Supraventricular Rhythms

Supraventricular Rhythms originate from the atria. Examples of supraventricular rhythms are:

• Sinustachycardia
• Atrial Rhythm
• Atrial Flutter
• Atrial Fibrillation
• Atrial Tachycardia
• Atrio-ventricular Reentry Tachycardia AVRT

Supraventricular ectopic beats can result in:

• Atrial Premature Complexes
• Wandering Pacemaker
• AV-nodal complexes

Also read:

• Flowchart: Approach to the Narrow Complex Tachycardia Adapted from [1].
• Mechanisms of Arrhythmias
• Ventricular Arrhythmias
• Sinus node rhythms and arrhythmias

An overview of supraventricular tachycardias

	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	150-250 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

References

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