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Supravetricular Tachyarrhythmias Part 1

Supravetricular Tachyarrhythmias Part 1. Rey Vivo, MD Assistant Professor of Medicine Texas Tech University Health Sciences Center. Define the mechanisms of arrhythmias Understand the relevance of the site of origin to the arrhythmia

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Supravetricular Tachyarrhythmias Part 1

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  1. SupravetricularTachyarrhythmiasPart 1 Rey Vivo, MD Assistant Professor of Medicine Texas Tech University Health Sciences Center

  2. Define the mechanisms of arrhythmias Understand the relevance of the site of origin to the arrhythmia Recognize and differentiate the Supraventricular Arrhythmias Objectives

  3. “You see only what you look for, you recognize only what you know.”

  4. Two most important aspects of arrhythmias: 1. Their mechanism 2. Their site of origin Basics • The two mechanisms that • produce arrhythmias are: • Automaticity • (problems of impulse • formation) • 2. Block or Reentry • (problems of impulse • conduction)

  5. Accelerated Automaticity Reentrant Atrial Tachyarrhythmias Reentrant Junctional Tachyarrhythmias - The Atrioventricular Nodal and Bypass Tachycardias SVTs

  6. Sinus Tachycardia Atrial Tachyarrhythmias e.g. PAT with Block, MAT 3. Accelerated Junctional Rhythm Accelerated Automaticity

  7. 1. Atrial Flutter 2. Atrial Fibrillation Reentrant Atrial Tachs

  8. Accelerated Automaticity

  9. Accelerated Automaticity • May originate from any of the pacemaker cells • “Ectopic” – any rhythm that comes from any other site than the SA node

  10. Sinus Tachycardia • Tips: • Max. rate: 220 – age • Discrete, antegrade P waves • Short PR interval • Normal QRS duration

  11. Sinus Tachycardia

  12. Accelerated atrial rhythm Paroxysmal Atrial Tachycardia with Block Multifocal Atrial Tachycardia Atrial Tachycardias

  13. Accelerated Atrial Rhythm

  14. Accelerated Atrial Rhythm

  15. PAT with Block

  16. PAT with Block

  17. Wandering Atrial Pacemaker-Multifocal Atrial Tachycardia Spectrum

  18. MAT

  19. Acelerated Junctional Rhythm

  20. Acelerated Junctional Rhythm

  21. Reentrant Atrial Tachyarrhythmias

  22. Atrial flutter Atrial fibrillation Reentrant Atrial Tachs Single circuit, Uniform F waves Multiple circuits, Multiform f waves

  23. Atrial Flutter Flutter waves best seen on inferior leads (II, III, aVF) and V1

  24. Atrial Flutter

  25. Atrial Flutter

  26. Atrial Flutter

  27. Atrial Fibrillation Fibrillatory waves best seen in inferior waves and V1

  28. Atrial Fibrillation

  29. Atrial Fibrillation

  30. We make most mistakes because of failure to apply reason and logic, not because of ignorance. Barney Marriott, MD EKG expert Author, Practical Electrocardiography Let’s practice!

  31. EKG 1

  32. EKG 2

  33. EKG 3

  34. EKG 4

  35. EKG 5

  36. EKG 6

  37. EKG 7

  38. EKG 8

  39. EKG 9

  40. The End(Part 2 next Tuesday)

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