HR >100 bpm; classify by QRS width and regularity.
Diagnosis
- • Narrow regular: sinus, AVNRT, AVRT, atrial tachy, flutter
- • Narrow irregular: AF, flutter with variable block, MAT
- • Wide regular: VT, SVT with aberrancy, antidromic AVRT
- • Wide irregular: polymorphic VT, torsades, pre-excited AF
Management
- • Unstable → synchronised DC cardioversion (or defib if torsades/pulseless)
- • Stable narrow: vagal manoeuvres → adenosine 6-12-18 mg
- • Stable wide: assume VT — amiodarone 300 mg over 20 min
- • Torsades: Mg 2 g IV, correct QT causes
Related in WardRound
Educational — verify locally.
