The Resus Room

Narrow Complex Tachycardia; Roadside to Resus

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Jan 17, 2022
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INSIGHT

Definition And Importance Of QRS Width

  • A narrow complex tachycardia is a rapid rhythm >100 bpm with QRS <0.12s (≤3 small squares at 25 mm/s).
  • QRS width reflects which conduction pathway the impulse used, guiding diagnosis.
ADVICE

Prioritise Clinical Context And Symptoms

  • Always assess clinical context: ask about onset, recurrence, and timing of palpitations.
  • Ask specifically about palpitations, dizziness, breathlessness and cardiac chest pain to gauge compromise.
INSIGHT

AV Node's Protective Delay

  • The AV node is the only electrical connection normally between atria and ventricles and delays conduction.
  • That delay (decremental conduction) protects ventricles from very rapid atrial rates.
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