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What Happens in Wide Complex Tachycardia?

Wide complex Tachycardia

Author:- Mr. Ritesh Sharma

There are some heart abnormalities that are characterized by the presentation of P wave, Q wave, R wave, and S wave in electrocardiograms. One of these arrhythmias is called Wide Complex Tachycardia. This arrhythmia causes widened QRS complexes in an ECG. Due to widened QRS complexes showing in this tachycardia, many underlying conditions are indicated by it. It is classified in the category of dangerous arrhythmias that require prompt evaluation and treatment by healthcare professionals. 

The study of wide complex tachycardia and what happens in it is thorough and elaborate. Let’s take a deep dive into the meaning, types, causes, underlying risk factors, treatment, and prevention methods of this tachycardia for a better understanding of it. 

What is Wide Complex Tachycardia?

Wide Complex Tachycardia is a type of arrhythmia characterized by rapid heartbeats. It originates in the lower chambers of the heart, i.e. ventricles. The heart abnormalities in this tachycardia are shown in the widened QRS complex which represents the electrical activity of the heart during ventricular depolarization. The duration of the QRS complex in this arrhythmia is 120 

The QRS complex in ECG widens for numerous reasons. Just like other tachycardias, the heart rate rapidly increases in this type of arrhythmia as well. It is important to identify its prominent symptoms on time and act promptly for its treatment. Wide complex tachycardia is further subdivided into various types, with each type of arrhythmia having a distinct impact on cardiovascular health.

Wide Complex Tachycardia classification

There are various types of wide complex tachycardia that affect our cardiovascular health differently. Below we will discuss these types in an elaborate manner. 

  1. Ventricular Tachycardia:-
  • Monomorphic Ventricular TachycardiaIn this arrhythmia, the QRS complexes are identical. Moreover, they have a consistent morphology. 
  • Polymorphic Ventricular Tachycardia- The QRS complexes vary in this type of tachycardia. In most cases, they twist around the isoelectric line. 

  1. Supraventricular Tachycardia with Aberrant Conduction:-
  • Bundle Branch Block- In this arrhythmia, the SVT is conducted aberrantly through the bundle branch blog. This leads to the wide QRS complex. Two common types of tachycardia are:-
    i. Right Bundle Branch Block Tachycardia
    Ii. Left Bundle Branch Block Tachycardia
  • Preexited Tachycardia- It is also known as the Wolf-Parkinson-White Syndrome. In this tachycardia, a pathway exists between the atria and the ventricles causing rapid heartbeats. 

  1. Ectopic Atrial Tachycardia with Aberrant Conduction:-

             Atrial fibrillation or flutter with aberrant conduction: In this type of arrhythmia, rapid atrial arrhythmias are conducted               abrrantly through the ventricle. This occurs due to an underlying bundle branch block or other conduction abnormalities. 

  1. Idiopathic Ventricular Tachycardia:-
    This type of wide complex tachycardia doesn’t have any underlying cause or structural abnormalities. 



Wide Complex Tachycardia Causes

The causes of wide complex tachycardia can vary in accordance with various factors. These factors include some arrhythmias and some structural abnormalities. Let’s discuss these factors in a detailed manner below:-

  1. Various Arrhythmias:-
    Various arrhythmias originating from different parts of the heart can cause rapid heartbeat and widen the QRS complex in the ECG test causing abnormal ECG waves
  2. Drug Effects:-
    Many medications and drugs can lead to wide complex tachycardia. This happens if the drugs have stimulant properties or if they affect cardiac conduction. 
  3. Electrolyte Imbalance:-
    An imbalance of electrolytes like potassium, calcium, and magnesium can substantially impact cardiac conduction and ultimately cause wide complex tachycardia. 
  4. Fever:-
    The elevated temperature of the body can have severe consequences, one of which is an elevated heart rate widening the QRS complex on ECG. 
  5. Thyrotoxicosis:-
    Increased levels of thyroid hormone can cause an elevation in the heart rate which can conversely lead to a widened QRS complex on ECG.
  6. Hypovolemia:-

             The loud blood volume often results in compensatory tachycardia.

