Supraventricular Rhythms
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Author(s) | J.S.S.G. de Jong | |
Moderator | J.S.S.G. de jong | |
Supervisor | ||
some notes about authorship |
Supraventricular tachycardias
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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[1] |
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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
References
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