Protocolo diagnóstico de las taquicardias de QRS ancho

Abstract

Ventricular tachycardia is the commonest underlying mechanism for wide QRS tachycardia, representing between 80% to even 95% of patients with ischemic heart disease. Accurate differentiation of ventricular tachycardia from supraventricular tachycardia with aberrant conduction or preexcitation syndromes and pacemaker mediated supraventricular tachycardias, holds important implications in terms of prognosis and dysrhythmia management. Haemodynamic tolerance should not be considered diagnostic criterion. Careful study of the electrocardiogram during sinus rhythm and tachycardia provides diagnostic clue. Different diagnostic algorithms have been published, but their use is complicated and may lead to misdiagnosis. We believe it is essential to understand the criteria for the development of diagnostic algorithms rather than merely its application. When in doubt, common sense should prevail and ventricular tachycardia should be considered the default diagnosis in wide-QRS-complex tachycardias.