Wide Complex Tachycardia Symptoms

The symptoms of wide complex tachycardia highly depend on the underlying conditions causing it. However, there are some common symptoms that are associated with the arrhythmia. Those symptoms are as follows:-

  • Heart Palpitations:-
    If you are affected by wide complex tachycardia, you will often experience episodes of heart palpitations or heart flutter. 
  • Dizziness or Lightheadedness:-
    In the case of WCT, the blood flow to the brain is decreased, so you can experience episodes of dizziness or lightheadedness. 
  • Shortness of Breath:-
    You will feel difficulty in breathing, especially when performing a physical activity. 
  • Chest Pain or Discomfort:-
    The episodes of tachycardia lead you to experience random instances of chest pain or discomfort. 
  • Fatigue:-
    Sometimes even with minimal exertion you will get a feeling of fatigue due to the presence of wide complex tachycardia. 
  • Syncope (Fainting):-
    In severe cases of tachycardia, the patient might occasionally faint indicating the requirement for prompt medical intervention. 
  • Anxiety or Panic:-
    Repeated episodes of heart palpitations might cause anxiety or panic in the patient. 
  • Nausea:-
    On being affected by WCT, you might occasionally feel nauseous. Moreover, you might also get sensations of vomiting. 

Underlying Risk Factors for Wide Complex Tachycardia

The occurrence of wide complex tachycardia can be due to numerous underlying risk factors. While anyone can experience WCT, certain risk factors can potentially trigger it in individuals:-

  1. Structural Heart Disease:-
    Structural heart diseases, such as coronary artery disease, cardiomyopathy, heart failure, and previous heart attacks can propel WCT in individuals. 
  2. Myocardial Ischemia or Infraction:-
    Partial or reduced blood flow to the heart muscles through coronary arteries can result in tachycardias like wide complex tachycardia. 
  3. Previous Cardiac Surgery:-
    People who have had previous cardiac surgery may have scar tissue or disrupted cardiac anatomy which can result in WCT. 
  4. Heart Failure:-
    Diastolic and systolic heart failure can lead to wide complex tachycardia due to alterations in cardiac structure and function. 
  5. Hypertrophic Cardiomyopathy:-
    It is a condition in which the heart muscle gets thickened. This can cause chaotic conditions in the heart’s conduction system and lead to arrhythmias like wide complex tachycardia. 
  6. Brugada Syndrome:-
    This is an inherited condition that can affect the heart’s electrical system and cause arrhythmias like wide complex tachycardia. 
  7. Long QT Syndrome:-
    This is another inherited disorder that can disrupt the heart’s electrical system and cause tachycardias like WCT. 
  8. Electrophysiological Abnormalities:-
    Having inherent abnormalities in the cardiac conduction system can make some individuals prone to arrhythmias like wide complex tachycardia. 
  9. Medication Side Effects:-
    Some medications like antiarrhythmics can elevate the risk of WCT.
  10. Age:-

             Older people tend to be more prone to wide complex tachycardia.

Wide Complex Tachycardia Treatment

The treatment approaches for wide complex tachycardia depend on the nature of the tachycardia. If the tachycardia is stable different treatment methods are opted and if the tachycardia is unstable different treatment methods are opted. 

Treatment for Stable Wide Complex Tachycardia:

  • Treatment methods like the Valsalva maneuver or carotid sinus massage are used if WCT is stable. 
  • Medications like amiodarone, procainamide, or lidocaine can stabilize or completely.
  • Balanced electrical shock delivered to the heart can restore normal sinus rhythm in some cases.

Treatment for Unstable Wide Complex Tachycardia:-

    • If WCT is unstable, methods like immediate cardioversion and intravenous medications are used.

    Prevention Strategies

    The following strategies can be used for the prevention of wide complex tachycardia:-

    • Quit Bad Habits:-
      If you engage in bad habits like smoking or alcohol consumption, quit it right away. 
    • Maintain a Healthy Weight:-
      You must maintain a healthy weight to steer clear of all kinds of arrhythmias including WCT. 
    • Take a Highly Nutritious Diet:-
      Consume a healthy diet high in nutrition, so that cardiovascular diseases don’t grapple. 
    • Engage in Physical Activities:-
      You must frequently engage in physical activities like running or brisk walking to not get affected by arrhythmias like wide complex tachycardia. 
    • Avoid Arrhythmia Triggers:-
      Take the triggers of cardiac arrhythmia like caffeine in moderation to reduce its effect on your heart. 

    Wide Complex Tachycardia is a potentially dangerous arrhythmia that has underlying conditions that can harm you. However, it is not incurable, and timely detection of its symptoms, and underlying causes can help save you from it. It is best to keep yourself aware of all the harm this tachycardia consists of and seek medical attention promptly if you are ever affected by it. 

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