Narrow complex tachycardia

Background

Clinical Features

Differential Diagnosis

Evaluation

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 (SVT) 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

Management

Narrow Regular Tachycardia

Narrow Irregular Tachycardia

Atrial fibrillation with RVR/flutter

AVNRT (SVT)

  • Vagal, adenosine, beta-blockers, calcium-channel blockers, dixogin, electric, procainamide, amio, sotalol

Junctional

Remove the cause, Amiodarone, beta-blockers, calcium-channel blockers

MAT

  • Diltiazem
  • Beta blockers often contraindicated (MAT occurs frequently with pulmonary disease)

Disposition

See Also

External Links

Video

[[Category:WikEM]]

References