Paroxysmal SVT Flashcards
What is atrial nodal re-entry tachycardia (AVNRT)
There are two pathways at the AV node that the impulse can take a “fast” and a “Slow” pathway. The slow pathway travels back up the atria causing another depolarization. This leads to tachycardia and the atria and the ventricles being depolarized at the same time
S/s of AVNRT
Rapid tachycardia, angina, pulmonary edema, hypotension, syncope, simultaneous AV contraction, elevated venous pressures causing an increase in BNP
What is a cannon a wave
Simultaneous AV contraction causing visible jugular venous pulse
ANRT treatment
Acute: valsalva maneuver
Chronic: BB, CBB, flecanide
EP: For recurrent or severe episodes, ineffective drug therapies
What is Junctional Tachycardia, what are the causes, and treatment
Junctional tachycardia is when the AV node takes over as primary pacemaker but at an accelerated rate. Typically follows a PVC.
Causes: increased adrenergic tone, isoproterenol, catheter ablations
Symptoms: can produce palpitation
Treatment: not warranted
What is an accessory pathway
An additional electrical pathway that connects two parts or circuits of the heart. Can produce a variety of ECG changes
What is the most common accessory pathway tachycardia
Orthodromic AV reentry
What is epistien’s anamoly?
Rare heart defect in the tricuspid valve creating an accessory pathway
Describe Danon’s disease
Genetic condition causing cardiomyopathies and associated with AP
What is fabry’s disease
A build up of fat leading to AP
PR and QRS interval findings in AP EKG
Shortened PR
QRS prolonged
EKG differences in right vs left sided AP
Right: LBB in V1
Left: RBB in V1
EKG changes in WPW
Pre-excited QRS
Episodes of PSVT
Treatment plan for narrow QRS PSVT
Continuous EKG
If unstable: Cardioversion, Adenosine
If Stable: verapamil, cardizem ,Vagal maneuver
Treatment plan for AP
Remove aggravating factors
Obtain ECHO
Ablation of anomaly
Chronic APs can be managed with vagal man, BB, CBB, flecanide
