Common varieties of supraventricular tachycardia: Differentiation and dangers

doi:10.1016/S0147-9563(96)80079-3

Heart & Lung

Volume 25, Issue 5, September–October 1996, Pages 373-381

https://doi.org/10.1016/S0147-9563(96)80079-3 Get rights and content

Two major types of supraventricular tachycardia (SVT) commonly seen in acute care situations are atrioventricular nodal reentrant tachycardia (AVNRT), and orthodromic atrioventricular reentrant tachycardia (AVRT). Intranodal reentry via fast and slow conduction pathways within the atrioventricular junction is the mechanism by which AVNRT develops. In contrast, reentrant tachycardia across accessory pathways is associated with preexcitation and AVRT. In the setting of Wolff-Parkinson-White syndrome, inappropriate treatment of AVRT may result in a potentially lethal type of atrial fibrillation. Electrocardiographic cues that differentiate between AVNRT and AVRT are discussed. Treatments range from emergency cardioversion to administration of intravenous agents such as adenosine. The tachycardias may be cured with radiofrequency catheter ablation.

References (0)

Cited by (4)

Slow supraventricular tachycardia in a patient on β-blocker therapy [11]
2005, American Journal of Emergency Medicine
Wolff Parkinson White (WPW) syndrome: what the critical care nurse needs to consider when administering antiarrhythmics
2001, Australian Critical Care
This paper discusses the importance of critical care and emergency nurses having an understanding of why pre-existing cardiac disorders can influence antiarrhythmic treatment. The patient with a pre-excitation syndrome is usually managed in a coronary care unit. However, these patients may be admitted to an intensive care unit (ICU) with complications of Wolff Parkinson White (WPW) syndrome; for example post cardiopulmonary arrest or WPW as a co-morbidity. It is common practice in critical care areas for registered nurses to administer antiarrhythmics without a doctor's prescription in life-threatening situations. Therefore, the critical care nurse must have knowledge of the implications of administering standard antiarrhythmic agents if this patient reverts into a tachyarrhythmia. If antiarrhythmics are administered that are contraindicated in patients with WPW syndrome, then there is potential for deleterious effects. This case study highlights the different pharmacological agents for treating tachyarrhythmias in a patient with WPW syndrome. The paper outlines the correct treatment and discusses the deleterious effects of incorrect administration of drugs in WPW syndrome.
Pseudo ventricular hypertrophy and pseudo myocardial infarction in wolff-parkinson-white
2000, American Journal of Emergency Medicine
In Wolff-Parkinson-White syndrome, the sequence of ventricular activation is altered and depending on the anatomic site of the accessory conduction pathway may result in pseudo ventricular hypertrophy and pseudo myocardial infarction patterns on electrocardiogram. The right-sided accessory pathway may direct the depolarization vector towards left amplifying R-wave amplitude in left-sided limb-leads simulating left ventricular hypertrophy. The left-sided accessory pathways may give rise to prominent R-waves in right precordial leads simulating right ventricular hypertrophy. The right lateral accessory pathways may simulate anterior infarction because of prominent Q-waves in right precordial leads. The left lateral accessory pathways directing depolarization vector towards right may cause Q-waves in lateral limb-leads simulating high lateral myocardial infarction. In posteroseptal accessory pathway, the ventricular depolarization vector is directed superiorily giving rise to prominent Q-waves in inferior limb leads simulating inferior myocardial infarction. Therefore, ventricular hypertrophy and myocardial infarction should not be diagnosed from the electrocardiograms of Wolff-Parkinson-White syndrome. (Am J Emerg Med 2000;18:807-809. Copyright © 2000 by W.B. Saunders Company)
Use of the Valsalva manoeuvre in the prehospital setting: A review of the literature
2009, Emergency Medicine Journal

View full text

Continuing educationCommon varieties of supraventricular tachycardia: Differentiation and dangers

Continuing education
Common varieties of supraventricular tachycardia: Differentiation and dangers