A 65-year-old man presented with chest discomfort and other symptoms. His ECG showed sinus rhythm with ST elevations and PR interval prolongation. The findings were consistent with an inferoposterior wall myocardial infarction as well as right atrial infarction, likely due to proximal right coronary artery occlusion. Atrial infarction can occur in up to 25% of STEMI cases but is often clinically unrecognized due to its subtle ECG changes such as P-Ta segment elevations. Complications of atrial infarction include arrhythmias and thromboembolism.
This document discusses approaches to narrow complex tachycardia. It begins by defining narrow QRS tachycardia as having a QRS width of less than 120ms. It then classifies different types of narrow complex tachycardia by site of origin and regularity, including sinus tachycardia, inappropriate sinus tachycardia, sinus node reentrant tachycardia, atrial tachycardia, atrial flutter, atrioventricular nodal reentrant tachycardia (AVNRT), and atrioventricular reentrant tachycardia (AVRT). It provides details on electrocardiogram features and diagnostic approaches for each type.
This document provides information on various types of supraventricular tachyarrhythmias including AV nodal reentrant tachycardia (AVNRT), orthodromic reciprocating tachycardia (ORT), atrial tachycardia, junctional tachycardias, Wolff-Parkinson-White (WPW) syndrome, and atrial fibrillation. It discusses the mechanisms, ECG patterns, symptoms, diagnostic approaches, and management options for these arrhythmias in 1-3 sentences per type of arrhythmia.
A 65-year-old man presented with chest discomfort and other symptoms. His ECG showed sinus rhythm with ST elevations and PR interval prolongation. The findings were consistent with an inferoposterior wall myocardial infarction as well as right atrial infarction, likely due to proximal right coronary artery occlusion. Atrial infarction can occur in up to 25% of STEMI cases but is often clinically unrecognized due to its subtle ECG changes such as P-Ta segment elevations. Complications of atrial infarction include arrhythmias and thromboembolism.
This document discusses approaches to narrow complex tachycardia. It begins by defining narrow QRS tachycardia as having a QRS width of less than 120ms. It then classifies different types of narrow complex tachycardia by site of origin and regularity, including sinus tachycardia, inappropriate sinus tachycardia, sinus node reentrant tachycardia, atrial tachycardia, atrial flutter, atrioventricular nodal reentrant tachycardia (AVNRT), and atrioventricular reentrant tachycardia (AVRT). It provides details on electrocardiogram features and diagnostic approaches for each type.
This document provides information on various types of supraventricular tachyarrhythmias including AV nodal reentrant tachycardia (AVNRT), orthodromic reciprocating tachycardia (ORT), atrial tachycardia, junctional tachycardias, Wolff-Parkinson-White (WPW) syndrome, and atrial fibrillation. It discusses the mechanisms, ECG patterns, symptoms, diagnostic approaches, and management options for these arrhythmias in 1-3 sentences per type of arrhythmia.
This document discusses supraventricular tachycardia (SVT), which are tachyarrhythmias originating from the atria or atrioventricular node that cause a rapid heart rate. SVTs are classified as either atrial or AV tachyarrhythmias based on their site of origin. Common causes include inherited conditions, structural heart abnormalities, coronary artery disease, and hyperthyroidism. Diagnosis involves an electrocardiogram (ECG), Holter or event monitor, exercise test, or electrophysiology study. Treatment depends on whether it is acute or long term, and may include vagal maneuvers, calcium channel blockers, cardioversion, or medications like digoxin, beta blockers,
Approach to a case of narrow complex tachycardiaPraveen Nagula
A 28-year-old woman presented to the emergency department with rapid palpitations, chest pain, and dizziness while playing cello. On examination, she had a regular pulse of 180 bpm and a blood pressure of 100/70 mm Hg with no signs of heart failure. An ECG showed a regular narrow-complex tachycardia without visible P-waves, consistent with supraventricular tachycardia.
This document provides an overview of principles of electrocardiography (ECG). It defines an ECG as a recording of the electrical activity of the heart from surface electrodes. It describes the normal ECG waveform including the P, QRS, and T waves. It lists common indications for an ECG and discusses how to interpret various abnormalities seen on the ECG such as enlarged heart chambers, arrhythmias, and electrolyte imbalances.
A 22-year-old male presented with acute onset breathlessness, palpitations, and profuse sweating. His ECG showed tachycardia at a rate of 200 bpm with a right bundle branch block pattern. This wide complex tachycardia was determined to be ventricular tachycardia based on Brugada criteria and AVR criteria, including the absence of an RS complex in leads V1-V6, a QRS duration greater than 100 ms, and a ventricular activation-velocity ratio greater than 1. The patient was diagnosed with ventricular tachycardia based on the ECG findings and treated accordingly.
This document provides an overview of evaluating and treating different types of tachycardia, including:
1) It discusses evaluating the patient's hemodynamic stability, history, and ECG to determine the characteristics and cause of the tachycardia.
2) It describes differentiating between narrow and wide complex tachycardias, and the differential diagnoses for each, including sinus tachycardia, atrial fibrillation, AV nodal reentrant tachycardia, and ventricular tachycardia.
