Tachyarrhythmias Flashcards
SLIDE 13 -- INCOMPLETE
What does the QRS width look like in a generalized tachyarrhythmia?
Narrow, less than or equal to 120 ms, and it is due to a rapid activation of ventricles via intact H-P system –> Supraventricular
OR
Wide, greater than 120 ms, due to ventricular activation outside normal conduction system –> due to bundle branch block, non-specific aberration, preexcitation or a ventricular origin.
What do the following have in common?
- Sinus Tachycardia
- AVNRT (AV Node Reentry Tachycardia)
- AVRT (AV Reentry Tachycardia)
- Atrial Tachycardia
- Atrial Flutter
Narrow QRS (Regular)
What do the following have in common?
- Atrial Fibrillation/Flutter
- MAT (Multifocal atrial tachycardia)
Narrow QRS (Irregular)
What do the following have in common?
- Ventricular Tachycardia
- SVT with aberrancy
- Preexcitation (WPW)
Wide QRS
This is an irregular Narrow QRS that is irregular. It is more common with other heart disease(s) present in the patient, and commonly increases in frequency with age.
Atrial Fibrillation
What heart diseases can cause A.Fib to occur?
- CAD
- CHF
- CM
- Valvular Dz
- Pericardial Dz
- Left Ventricular Hypertrophy
What other conditions can cause A.Fib to occur?
- Age
- HTN
- Stress (post-op or personal)
- ETOH, esp withdrawal “Holiday Heart”
- Thyroid Dz
- Electrolyte Disorder
- Pulmonary Dz and/or PE
On an EKG for A. Fib, what will you not see? Why?
No P waves present because of no sinoatrial node conduction.
This classification of A. Fib can be described as recurrent self-terminating episodes, generally less than 24 hours.
Paroxysmal
This classification of A. Fib can be described as lasting more than 1 year. Cardioversion may have either been not attempted or failed.
Longstanding Persistent
This classification of A. Fib can be described as attempts at rhythm control have been abandoned if favor of rate control and anticoagulation.
Permanent
This classification of A. Fib can be described as a failure to self-terminate, greater than 7 days. This requires cardiversion!
Persistent
This is an irregular Narrow QRS that is irregular. It is defined by at least 3 different P wave morphologies.
MAT (Multifocal Atrial Tachycardia)
What dz is MAT usually assc with?
COPD Exacerbations
This is a regular Narrow QRS. It is usually assc with an underlying cause such as fever, infection, pain, anemia, thyrotoxicosis, alcohol/drug withdrawal, heart failure, or shock.
Sinus Tachycardia
This is a regular (and sometimes irregular) Narrow QRS. It is usually assc with intra-atrial reentrant pathways classically in the right atrium crossing the cavo-tricuspid isthmus.
Atrial Flutter
This type of tachyarrhythmia is commonly seen with A. Fib or with the same situations.
Atrial Flutter
A variable AV block leading to irregular heart beat may most commonly cause this kind of tachyarrhythmia.
Atrial Flutter
This is a regular Narrow QRS. It is most common in younger patients and mediated by slow and fast conduction pathways within the AV nodal region.
AVNRT (AV Node Reentrant Tachycardia)
This is the most common regular narrow tachyarrhythmia
AVNRT (AV Node Reentrant Tachycardia)
Are there any discernible P waves in this Narrow QRS tachyarrhythmia?
NO!
How do you determine between AVNRT and AFib?
Both are narrowed QRS, but A. Fib has no pattern and haphazard distribution. Whereas AVNRT had a pattern.
