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Supravetricular Tachyarrhythmias Part 2. Rey Vivo, MD Assistant Professor of Medicine Texas Tech University Health Sciences Center. Describe the AVNRT Recognize and differentiate the Supraventricular Tachyarrhythmias PRACTICE, PRACTICE, PRACTICE!!!. Objectives.
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SupravetricularTachyarrhythmiasPart 2 Rey Vivo, MD Assistant Professor of Medicine Texas Tech University Health Sciences Center
Describe the AVNRT Recognize and differentiate the Supraventricular Tachyarrhythmias PRACTICE, PRACTICE, PRACTICE!!! Objectives
Two most important aspects of arrhythmias: 1. Their mechanism 2. Their site of origin Review of last week • The two mechanisms that • produce arrhythmias are: • Automaticity • (problems of impulse • formation) • 2. Block or Reentry • (problems of impulse • conduction)
Accelerated Automaticity Sinus Tachycardia Atrial Tachyarrhythmias e.g. PAT with Block, MAT 3. Accelerated Junctional Rhythm Reentrant Atrial Tachyarrhythmias Atrial Flutter Atrial Fibrillation Reentrant Junctional Tachyarrhythmias - The Atrioventricular Nodal and Bypass Tachycardias SVTs
Reentrant Junctional Tachyarrhythmias AVNRT – Atrioventricular Nodal Reentrant Tachycardia Atrioventricular Bypass Tachycardia RJT
AVNRT • Rate: 140 – 220 beats/minute • Usually 1:1 atrial-ventricular association • Every QRS has a P (concealed, fused or retrograde)
Regular “Normal” ante Ps..ST Abnormal Ps Rate < 140……….AJR Rate > 140 Ante P…………AAR No or Retro P...AVNRT F waves………….Flut Irregular Polymorphic Ps…..MAT f waves…………….Fib (Reg. irreg, F……...Flut) Narrow Complex Tachs
Bix rule Whenever the P of an SVT is halfway between QRS complexes always suspect that an extra P is hiding within the QRS Let’s practice!