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What is the characteristic electrocardiogram appearance of atrial flutter?
What is the characteristic electrocardiogram appearance of atrial flutter?
What is the definition of tachyarrhythmia?
What is the definition of tachyarrhythmia?
What is the primary difference between narrow and wide complex tachyarrhythmias?
What is the primary difference between narrow and wide complex tachyarrhythmias?
What is the most common cause of sudden cardiac death (SCD)?
What is the most common cause of sudden cardiac death (SCD)?
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What is the primary focus of management for atrial fibrillation and atrial flutter?
What is the primary focus of management for atrial fibrillation and atrial flutter?
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What is the diagnostic criterion for ventricular tachycardia?
What is the diagnostic criterion for ventricular tachycardia?
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What is the characteristic feature of Wolff-Parkinson-White syndrome?
What is the characteristic feature of Wolff-Parkinson-White syndrome?
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What is the initial management for ventricular fibrillation?
What is the initial management for ventricular fibrillation?
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What is the key principle in managing tachyarrhythmias?
What is the key principle in managing tachyarrhythmias?
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What is the default diagnosis for any wide complex tachycardia?
What is the default diagnosis for any wide complex tachycardia?
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Study Notes
Tachyarrhythmia
- Definition: Any abnormality in the rate or rhythm of heart beats, with a normal heart rate of 60-100 BPM and a normal heart rhythm of sinus rhythm, passing through the AVN (atrioventricular node).
Classification of Tachyarrhythmia
- Narrow complex tachycardia:
- Originating from above the AVN
- QRS duration < 120 ms
- Subclassified into:
- Regular: Supraventricular tachycardia (SVT)
- Irregular: Atrial fibrillation (AF)
- Wide complex tachycardia:
- Originating from below the AVN
- QRS duration > 120 ms
- Subclassified into:
- Regular: Ventricular tachycardia (VT)
- Irregular: Ventricular fibrillation (VF)
Sinus Tachycardia
- Heart rate > 100 BPM, sinus rhythm
- Causes:
- Physiological: exercise, pregnancy, anxiety
- Pathological: pulmonary embolism, anemia, hyperthyroidism, acute heart failure, drug-induced
- Inappropriate sinus tachycardia: increased SAN automaticity
- Presentation:
- Palpitation, chest pain, shortness of breath
- Management:
- Treatment of the cause
- Withdrawal of offending drug
- Beta blockers
- Ivabradine
- SAN ablation (rare, in resistant cases)
Supraventricular Tachycardia (SVT)
- Heart rate > 100 BPM, originating from above the AVN, outside the SAN
- Classification:
- Atrial flutter
- Atrial tachycardia
- AVNRT (AV nodal reentrant tachycardia)
- AVRT (atrioventricular reentrant tachycardia)
- Pathophysiology:
- Reentry due to presence of two pathways for conduction with different speeds of conduction and refractory periods through the AVN and accessory pathway, triggered by PAC
- Presentation:
- Sudden onset palpitation
- Chest pain
- Dizziness
- Syncope
- Shock
- Management:
- Acute management: see below
Atrial Fibrillation (AF)
- Irregular rhythm caused by uncoordinated atrial electrical activation
- Usually > 100 BPM, but controlled AF by medication may be < 100 BPM
- The most common sustained arrhythmia in adults
- Management:
- ABC pathway:
- A: Anticoagulation/avoid stroke
- B: Better symptom control (rate and rhythm)
- C: Cardiovascular risk factors and concomitant diseases
- Anticoagulation:
- Who should take anticoagulation: patients with prosthetic valves, moderate or severe mitral stenosis, high ischemic risk (CHADSVASC score)
- Types of anticoagulation: Vitamin K antagonists (warfarin), Novel oral anticoagulants (NOACS)
- Rhythm control: selected for patients with normal left atrial dimensions and morphology, HCM, and persistent symptoms despite adequate rate control
- ABC pathway:
Atrial Flutter
- Characteristic saw-tooth appearance
- May be regular (2:1, 3:1, 4:1, etc.) or irregular (flutter with variable block)
- Same management as AF with more insistence on rhythm control
Ventricular Tachycardia (VT)
- 3 or more consecutive wide QRS complex beats
- Originating from the ventricles
- A rate > 100 BPM
- VT and VF account for the most common causes of SCD
Ventricular Fibrillation (VF)
- Requires urgent CPR
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Description
Learn about the definition and classification of tachyarrhythmia, including normal heart rate and rhythm, and narrow complex tachyarrhythmias. This quiz is perfect for cardiology students and medical professionals.
