Okay... i know that WCT is v-tach until proven otherwise and if unstable shock and if stable determine rhythm causing WCT and give medication. I have been reading that narrow complex tachycardia is supraventricular tachycardia, but wide complex tachycardia may be supraventricular or ventricular depending if aberrancy is present. My question is does it matter? Can't I give amiodarone and that would stop the SVT or v-tach(stable) so why does it matter? i know I am missing something.
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It matters because you want to choose the most effective / expedient treatment for the condition at hand. A narrow complex SVT involving the AV node, s/a AVRT or AVNRT, will respond immediately to adenosine in most cases. Will amiodarone work for such an SVT? It may, as Amio is a "dirty" antiarrhyhmic with some properties of all the different Vaughn-Williams classes, but it would be much less likely to work and take a lot longer.
In the most recent iteration of the ACLS protocol, first line treatment for a REGULAR, stable wide complex rhythm is adenosine, as if its an SVT involving the AV node this is likely to terminate the rhyhtm, and if its true stable VT adenosine is probably not harmful (there used to be concern in the past that adenosine in stable VT could cause degeneration to fib but presumably there's no data to support this).
True stable VT, on the other hand, amio is a good bet, but it generally doesn't stay stable for long, so you don't want to sit on it for hours waiting for amio to work (generally speaking).
