Understanding Fundamentals of Electrophysiology and Wide Complex Tachycardia through a Case Report

Author(s): Nayanjyoti Kaushik, Prabhat Singh, Deobrat C Mallick

Wide complex tachycardia (WCT) is common clinical condition seen in Emergency Department (ED), post cardiac surgery patient, coronary care or intensive care unit posing diagnostic challenge to physician. While there are several arrhythmias that can manifest as WCT, in one extreme of this spectrum there are potentially life threatening and hemodynamically unstable arrhythmia like Ventricular Tachycardia (VT) versus non lethal Supraventricular tachycardia, or other medical causes such as electrolyte imbalance, acid-base and metabolic disorders. An accurate diagnosis and appropriate arrhythmia management is critical for effective therapy and good outcome. WCT is a rhythm with a rate of more than 100 beats/min and a QRS duration of more than 120 milliseconds [1].

In this case report we seek to describe a patient presenting with WCT and subsequent methodical approach to diagnosis illustrating few common fundamental electrophysiology concepts.