
• Intermittent aberrancy (e.g. rate-related aberrancy)

What causes QRS complex to widen?

Causes of a widened QRS complex include right or left BBB, pacemaker, hyperkalemia, ventricular preexcitation as is seen in Wolf-Parkinson-White pattern, and a ventricular rhythm. Because there is a P wave associated with every QRS complex, a ventricular rhythm can be ruled out.

What causes sinus rhythm with wide QRS?

The QRS complex duration is wide (>0.12 seconds or 3 small boxes) in every lead. Causes of a widened QRS complex include right or left BBB, pacemaker, hyperkalemia, ventricular preexcitation as is seen in Wolf-Parkinson-White pattern, and a ventricular rhythm.

What is the first line of treatment for unstable bradycardia?

Atropine. In the absence of reversible causes, atropine remains the first-line drug for acute symptomatic bradycardia (Class IIa). In 1 randomized clinical trial in adults (LOE 2)5 and additional lower-level studies (LOE 4),6,7 IV atropine improved heart rate and signs and symptoms associated with bradycardia.

What does QRS complex represent on ECG?

A combination of the Q wave, R wave and S wave, the “QRS complex” represents ventricular depolarization. This term can be confusing, as not all ECG leads contain all three of these waves; yet a “QRS complex” is said to be present regardless.

What causes wide QRS?

Wide QRS complexes, or those lasting longer than the normal rate, indicate ventricle impairment such as bundle branch blocks. Often with bundle branch blocks, a second upward deflection occurs within the complex. Other causes for a wide QRS complex include ectopic foci or abnormal pacemaker sites…

What are the indications of wide QRS complex?

A wider QRS may indicate that the bottom of the heart is contracting a little later than it should . Wide QRS is noted on ECG when there is a delay, or widening, in the part of the ECG called the QRS complex.

What is the treatment for wide complex tachycardia?

As previously stated, short-term management of supraventricular tachycardia ( SVT ) involves intravenous adenosine or calcium channel blockers. In cases of wide-complex tachycardia, hemodynamically stable patients can be treated with intravenous procainamide, propafenone, or flecainide.

What causes wide complex tachycardia?

A wide complex tachycardia (WCT) is either of ventricular origin (ventricular tachycardia), of supraventricular origin with aberrant conduction ( SVT with aberrancy), of supraventricular origin and is conducted down a bypass tract such as in Wolff-Parkinson-White syndrome ( WPW ), or is due to a pacemaker malfunction.