Supraventricular Rhythms: Difference between revisions

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===An overview of supraventricular tachycardias===
===Supraventricular tachycardias===
{| class="wikitable" border="1" width="610px"
|-
| [[Image:atrial_ventricular.png|300px]]
| [[image:SVT_overview.svg|300px]]
| [[Image:Svt_algorythm_en.png|300px]]
|-
!Arrhythmias are categorized into supraventricular and ventricular depending on their origin (below the bifurcation of the His bundle is ventricular)
!An overview of pathological supraventricular arrhythmias and their origin
!Algorithm to diagnose SVTs<cite>ACC</cite>
|}
{| class="wikitable" font-size="90%"
{| class="wikitable" font-size="90%"
|- style="text-align:center;background-color:#6EB4EB;"
|- style="text-align:center;background-color:#6EB4EB;"
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|-
|-
!
!
!example
!Example (lead II)
!regularity
!Regularity
!atrial frequency
!Atrial frequency
!ventricular frequency
!Ventricular frequency
!origin (SVT/VT)
!Origin (SVT/VT)
!p-wave
!P-wave
!effect of adenosine
![[Effect of adenosine]]
|-  
|-  
| colspan="8" style="text-align:left;background-color:#cfefcf;" | '''Narrow complex (QRS<0.12)'''
| colspan="8" style="text-align:left;background-color:#cfefcf;" | '''Narrow complex (QRS<0.12)'''
|-
|-
! [[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
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|-
|-
! [[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  
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|-
|-
! [[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  
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|-
|-
! [[AVNRT]]  
! [[AVNRT]]  
| [[Image:avnrt_small.svg|200px]]
| [[Image:avnrt_small.svg|200px|ANVRT - rSR' in lead V1]]
| regular  
| regular  
| 180-250 bpm
| 180-250 bpm
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|-
|-
! [[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
| 150-250 bpm
| 100-250 bpm
| 75-200 bpm
| 75-200 bpm
| atria (SVT)
| atria (SVT)
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|}
|}


{{Box|
===Supraventricular [[Ectopic Beats|ectopic beats]]===
===Supraventricular [[Ectopic Beats|ectopic beats]]===
*[[Atrial Premature Complexes]]
*[[Atrial Premature Complexes]]
*[[Wandering Pacemaker]]
*[[Wandering Pacemaker]]
*[[AV-nodal complexes]]
*[[AV-nodal complexes]]
 
}}
===Also read:===
{{Box|
*Flowchart: [[Media:narrow_tachycardia_flow.png|Approach to the Narrow Complex Tachycardia]] Adapted from <cite>ESCnarrowQRS</cite>.
===Also read===
*[[Introduction to Arrhythmias]]
*[[Introduction to Arrhythmias]]
*[[Mechanisms of Arrhythmias]]
*[[Mechanisms of Arrhythmias]]
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*[[Junctional Tachycardias]]
*[[Junctional Tachycardias]]
*[[Ventricular Arrhythmias]]
*[[Ventricular Arrhythmias]]
 
}}
{{Box|
==References==
==References==
<biblio>
<biblio>
#ESCnarrowQRS pmid=14563598
#ACC pmid=14563598
</biblio>
</biblio>
}}
[[Category:ECG Textbook]]

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