Introduction
Any arrhythmia originating in the upper cardiac chambers with atrial rate greater than 100 beats/min.
Gradual onset = tachycardia gradually accelerates and decelerates (gradual shortening/prolongation of P-P interval.
Sudden onset = abruptly starts and ends, typically with symptoms.
We can divide these by duration on:
Symptoms during SVT
Complications of SVT
ECG features
A four-step approach to diagnose the underlying rhythm:
Picture 1 Differential diagnosis of narrow complex tachycardia
Management
Acute management
Initial treatment of SVT depends on hemodynamic stability of the patient.
Acute therapy of narrow complex tachycardia
Vagal manoeuvres
If this fails -
Adenosine – through cardiac adenosine A1 receptor > transient AV block
Outcome:
If Vagal manoeuvres and adenosine application fails:
If all pharmacological therapies fail - synchronized cardioversion is recommended, even in hemodynamically stable patients.
Chronic management
Acute therapy of wide complex tachycardia
Picture 2 and 3 Treatment of narrow and wide complex tachycardias as per ESC guidelines
References
Pictures:
Picture no. 1 HARAN BURRI. Oxford Medicine Online [online]. [cit. 30.1.2021]. Accessible at WWW: https://oxfordmedicine.com/oxford/fullsizeimage?imageUri=%2F10.1093%2Fmed%2F9780198784906.001.0001%2Fmed-9780198784906-graphic-41177-full.gif&uriChapter=%2F10.1093%2Fmed%2F9780198784906.001.0001%2Fmed-9780198784906-chapter-479
Picture no. 2 Acute therapy of narrow QRS tachycardia in the absence of an established diagnosis (2019). [Graph]. Accessible at: https://academic.oup.com/eurheartj/article/41/5/655/5556821
Picture no. 3 Acute therapy of wide complex tachycardia in the absence of an established diagnosis.[Graph]. Accessible at: https://academic.oup.com/eurheartj/article/41/5/655/5556821
Introduction
Any arrhythmia originating in the upper cardiac chambers with atrial rate greater than 100 beats/min.
Gradual onset = tachycardia gradually accelerates and decelerates (gradual shortening/prolongation of P-P interval.
Sudden onset = abruptly starts and ends, typically with symptoms.
We can divide these by duration on:
Symptoms during SVT
Complications of SVT
ECG features
A four-step approach to diagnose the underlying rhythm:
Picture 1 Differential diagnosis of narrow complex tachycardia
Management
Acute management
Initial treatment of SVT depends on hemodynamic stability of the patient.
Acute therapy of narrow complex tachycardia
Vagal manoeuvres
If this fails -
Adenosine – through cardiac adenosine A1 receptor > transient AV block
Outcome:
If Vagal manoeuvres and adenosine application fails:
If all pharmacological therapies fail - synchronized cardioversion is recommended, even in hemodynamically stable patients.
Chronic management
Acute therapy of wide complex tachycardia
Picture 2 and 3 Treatment of narrow and wide complex tachycardias as per ESC guidelines
References
Pictures:
Picture no. 1 HARAN BURRI. Oxford Medicine Online [online]. [cit. 30.1.2021]. Accessible at WWW: https://oxfordmedicine.com/oxford/fullsizeimage?imageUri=%2F10.1093%2Fmed%2F9780198784906.001.0001%2Fmed-9780198784906-graphic-41177-full.gif&uriChapter=%2F10.1093%2Fmed%2F9780198784906.001.0001%2Fmed-9780198784906-chapter-479
Picture no. 2 Acute therapy of narrow QRS tachycardia in the absence of an established diagnosis (2019). [Graph]. Accessible at: https://academic.oup.com/eurheartj/article/41/5/655/5556821
Picture no. 3 Acute therapy of wide complex tachycardia in the absence of an established diagnosis.[Graph]. Accessible at: https://academic.oup.com/eurheartj/article/41/5/655/5556821
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