Supravetricular Tachyarrhythmias Part 1
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Transcript of Supravetricular Tachyarrhythmias Part 1
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SupravetricularTachyarrhythmias
Part 1
Rey Vivo, MDAssistant Professor of Medicine
Texas Tech University Health Sciences Center
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Objectives
• Define the mechanisms of arrhythmias
• Understand the relevance of the site of origin to the arrhythmia
• Recognize and differentiate the Supraventricular Arrhythmias
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“You see only what you look for, you recognize only what you know.”
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Basics
• Two most important aspects of arrhythmias:1. Their mechanism2. Their site of origin
The two mechanisms that produce arrhythmias are:
1. Automaticity (problems of impulse formation)
2. Block or Reentry(problems of impulse
conduction)
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SVTs
• Accelerated Automaticity
• Reentrant Atrial Tachyarrhythmias
• Reentrant Junctional Tachyarrhythmias- The Atrioventricular Nodal and Bypass Tachycardias
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Accelerated Automaticity
1. Sinus Tachycardia
2. Atrial Tachyarrhythmiase.g. PAT with Block, MAT
3. Accelerated Junctional Rhythm
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Reentrant Atrial Tachs
1. Atrial Flutter
2. Atrial Fibrillation
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Accelerated Automaticity
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Accelerated Automaticity
• May originate from any of the pacemaker cells
• “Ectopic” – any rhythm that comes from any other site than the SA node
Site Term Rate RangeSA node Sinus tachycardia 100-200 bpm
Atria Atrial tachycardia 100-200 bpm
Common bundle AJR 60-130
Bundle branches AVR 50-110
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Sinus Tachycardia
Tips:1. Max. rate: 220 – age2. Discrete, antegrade P waves3. Short PR interval4. Normal QRS duration
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Sinus Tachycardia
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Atrial Tachycardias
1. Accelerated atrial rhythm
2. Paroxysmal Atrial Tachycardia with Block
3. Multifocal Atrial Tachycardia
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Accelerated Atrial Rhythm
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Accelerated Atrial Rhythm
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PAT with Block
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PAT with Block
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Wandering Atrial Pacemaker-Multifocal Atrial Tachycardia Spectrum
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MAT
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Acelerated Junctional Rhythm
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Acelerated Junctional Rhythm
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Reentrant Atrial Tachyarrhythmias
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Reentrant Atrial Tachs
• Atrial flutter • Atrial fibrillation
Single circuit,Uniform F waves
Multiple circuits,Multiform f waves
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Atrial Flutter
Flutter waves best seen oninferior leads (II, III, aVF) and V1
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Atrial Flutter
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Atrial Flutter
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Atrial Flutter
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Atrial Fibrillation
Fibrillatory waves best seen ininferior waves and V1
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Atrial Fibrillation
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Atrial Fibrillation
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Let’s practice!
We make most mistakes because of failure to apply reason and logic,
not because of ignorance.
Barney Marriott, MDEKG expert
Author, Practical Electrocardiography
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EKG 1
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EKG 2
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EKG 3
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EKG 4
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EKG 5
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EKG 6
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EKG 7
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EKG 8
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EKG 9
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The End(Part 2 next Tuesday)