Tachycardia - Differential Diagnosis Table - Wide vs Narrow, Regular vs Irregular



Regular Rhythm - Narrow Complex Tachycardia:

 • ST vs SVT (AVNRT, OAVRT, AFIutter)

 •  P-waves. Bedside eval of rate and variability

 • Tx: Vagal maneuvers, Adenosine/CCBs



Regular Rhythm - Wide Complex Tachycardia:

 • HyperK vs VT > SVT+conduction abnormality

 • Don't rely on criteria

 • Tx: Meds vs. electricity - amio, procainamide, adenosine



Irregular Rhythm - Narrow Complex Tachycardia:

 • AFib > AFIutter + variable block >> MAT

 • Determine whether AF is cause/effect

 • Tx: Underlying cause vs. Rate/Rhythm control



Irregular Rhythm - Wide Complex Tachycardia:

 • HyperK vs AF+WPW vs PMVT vs AFib + conduction abnormality

 • Beware AV nodal blockers unless certain of AFib + RBBB/LBBB or identical morphology to prior known QRS

 • AFib tx vs. Procainamide vs. electricity



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