Session III: Invasive Diagnosis and Treatment-6155-Wide Complex Tachycardias

Video Transcription

Video Summary

In this video, electrophysiologist Dr. Sam Masroudian discusses wide complex tachycardias and how to interpret ECGs to determine if they are ventricular tachycardias (VTs) or supraventricular tachycardias (SVTs) with aberrancy. He explains that understanding the principle of electrical force or vector can help interpret ECG leads and identify positive and negative waves. He also covers the importance of recognizing the location of positive electrodes in different leads.<br /><br />Dr. Masroudian emphasizes that a wide QRS tachycardia is usually a VT, and a wider QRS suggests a greater likelihood of VT. He provides several criteria to help differentiate between VT and SVT with aberrancy, including examining the axis, looking for AV dissociation, and analyzing the morphology of the QRS complexes.<br /><br />He also discusses various patterns of wide complex tachycardias, such as outflow pattern VT, left ventricular exit pattern VT, and pre-excited tachycardias caused by accessory pathways. He explains that recognizing these patterns can aid in diagnosing and differentiating these tachycardias.<br /><br />Lastly, Dr. Masroudian discusses the use of invasive recordings, such as the HISS bundle and right bundle signals, to further confirm the diagnosis of pre-excited tachycardias.<br /><br />In summary, this video provides an in-depth explanation of how to interpret ECGs to differentiate between wide complex tachycardias and highlights various patterns that can help in making a diagnosis.

Keywords

wide complex tachycardias

ECGs

ventricular tachycardias

supraventricular tachycardias

aberrancy

QRS tachycardia

axis

diagnosis