Tachycardia

Diagnosis and treatment

  1. Diagnosis
  2. Treatment
  3. Scores
  4. Pharmaceuticals
  5. ESC recommandations

Treatment

  1. Treatment of narrow QRS complexes tachycaridas.
  2. Treatment of wide QRS complex tachycardias

Treatment of wide QRS complex tachycardias

  1. Non sustained wide QRS complexes tachycardia < 30 sec, well tolerated and not recurrent
  2. Sustained tachycardia > 30 sec

Sustained tachycardia > 30 sec

  1. Torsades de pointes
  2. VT or ventricular flutter
  3. Digitalis intoxication
  4. TV or wide QRS tachycardia and unknown diagnosis

Torsades de pointes

Torsades de pointes
  • MgSO4 2g i.v. to be repeated every 15 minutes.
  • Stop all medication (anti-arrhythmic, anti-depressive drugs) extending QT interval.
  • Eventually temporary pacemaker.
  • In long QT interval and bradycardia consider heart rate acceleration with isoprenalin (Isuprel - dilute 5 doses in 250 ml of NaCL or G5% - monitor to obtain HR > 90 bpm)