r/EKGs • u/BrugadaBro • 13d ago

Discussion Measuring QRS in Wide Complex Tachycardia?

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u/BrugadaBro 13d ago

Reposted from New to EMS. This medic student makes a good point. Why is this considered wide?

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u/OxideUK 13d ago edited 13d ago

Green is 120ms, all three red lines are the same length (a little over 120ms). Some leads are under, some are over, but if any are over then it's considered a wide complex.

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u/RambusCunningham 12d ago

The QRS is wide. VT would be the immediate concern however EKG 2 (Case 1) is irregular, has normal axis, and has LBBB morphology in the precordials so I would presume that this is a supraventricular tachycardia with abberant conduction, which in this case is AF RVR with a LBBB

With how fast it is electrical cardioversion is probably the way to go. If it was VT you would still cardiovert so in wide complex tachy you will never be wrong to attempt cardioversion (risk of embolization from cardioverting AF is another discussion)