Differential Diagnosis for AFib with Aberrancy vs VTach
- Single most likely diagnosis:
- Atrial Fibrillation (AFib) with aberrancy: This is the most likely diagnosis because AFib is a common arrhythmia that can present with aberrant conduction, resulting in a wide QRS complex that may mimic ventricular tachycardia (VTach). The irregularly irregular rhythm and the presence of fibrillatory waves on the ECG support this diagnosis.
- Other Likely diagnoses:
- Ventricular Tachycardia (VTach): This is another likely diagnosis, as VTach can present with a wide QRS complex and a rapid heart rate. However, the presence of AV dissociation, fusion beats, or capture beats on the ECG would support this diagnosis.
- Supraventricular Tachycardia (SVT) with aberrancy: This diagnosis is also possible, as SVT can present with a wide QRS complex if there is aberrant conduction. However, the regular rhythm and the absence of fibrillatory waves on the ECG would support this diagnosis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Torsades de Pointes: This is a life-threatening arrhythmia that can present with a wide QRS complex and a rapid heart rate. The presence of a long QT interval and a characteristic "twisting" pattern on the ECG would support this diagnosis.
- Wolff-Parkinson-White (WPW) syndrome: This condition can present with a wide QRS complex and a rapid heart rate due to anterograde conduction down an accessory pathway. The presence of a delta wave and a short PR interval on the ECG would support this diagnosis.
- Rare diagnoses:
- Atrial Flutter with aberrancy: This is a rare diagnosis, as atrial flutter is less common than AFib and SVT. However, the presence of a regular rhythm and a characteristic "sawtooth" pattern on the ECG would support this diagnosis.
- Junctional Tachycardia with aberrancy: This is another rare diagnosis, as junctional tachycardia is less common than other supraventricular arrhythmias. However, the presence of a regular rhythm and a narrow QRS complex would support this diagnosis, with aberrancy resulting in a wide QRS complex.