Supraventricular Rhythms: Difference between revisions
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! [[Sinustachycardia]] | ! [[Sinustachycardia]] | ||
| [[Image:sinustachy_small.svg|200px]] | | [[Image:sinustachy_small.svg|200px|Sinustachycardia - a normal p wave precedes every QRS complex]] | ||
| regular | | regular | ||
| 100-180 bpm | | 100-180 bpm | ||
| Line 30: | Line 30: | ||
|- | |- | ||
! [[Atrial Fibrillation]] | ! [[Atrial Fibrillation]] | ||
| [[Image:afib_small.svg|200px]] | | [[Image:afib_small.svg|200px|Atrial fibrillation - irregular rate, no p waves]] | ||
| grossly irregular | | grossly irregular | ||
| 400-600 bpm | | 400-600 bpm | ||
| Line 39: | Line 39: | ||
|- | |- | ||
! [[Atrial Flutter]] | ! [[Atrial Flutter]] | ||
| [[Image:aflutt_small.svg|200px]] | | [[Image:aflutt_small.svg|200px|Atrial flutter - sawtooth in lead II with 2:1 block]] | ||
| regular (sometimes alternating block) | | regular (sometimes alternating block) | ||
| 250-350 bpm | | 250-350 bpm | ||
| Line 48: | Line 48: | ||
|- | |- | ||
! [[AVNRT]] | ! [[AVNRT]] | ||
| [[Image:avnrt_small.svg|200px|ANVRT - lead V1]] | | [[Image:avnrt_small.svg|200px|ANVRT - rSR' in lead V1]] | ||
| regular | | regular | ||
| 180-250 bpm | | 180-250 bpm | ||
| Line 57: | Line 57: | ||
|- | |- | ||
! [[Atrial Tachycardia]] | ! [[Atrial Tachycardia]] | ||
| [[Image:atrialtachy_small.svg|200px]] | | [[Image:atrialtachy_small.svg|200px|Atrial tachycardia - like sinustachycardia but the p wave has a different morphology]] | ||
| regular | | regular | ||
| 120-250 bpm | | 120-250 bpm | ||
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|- | |- | ||
! [[AVRT|Atrio-Ventricular Reentry Tachycardia (AVRT)- orthodromic]] | ! [[AVRT|Atrio-Ventricular Reentry Tachycardia (AVRT)- orthodromic]] | ||
| [[Image:avrt_small.svg|200px]] | | [[Image:avrt_small.svg|200px|AVRT - inverted p wave behind every QRS complex]] | ||
| regular | | regular | ||
| 150-250 bpm | | 150-250 bpm | ||
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|- | |- | ||
! [[AVJT|AV junctional tachycardia]] | ! [[AVJT|AV junctional tachycardia]] | ||
| [[Image:avnodal_small.svg|200px]] | | [[Image:avnodal_small.svg|200px|AV junctional tachycardia - no or inverted p-waves within QRS complex]] | ||
| regular | | regular | ||
| 60-100 bpm | | 60-100 bpm | ||
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|- | |- | ||
! [[Supraventricular tachycardia with block]] | ! [[Supraventricular tachycardia with block]] | ||
| [[Image:atrial_tachy_with_LBBB_leadII.svg|200px]] | | [[Image:atrial_tachy_with_LBBB_leadII.svg|200px|SVT with block - any SVT combined with LBBB or RBBB]] | ||
| (ir)regular depending on SVT | | (ir)regular depending on SVT | ||
| 100-250 bpm | | 100-250 bpm | ||
Revision as of 08:44, 7 January 2008
| Author(s) | J.S.S.G. de Jong | |
| Moderator | J.S.S.G. de jong | |
| Supervisor | ||
| some notes about authorship | ||
An overview of supraventricular tachycardias
| example (lead II) | regularity | atrial frequency | ventricular frequency | origin (SVT/VT) | p-wave | effect of adenosine | |
|---|---|---|---|---|---|---|---|
| Narrow complex (QRS<0.12) | |||||||
| Sinustachycardia | 
|
regular | 100-180 bpm | 100-180 bpm | sinusnode (SVT) | precedes every QRS complex | gradual slowing |
| Atrial Fibrillation | 
|
grossly irregular | 400-600 bpm | 75-175 bpm | atria (SVT) | absent | slows down rate; irregularity remains |
| Atrial Flutter | 
|
regular (sometimes alternating block) | 250-350 bpm | 75-150 bpm (3:1 or 2:1 block is most common) | atria (SVT) | negative sawtooth in lead II | temporary reduced conduction (e.g. 4:1) |
| AVNRT | 
|
regular | 180-250 bpm | 180-250 bpm | AV-node (SVT) | in QRS complex (R') | stops |
| Atrial Tachycardia | 
|
regular | 120-250 bpm | 75-200 bpm | atria | precedes QRS, p wave differs from sinus-p | temporary AV-block |
| Atrio-Ventricular Reentry Tachycardia (AVRT)- orthodromic | 
|
regular | 150-250 bpm | 150-250 bpm | circle: av-node - ventricles - bypass - atria | RP < PR | stops |
| AV junctional tachycardia | 
|
regular | 60-100 bpm | 70-130 bpm | AV node | RP < PR | reduces rate |
| Wide complex (QRS>0.12) | |||||||
| Supraventricular tachycardia with block | 
|
(ir)regular depending on SVT | 100-250 bpm | 75-200 bpm | atria (SVT) | absent | temporary increased AV-block (eg 4:1) |
| Atrio-ventricular Reentry Tachycardia (AVRT) - antidrome | regular | 150-250 bpm | 150-250 bpm | circular: bypass - atria - av-node - ventricles | RP < PR | stops | |
Supraventricular ectopic beats
Also read
- Flowchart: Approach to the Narrow Complex Tachycardia Adapted from ESCnarrowQRS.
- Introduction to Arrhythmias
- Mechanisms of Arrhythmias
- Sinus node rhythms and arrhythmias
- Junctional Tachycardias
- Ventricular Arrhythmias
References
<biblio>
- ESCnarrowQRS pmid=14563598
</biblio>