![]() ![]() What does IVCD stand for?įamilies and physicians often wonder what the terms“intraventricular conduction delay” (IVCD) or “incomplete right bundle branch block” (IRBBB) or “rsR’” on an electrocardiogram mean and what to do with the information. The study protocol was approved by the Institutional Review Board. IVCD was defined as a QRS duration ≥ 120 ms without typical features of LBBB or RBBB, according to accepted criteria. IVCD was defined overall as QRS 101 to 120 ms irrespective of morphology, or as QRS > 120 ms not identifiable as BBB. The main finding of the present study is that nonspecific intraventricular conduction disturbance (IVCD) in an ECG is associated with increased mortality and a markedly elevated risk of sudden arrhythmic death in a general population. Is intraventricular conduction delay serious?Ĭonclusions: Prolonged QRS duration in a standard 12-lead ECG is associated with increased mortality in a general population, with intraventricular conduction delay being most strongly associated with an increased risk of arrhythmic death. Capture beats and Fusion Beats : signifies AV dissociation.An IVCD is the result of abnormal activation of the ventricles caused by conduction delay or block in one or more parts of the specialized conduction system (bundle of His, bundle branch or purkinje conduction system) resulting in widening of QRS complex.Every thing is positive in lead in QRS: VT.RS in same side in all precordial leads.Brugada Algorithm for the differentiation.Rate and Hemodynamic stability ARE NOT factors.BBB now starts to conduct, causing shorter QRS on tachycardia.RBBB : even if typically VT does not present as RBBB do not close the diagnosis just yet.Anti-dromic ART (down the accessory pathway).Accessory pathway (His PUrkinje system is bypassed).BBB, IVCD (intraventricular conduction delay), rate-related aberrancy.Aberrant conduction via normal conduction pathway (in BB, or distal purkinji system).SVT with abnormal ventricular activation.Closer it is, more symptomatic it will be How much ventricle activates from alternate pathway or abberent pathway depends on how far is the abberent pathway from AV Node.Site of origin is SVT but there is a ventricular pre excitation i.e part of ventricle activates through alternate pathway while simultaneously part of the ventricle is activating through his-purkinjee system.Site of origin is SVT but there is a preexisting conduction abnormalities in the his-purkinje system, like BBB, or rate related aberrancy.Site of origin is either at or below his bundle, or in perkinje fibers, or ventricular myocardium OR.Just a response to Adenosine does not mean it is AV node involved tachycardia. 10-20 % of Atrial Tachycardia can respond to Adenosine.If different morphology is present, then it may actually be Atrial Fibrillation Flutter wave in atrial flutter is of same morphology.If prior history of cardiac surgery or ablation is present, it is atrial flutter even if isoelectric lines are present.Atrial flutter has no isolectric line that is representation of atrial depolarization.Look for Isoelectric line to differentiate AT from A flutter.Understand AT typically does not exceed 200 atrial bpm.ORtw with a slow decremental pathway (PJRT).Short PR Tachycardias and Long PR tachycardias are different.In reviewing Narrow Complex tachycardia,.Understand, normal looking p wave can occur in AT if the origin of atrial tachycardia is near SA Node.Always have a same sequence of reviewing EKG.Always use caliper or tool in computer.In order to avoid misdiagnosis, few catch points, or not to miss points while reviewing EKG are.After this you are ready to look at an EKG.Know the pathophysiology of tachycardia.PR segment present or absent (as in pre excitation).Locate the possible site of origin of cardiac conduction, and its propagation into the ventricle in the narrow complex tachycardia and in wide complex tachycardia.Understand how does narrow complex and wide complex QRS occur.Then, understand the cardiac conduction pathway, and review the sequences of normal ventricular activation.First: Be able to define narrow complex and wide complex tachycardia.Even before you look at any EKG, you need to understand the following to make sense of any EKG. ![]()
0 Comments
Leave a Reply. |