Re-entry supraventricular tachycardia: Difference between revisions
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===Clinical Features=== | ===Clinical Features=== | ||
Palpitations | *[[Palpitations]] | ||
*[[Syncope]]/presyncope | |||
*[[Chest pain]] and polyuria. | |||
Symptoms can be associated with exertion | |||
===ECG findings=== | ===ECG findings=== | ||
Rate of 130-250. Narrow '''QRS''' complex (except in [[bundle branch block]]), P waves are: inverted, masked by QRS complex ([[#Definition|AVNRT]]) or occur halfway between complexes ([[#Definition|AVRT]]), one P wave per QRS complex. | Rate of 130-250. Narrow '''QRS''' complex (except in [[bundle branch block]]), P waves are: inverted, masked by QRS complex ([[#Definition|AVNRT]]) or occur halfway between complexes ([[#Definition|AVRT]]), one P wave per QRS complex. | ||
Latest revision as of 09:19, 23 May 2010
Definition
An arrhythmia caused by a second connection between atria and ventricles, in addition to the normal conduction system. There are two types:
- AVRNT (Atrio-Ventricular Node Re-entry Tachycardia) - the second connection is closely related to the AV node.
- AVRT (Atrio-Ventricular Re-entry Tachycardia) - the second connection is not related to the AV node.
Clinical Features
- Palpitations
- Syncope/presyncope
- Chest pain and polyuria.
Symptoms can be associated with exertion
ECG findings
Rate of 130-250. Narrow QRS complex (except in bundle branch block), P waves are: inverted, masked by QRS complex (AVNRT) or occur halfway between complexes (AVRT), one P wave per QRS complex.
Management
- Drugs - adenosine or verapamil. (Flecanide, sotalol, dispyramide are other options).
- Electrical - pacing and cardioversion as above.
- Vagal - carotid sinus massage, pressure on closed eyes, application of ice to face.
- Ablation - burning away the dodgy bit of conduction pathway.