Tachycardia classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: M.Umer Tariq [2]

Overview

Tachycardias can be classified in a variety of ways. One form of classification is whether it is a wide-complex tachycardia, or whether it is a narrow-complex tachycardia. Another way of classifying tachycardia is whether the rhythm is regular or whether it is irregular. Tachycardia can also be distinguished by type; whether is is a sinus tachycardia, a ventricular tachycardia, a supraventricular tachycardia, or atrial fibrillation.

Classification

Origin of the Pacemaker

Tachycardia

Narrow complex tachycardia (SVT)

Wide complex tachycardia

The origin of the impulse: Atria

The origin of the impulse: AV junction

The origin of the impulse: Atria or AV junction

The origin of the impulse: AV junction

The origin of the impulse: Atria, AV junction or ventricles Presence of an accessory pathway

The origin of the impulse: Pacemaker

Atrial fibrillation Atrial flutter Ectopic atrial rhythm Multifocal atrial tachycardia (MAT) Paroxysmal atrial tachycardia (PAT) with block Premature atrial contractions (PAC) Sinus tachycardia Wandering atrial pacemaker Sick sinus syndrome

AVNRT AVRT (accessory pathway): - Wolff-Parkinson-White syndrome (WPW) - Lown-Ganong-Levine syndrome (LGL)

Accelerated junctional rhythm

SVTAC (SVT with aberrant conduction): Left bundle branch block Left anterior hemi-block Lefo posterior hemi-block Right bundle branch block Trifascicular block

Ventricular tachycardia Ventricular fibrillation Ventricular parasystole

Wolff-Parkinson-White syndrome (WPW) Lown-Ganong-Levine syndrome (LGL)

Pacemaker-mediated tachycardia Runaway pacemaker syndrome Sensor induced tachycardia

Atrial Rhythms

• Sinus tachycardia
• Premature atrial contractions (PACs)
• Wandering atrial pacemaker
• Multifocal atrial tachycardia
• Supraventricular tachycardia (SVT)
• Atrial flutter
• Atrial fibrillation (Afib)

Atrial Ventricular Arrhythmias

• AV nodal reentrant tachycardia
• AV reentrant tachycardia
  • Wolff-Parkinson-White syndrome
  • Lown-Ganong-Levine syndrome

Junctional Arrhythmias

• Junctional rhythm
• Junctional tachycardia
• Premature junctional complex

Ventricular Rhythms

• Premature ventricular contractions (PVC)
• Accelerated idioventricular rhythm
• Ventricular tachycardia
• Ventricular fibrillation
  • Polymorphic ventricular tachycardia

QRS Morphology

It is sometimes useful to classify tachycardias as either narrow complex tachycardias (often referred to as supraventricular tachycardias) or wide complex tachycardias. Narrow and wide refer to the width of the QRS complex on the ECG. Narrow complex tachycardias tend to originate in the atria, while wide complex tachycardias tend to originate in the ventricles.

Rhythm Regularity

Tachycardias can be further classified as either regular or irregular.