AVNRT

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This is part of: Supraventricular Rhythms
AV Nodal Re-entry Tachycardia (AVNRT)
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Atrial rate 180-250 bpm
Ventricular rate 180-250 bpm
Regularity regular
Origin AV node
P-wave inside or right after the QRS complex
Effect of adenosine terminates the arrhythmia(!)
Example ECG: The first part of this example shows AVNRT. After injection of adenosine, the arrhythmia terminates. AV Nodal Re-entry Tachycardia (AVNRT) terminated by adenosine injection
Example ECG2: AV Nodal Re-entry Tachycardia (AVNRT)

An AV Nodal Re-entry Tachycardia (AVNRT) is a rapid tachycardia with a typical frequency around 200 bpm. The tachycardia origin is the AV node. A prerequisite for AVNRT is a slow and fast pathway in the AV node, most often caused by degradation of the AV nodular tissue. The dual pathways facilitate re-entry.

Two sensitive characteristics to identify AVNRT on the ECG are:

  • R'. This is a small secondary R wave. It resembles a right bundle branch block, but the QRS width stays < 120ms.
  • RP << 100ms. The distance between the R and P waves is less than 100ms.