What does a widened QRS complex mean?

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.

What causes widening of the QRS complex?

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 medication should not be given when treating wide complex tachycardia?

It is so very critical to choose the right kind of medication once the decision is made to treat a patient with wide complex tachycardia. Calcium channel blockers (Diltiazem and verapamil) are strongly advised not to be used for fear of hemodynamic collapse, hypotension and cardiac arrest [4].

How do you treat rapid irregular wide complex tachycardia?

For a wide irregular rhythm use immediate defibrillation. Adenosine is given as a rapid IV push. First dose is 6 mg followed by a normal saline flush. If a second dose is required, give 12 mg IV rapid push.

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.