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Points & Pearls Excerpt
Supraventricular tachycardias (SVTs) arise at or above the atrioventricular (AV) node due either to abnormal automaticity or abnormal conduction.
AV nodal re-entry tachycardia (AVNRT) makes up 60%-70% of SVT cases due to a functional obstruction with 2 conduction systems within the node.
Ventricular pre-excitation (VPE) occurs when circus movements rely on anatomical accessory pathways from the atria to the ventricle. This is the mechanism of AV re-entry tachycardia (AVRT).
Wolff-Parkinson-White syndrome (WPW) involves conduction through a congenital accessory pathway, leading to pre-excitation to the ventricle. An ECG will reveal a shortened PR wave and up-swerving initiation of the R wave, called a delta wave.
Orthodromic (antegrade) conduction depolarizes through the bundle, resulting in a narrow QRS.
Antidromic (retrograde) conduction causes depolarization through the accessory pathway and retrograde progression through the AV node, leading to a wide QRS.
Upon completion of this article, you should be able to:
Identify common supraventricular tachyarrhythmias (SVTs) and discuss the causes
Identify specific treatments for different types of SVTs
Discuss the advantages and disadvantages associated with each intervention available
Determine the appropriate disposition, given different presentation criteria.
Date of Original Release: August 1, 2020. Date of most recent review: July 10, 2020. Termination date: August 1, 2023.
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