Difference between revisions of "Atrial Tachycardia"

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{{Chapter|Supraventricular Rhythms}}
 
{{Chapter|Supraventricular Rhythms}}
Atrial tachcyardia is a more or less regular heart rate > 100 bpm that does not origin from the sinus node. The p-waves therefore have a different configuration and easily be recognized if the P waves are negative in I and/or aVF.
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Atrial tachycardia has a more or less regular heart rate > 100 bpm, with narrow QRS complexes but P-waves that do not originate from the sinus node but from another site in the atria. The P-waves therefore have a different configuration and their non-sinus origin can easily be recognized if the P waves are negative in I and/or aVF.
  
[[Image:DVA0237.jpg|thumb| In this small complex tachycardia with a normal morphology of the QRS-complexes (thus no ventricular tachycardia) you can see that there is AV-association (i.e. every QRS complex is preceded by a P-wave) but the P-waves are inverted (negative in aVF), therefore this is an atrial tachycardia ]]
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[[Image:DVA0237.jpg|thumb| In this narrow complex tachycardia with a normal morphology of the QRS-complexes (thus no ventricular tachycardia) you can see that there is AV-association (i.e. every QRS complex is preceded by a P-wave) but the P-waves are inverted (negative in aVF), therefore this is an atrial tachycardia ]]
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In ill patients the atrial tachycardia may originate from multiple atrial sites and therefore may have varying P-wave morphologies, PR-intervals (AV block may occur) and subsequent variable ventricular frequencies.
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Vagal stimulation (carotid sinus massage) should lower AV conduction and will then clearly show the fast atrial rhythm dissociating from the ventricular rhythm (AV dissociation). Atrial tachycardias may be treated with antiarrhythmic drugs or ablation.

Revision as of 20:33, 20 October 2008

This is part of: Supraventricular Rhythms

Atrial tachycardia has a more or less regular heart rate > 100 bpm, with narrow QRS complexes but P-waves that do not originate from the sinus node but from another site in the atria. The P-waves therefore have a different configuration and their non-sinus origin can easily be recognized if the P waves are negative in I and/or aVF.

In this narrow complex tachycardia with a normal morphology of the QRS-complexes (thus no ventricular tachycardia) you can see that there is AV-association (i.e. every QRS complex is preceded by a P-wave) but the P-waves are inverted (negative in aVF), therefore this is an atrial tachycardia


In ill patients the atrial tachycardia may originate from multiple atrial sites and therefore may have varying P-wave morphologies, PR-intervals (AV block may occur) and subsequent variable ventricular frequencies.

Vagal stimulation (carotid sinus massage) should lower AV conduction and will then clearly show the fast atrial rhythm dissociating from the ventricular rhythm (AV dissociation). Atrial tachycardias may be treated with antiarrhythmic drugs or ablation.