FN: Narrow Complex Tachycardias = SVT Flashcards Preview

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Flashcards in FN: Narrow Complex Tachycardias = SVT Deck (15):
1

Definition

rate >100 bpm
QRS width

2

differentials

Sinud tachycardia
Atrial:
1. AF
Atrial flutter
Atrial tachycardia

AV nodal re-entry tachycardia
AV re-entry Tachycardia

3

Rx patient compromised

Sedate + DC cardioversion

4

Rx if patient not compromised

Vagal manoeuvers (carotid sinus massage, valsalva) transiently increase AV block and may unmask underyling atrial rhythm

5

If manoeuvres unsuccessful

Give adenosine while recording rhythm strip
1. transient AV blook, unmasking atrial rhythm
2. Cardioverts AVNRT, AVRT to sinus rhythm

6

If adenosine fails

digoxin
Atenolol
Verapamil (not if on beta blocker)
Amiodarone

7

If unsuccessful

DC cardioversion

8

Management pathway

1. Oxygen + IV access
2. Irregular rhythm? treat as AF
3. Regular rhythm?
--> ECG trace continues
2. Vagal manoeuvres
3. Adenosine 6mg IV bolus, then 12mg, then 12mg
4. Adverse signs - cardioversion
5. No adverse signs - medical management

9

Adverse signs?

BP 200

10

No adverse signs Rx

Digoxin (500ug over 30min)
Amiodarone
Verapamil
Atenolol

11

Adenosine MOA

Temporary AVN block

12

Adenosine SE

Transient chest tightness
Dyspnoea
Flushing
Headache

13

Adenosine Relative CI

Asthma
2nd/3rd degree block

14

Adenosine interactinos

Fx increased by dipyridimole
Fx increased by theophyline

15

Prophylaxis of tachycardia

Beta-blockers
AVRT: flecainide
AVNRT: verapamil

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