Narrow-complex tachycardia: Difference between revisions
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==Diagnosis== | == Diagnosis == | ||
{| border="1" | {| border="1" | ||
|- | |- | ||
| '''Differential''' | | '''Differential''' | ||
| '''A.Rhythm''' | | '''A.Rhythm''' | ||
| '''A.rate''' | | '''A.rate''' | ||
| '''A.morphology''' | | '''A.morphology''' | ||
| '''Vagal/adenosine''' | | '''Vagal/adenosine''' | ||
|- | |- | ||
| A Fib | | [[A Fib]] | ||
| Irregular | | Irregular | ||
| | | >350 | ||
| Fibrillatory (V1) | | Fibrillatory (V1) | ||
| Incr. AV block | | Incr. AV block | ||
|- | |- | ||
| A Flutter | | A Flutter | ||
| Regular | | Regular | ||
| | | >250, <350 | ||
| Sawtooth (II, III, AVF) | | Sawtooth (II, III, AVF) | ||
| Incr. AV block | | Incr. AV block | ||
|- | |- | ||
| A Tach | | A Tach | ||
| Regular | | Regular | ||
| | | >100 | ||
| Neg in II, III, AVF | | Neg in II, III, AVF | ||
| Nothing | | Nothing | ||
|- | |- | ||
| AVNRT | | AVNRT | ||
| Regular | | Regular | ||
| | | >160 | ||
| No p's | | No p's | ||
| -- | | --> NSR | ||
|- | |- | ||
| Junctional | | Junctional | ||
| Regular | | Regular | ||
| | | >100, <150 | ||
| No p's or retrograde p's | | No p's or retrograde p's | ||
| Nothing | | Nothing | ||
|- | |- | ||
| MAT | | MAT | ||
| Irregular | | Irregular | ||
| | | >100 | ||
| | | >3 p shapes | ||
| Transient slowing | | Transient slowing | ||
|- | |- | ||
| Sinus | | Sinus | ||
| Regular | | Regular | ||
| | | | ||
>100 <180 | |||
| Normal | | Normal | ||
| Transient slowing | | Transient slowing | ||
|} | |} | ||
Revision as of 18:56, 18 July 2011
Diagnosis
| 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
- A-fib/flutter
- Rate control: Dilt, MTP, Digoxin
- Dig usually only helpful when already w/ a block (e.g. 2:1)
- Cardioversion: Sotalol, electric
- Rate control: Dilt, MTP, Digoxin
- AVNRT
- Vagal, adenosine, BBs, CCBs, dixogin, electric, procainamide, amio, sotalol
- Junctional
- Remove the cause, Amiodarone, BBs, CCBs
- MAT
- Dilt
- BBs often contraindicated (MAT occurs frequently w/ pulm dz)