Svt

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  • Atypical AVNRT. Long RP interval. This might be confused with atrial tachycardia or AVRT.
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  • Adenosine can aid in the diagnosis of SVT.
  • Svt

    1. 1. AVNRT <ul><li>2/3 of all Paroxysmal SVT cases </li></ul><ul><li>Regular rhythm </li></ul><ul><li>No discernible P wave or retrograde P wave (Short RP tachycardia) </li></ul><ul><li>Pathophysiology: Dual AV nodal pathway </li></ul>
    2. 2. <ul><li>PAC precipitates reentrant circuit. </li></ul>ECG Concept Using Electrophysiologic Principle
    3. 6. Management of AVNRT ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias--executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Supraventricular Arrhythmias). 2003
    4. 7. Acute setting <ul><li>Vagal Maneuver </li></ul><ul><li>Adenosine 90% success rate </li></ul><ul><li>Calcium channel blocker: terminate in 2 minutes </li></ul><ul><li>DC cardioversion 10-50 J </li></ul>
    5. 10. V1 II
    6. 11. Long term management <ul><li>Severity of attack </li></ul><ul><li>Medication </li></ul><ul><ul><li>Digoxin </li></ul></ul><ul><ul><li>Beta blocker </li></ul></ul><ul><ul><li>Calcium channel blocker </li></ul></ul>
    7. 12. Catheter Ablation <ul><li>95% success rate, 1% chance of AV block </li></ul><ul><li>Patient preference </li></ul><ul><li>Fail pharmacologic therapy or side effect from medication </li></ul><ul><li>Severely symptomatic eg syncope angina dyspnea </li></ul>

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