Narrow-complex tachycardia: Difference between revisions

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{|
| Differential
| A.�Rhythm
| A.rate
| A.�morphology
| Vagal/adenosine
|-
| A Fib
| Irregular
| >350
| Fibrillatory (V1)
| Incr. AV block
|-
| A Flutter
| Regular
| >250, <350
| Sawtooth (II, III, AVF)
| Incr. AV block
|-
| A Tach
| Regular
| >100
| Neg�in II, III, AVF
| Nothing
|-
| AVNRT
| Regular
| >160
| No p's
| --> NSR
|-
| Junctional
| Regular
| >100, <150
| No p's or retrograde p's
| Nothing
|-
| MAT
| Irregular
| >100
| >3 p shapes
| Transient slowing
|-
| Sinus
| Regular
|
>100 <180
| Normal
| Transient slowing
|}
Flutter vs coarse AFib: determine atrial regularity by taking big bites
TREATMENT:
Digoxin usually only helpful when already c a block (i.e. AF c 2:1 block) NOT c an SVT c 1:1 conduction.
AFib: IV Beta-block> IV digoxin > CCB (diltiazem) > Type IA to covert to SR
<nowiki>*CARDIOVERSION if UNSTABLE* start c 80joules</nowiki>
AFlutter: same as AFib
AT: same as AFib
AVNRT: CSM > adenosine > then Beta blockers > CCB > Digoxin PO. Consider eCV (not if low LVEF), ?procanamide , amio, sotalol.
Junctional: remove the cause, Amiodarone(, Beta-blocker, CCB).
ST: B blocker > CCB > Digoxin
MAT: Verapamil/ Diltiazem. CAREFUL of Beta-blockers b/c usually in pts with pulmonary dz. Amiodarone
Differential A. Rhythm  A.rate A. morphology Vagal/adenosine
Differential A. Rhythm  A.rate A. morphology Vagal/adenosine
A Fib Irregular >350 Fibrillatory (V1) Incr. AV block
A Fib Irregular >350 Fibrillatory (V1) Incr. AV block

Revision as of 07:55, 12 March 2011

Differential A.�Rhythm A.rate A.�morphology Vagal/adenosine
A Fib Irregular >350 Fibrillatory (V1) Incr. AV block
A Flutter Regular >250, <350 Sawtooth (II, III, AVF) Incr. AV block
A Tach Regular >100 Neg�in II, III, AVF Nothing
AVNRT Regular >160 No p's --> NSR
Junctional Regular >100, <150 No p's or retrograde p's Nothing
MAT Irregular >100 >3 p shapes Transient slowing
Sinus Regular

>100 <180

Normal Transient slowing

Flutter vs coarse AFib: determine atrial regularity by taking big bites

TREATMENT:

Digoxin usually only helpful when already c a block (i.e. AF c 2:1 block) NOT c an SVT c 1:1 conduction.

AFib: IV Beta-block> IV digoxin > CCB (diltiazem) > Type IA to covert to SR

*CARDIOVERSION if UNSTABLE* start c 80joules

AFlutter: same as AFib

AT: same as AFib

AVNRT: CSM > adenosine > then Beta blockers > CCB > Digoxin PO. Consider eCV (not if low LVEF), ?procanamide , amio, sotalol.

Junctional: remove the cause, Amiodarone(, Beta-blocker, CCB).

ST: B blocker > CCB > Digoxin

MAT: Verapamil/ Diltiazem. CAREFUL of Beta-blockers b/c usually in pts with pulmonary dz. Amiodarone


Differential A. Rhythm A.rate A. morphology Vagal/adenosine A Fib Irregular >350 Fibrillatory (V1) Incr. AV block A Flutter Regular >250, <350 Sawtooth (II, III, AVF) Incr. AV block A Tach Regular >100 Neg in II, III, AVF Nothing AVNRT Regular >160 No p's --> NSR Junctional Regular >100, <150 No p's or retrograde p's Nothing MAT Irregular >100 >3 p shapes Transient slowing Sinus Regular >100 <180

Normal Transient slowing


Flutter vs coarse AFib: determine atrial regularity by taking big bites


TREATMENT:

Digoxin usually only helpful when already c a block (i.e. AF c 2:1 block) NOT c an SVT c 1:1 conduction.

AFib: IV Beta-block> IV digoxin > CCB (diltiazem) > Type IA to covert to SR

  • CARDIOVERSION if UNSTABLE* start c 80joules


AFlutter: same as AFib


AT: same as AFib


AVNRT: CSM > adenosine > then Beta blockers > CCB > Digoxin PO. Consider eCV (not if low LVEF), ?procanamide , amio, sotalol.


Junctional: remove the cause, Amiodarone(, Beta-blocker, CCB).


ST: B blocker > CCB > Digoxin


MAT: Verapamil/ Diltiazem. CAREFUL of Beta-blockers b/c usually in pts with pulmonary dz. Amiodarone