Wide complex tachycardia in the emergency department: an updated approach to diagnosis and management.

Abstract

Wide complex tachycardia encompasses a range of cardiac tachydysrhythmias, several of which can be life-threatening, difficult to distinguish, and require distinct treatment approaches. This review summarizes the etiologies and pathophysiology of wide complex tachycardia, outlines the differential diagnosis, and provides an evidence-based approach to distinguishing the various types using the history, physical examination, electrocardiography, and response to intravenous adenosine. Management strategies and disposition decisions are also reviewed, with attention to special clinical circumstances and selected areas of ongoing controversy, including emerging artificial intelligence tools.