3) It provides guidance on therapies for different tachycardias, such as electrical or chemical cardioversion, rate control, and ablation. The importance of correctly diagnosing wide complex tachycard
This document discusses supraventricular tachycardias (SVT). It defines different types of SVT including paroxysmal SVT, which is common in emergency rooms. Quality of life is often poor for those with paroxysmal SVT. The document discusses mechanisms of SVT including reentry circuits, enhanced automaticity, and triggered activity. It provides details on differentiating AV nodal reentrant tachycardia from AV reentrant tachycardia using electrocardiogram findings. Treatment options discussed include carotid sinus massage, adenosine, and catheter ablation.
Ventricular tachycardia can occur due to various causes like acute myocardial infarction, chronic infarction, dilated cardiomyopathy, etc. It is classified as sustained, non-sustained, monomorphic, polymorphic, etc. based on characteristics. Diagnosis involves ECG, echocardiogram, and monitoring. Treatment depends on hemodynamic stability and includes electrical cardioversion, antiarrhythmic drugs like amiodarone, lidocaine, ablation, and ICD implantation in selected cases. Recurrence risk is high in structurally abnormal hearts and prevention involves controlling triggers, antiarrhythmics, and ICDs.
1) The digital ESC Congress 2020 attracted over 116,000 healthcare professionals from 211 countries, focusing on new knowledge in arrhythmias and device therapy.
2) New guidelines and studies provided updates on atrial fibrillation screening and management, showing benefits of early rhythm control and new anticoagulants.
3) Studies explored new pacing approaches like His bundle and left bundle pacing to improve effectiveness and reduce fluoroscopy time.
This document discusses supraventricular tachycardia (SVT), which are tachyarrhythmias originating from the atria or atrioventricular node that cause a rapid heart rate. SVTs are classified as either atrial or AV tachyarrhythmias based on their site of origin. Common causes include inherited conditions, structural heart abnormalities, coronary artery disease, and hyperthyroidism. Diagnosis involves an electrocardiogram (ECG), Holter or event monitor, exercise test, or electrophysiology study. Treatment depends on whether it is acute or long term, and may include vagal maneuvers, calcium channel blockers, cardioversion, or medications like digoxin, beta blockers,
Approach to a case of narrow complex tachycardiaPraveen Nagula
A 28-year-old woman presented to the emergency department with rapid palpitations, chest pain, and dizziness while playing cello. On examination, she had a regular pulse of 180 bpm and a blood pressure of 100/70 mm Hg with no signs of heart failure. An ECG showed a regular narrow-complex tachycardia without visible P-waves, consistent with supraventricular tachycardia.
This document provides an overview of principles of electrocardiography (ECG). It defines an ECG as a recording of the electrical activity of the heart from surface electrodes. It describes the normal ECG waveform including the P, QRS, and T waves. It lists common indications for an ECG and discusses how to interpret various abnormalities seen on the ECG such as enlarged heart chambers, arrhythmias, and electrolyte imbalances.
A 22-year-old male presented with acute onset breathlessness, palpitations, and profuse sweating. His ECG showed tachycardia at a rate of 200 bpm with a right bundle branch block pattern. This wide complex tachycardia was determined to be ventricular tachycardia based on Brugada criteria and AVR criteria, including the absence of an RS complex in leads V1-V6, a QRS duration greater than 100 ms, and a ventricular activation-velocity ratio greater than 1. The patient was diagnosed with ventricular tachycardia based on the ECG findings and treated accordingly.
This document provides an overview of evaluating and treating different types of tachycardia, including:
1) It discusses evaluating the patient's hemodynamic stability, history, and ECG to determine the characteristics and cause of the tachycardia.
2) It describes differentiating between narrow and wide complex tachycardias, and the differential diagnoses for each, including sinus tachycardia, atrial fibrillation, AV nodal reentrant tachycardia, and ventricular tachycardia.
3) It provides guidance on therapies for different tachycardias, such as electrical or chemical cardioversion, rate control, and ablation. The importance of correctly diagnosing wide complex tachycard
This document discusses supraventricular tachycardias (SVT). It defines different types of SVT including paroxysmal SVT, which is common in emergency rooms. Quality of life is often poor for those with paroxysmal SVT. The document discusses mechanisms of SVT including reentry circuits, enhanced automaticity, and triggered activity. It provides details on differentiating AV nodal reentrant tachycardia from AV reentrant tachycardia using electrocardiogram findings. Treatment options discussed include carotid sinus massage, adenosine, and catheter ablation.
Ventricular tachycardia can occur due to various causes like acute myocardial infarction, chronic infarction, dilated cardiomyopathy, etc. It is classified as sustained, non-sustained, monomorphic, polymorphic, etc. based on characteristics. Diagnosis involves ECG, echocardiogram, and monitoring. Treatment depends on hemodynamic stability and includes electrical cardioversion, antiarrhythmic drugs like amiodarone, lidocaine, ablation, and ICD implantation in selected cases. Recurrence risk is high in structurally abnormal hearts and prevention involves controlling triggers, antiarrhythmics, and ICDs.
1) The digital ESC Congress 2020 attracted over 116,000 healthcare professionals from 211 countries, focusing on new knowledge in arrhythmias and device therapy.
2) New guidelines and studies provided updates on atrial fibrillation screening and management, showing benefits of early rhythm control and new anticoagulants.
3) Studies explored new pacing approaches like His bundle and left bundle pacing to improve effectiveness and reduce fluoroscopy time.
A meeting was held on August 10, 2019 (Saturday) in room 803 of the Taipei Chang Yung-fa International Convention Center. The meeting location and date are provided.