Supraventricular Tachycardia Flashcards
MC SVTs aside from AF and atrial flutter?
- AVNRT
- AVRT
- atrial tachycardia
when is the QRS complex wide in SVT?
usually narrow-complex tachycardia
- BBB
- aberrancy
- pacing
- anterograde accessory pathway
MC paroxysmal SVT
AVNRT
narrow-complex tachycardia:
- possibilities if REGULAR rhythm
- ST
- AVNRT
- AVRT
- AT
narrow-complex tachycardia:
- possibilities if IRregular rhythm
- atrial flutter
- AF
- MAT
narrow-complex tachycardia:
- P wave morphology same as sinus
- seen before EVERY QRS complex
ST
narrow-complex tachycardia:
- P wave just after QRS (pseudo R’ in lead V1) or buried in QRS
AVNRT
narrow-complex tachycardia:
- short RP interval
AVRT
narrow-complex tachycardia:
- long RP interval
AT
narrow-complex tachycardia:
- flutter waves in leads 2, 3, aVF, and V1
atrial flutter
narrow-complex tachycardia:
- irregular baseline
- NO P waves
AF
narrow-complex tachycardia:
- at least 3 different morphologies of P wave
MAT
maneuvers to terminate SVT
- Valsalva maneuver
- carotid sinus massage
- facial immersion in cold water
which med can be used to terminate SVT and help dx etiology?
adenosine
if SVT terminates w/ adenosine, most likely etiology?
- AV node dependence; AVNRT and AVRT
if SVT does NOT terminate w/ adenosine, most likely etiology?
- continued atrial activity (P waves); atrial flutter and atrial tachycardia
rate control for atrial tachycardia w/ which meds?
- BBs
- CCBs
prevent recurrent AVNRT w/ which meds?
- BBs
- CCBs
next step for AVNRT if resistant to or intolerant of drug therapy?
catheter ablation
tx for MAT
- correcting associated pulmonary or cardiac disease -
- correcting hypoKalemia
- correcting hypoMAGnesemia
DOC for MAT if symptomatic or have complications such as HF or CP 2/2 ischemia
metoprolol
2nd DOC for MAT if symptomatic or have complications such as HF or CP 2/2 ischemia in pts w/ BRONCHOSPASTIC DZ
verapamil
DON’T BE TRICKED
- which med can induce bronchospasm in pts w/ reactive airways dz?
adenosine
which 2 arrhythmias SHOULD NOT be tx’d w/ adenosine?
- irregular wide-complex tachycardia
- polymorphic tachycardia
FIRST-LINE therapy for symptomatic AVRT (WPW syndrome)
catheter ablation