Sasikumar Mahalingam1, Gunaseelan Rajendran1, Balamurugan Nathan2, Manu Ayyan2, Vivekanandan Muthu Pillai2

1Department of Emergency Medicine, Aarupadai Veedu Medical College and Hospital, Puducherry, India
2Department of Emergency Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

Keywords: Differential diagnosis, distinction, point of care testing, supraventricular tachycardia, TOP-UP technique, ultrasonography, ventricular tachycardia


Narrow complex tachycardia (NCT) is often due to supraventricular tachycardia (SVT). SVT with aberrancy, preexcitation, paced rhythm, rate-dependent bundle branch block, preexisting conduction defects or SVT due to drugs, and electrolyte abnormality can also be wide complex. Wide-complex tachycardia (WCT) is often ventricular tachycardia (VT), but fascicular VT (fVT) can present as NCT. Thus, WCT can be either VT or SVT. This has been a perplexing problem for the emergency physician for ages. Here, in this case series, we describe the novel use of point-of-care ultrasound to differentiate SVT from VT.

How to cite this article: Mahalingam S, Rajendran G, Nathan B, Ayyan M, Pillai VM. Tachycardia origin prediction using point of care ultrasound (TOP-UP) - A novel technique. Turk J Emerg Med 2022;22:221-5.

Author Contributions

SM: Conceptualization (lead), Resources (lead), Writing‑original draft (lead), Writing, Reviewing and Editing (lead). GR: Conceptualization (equal), Writing Reviewing and Editing (equal). BN: Conceptualization (equal), Writing Reviewing and Editing (equal). MA: Conceptualization (supporting), Writing Reviewing and Editing (supporting). VMP: Conceptualization (supporting), Writing Reviewing and Editing (supporting).

Conflict of Interest

None declared.

Financial Disclosure