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Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

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Nội dung chi tiết: Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

ATRIAL TACHYCARDIAAtrial tachycardia (AT) is defined as a regular atrial rhythm originating from the atrium at 100 bpm to 240 bpm. T e presence of an

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2 atrial rate above 100 bpm with three different p wave morphologies signifies different foci of atrial depolarization and is called a multifocal atria

l tachycardia (MAT). Previous classifications of AT had been based exclusively on the routine electrocardiogram (ECG) with a constant rate and an isoe Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

lectric line between the two consecutive p waves. Atrial flutter (AFL) is typically a reentrant arrhythmia defined as having a pattern of regular tach

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

ycardia with a rate above 240 bpm without an isoelectric baseline between deflections. T e typical (cavotricuspid dependent) AFL usually shows sawtoot

ATRIAL TACHYCARDIAAtrial tachycardia (AT) is defined as a regular atrial rhythm originating from the atrium at 100 bpm to 240 bpm. T e presence of an

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2cal (noncavotricuspid dependent) AFL. However, neither rate nor lack of isoelectric baseline is specific for any tachycardia mechanism. A rapid AT in

a scarred atrium can mimic AFL. and. on the other hand, a typical AFL can show distinct isoelectric intervals between flutter waves, in diseased atria Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

, or in the presence of antiarrhythmic drug therapy. Terefore it becomes a matter of semantics to define an AT or an atypical AFL. AT can result from

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

a focal mechanism such as abnormal automaticity or triggered activity. Unlike prior definitions stating that focal AB have a constant rate, a focal AT

ATRIAL TACHYCARDIAAtrial tachycardia (AT) is defined as a regular atrial rhythm originating from the atrium at 100 bpm to 240 bpm. T e presence of an

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2 classification of AT AFL. Focal automatic ATs occur mostly in children and young adults. Focal automatic AB begin with a p wave identical co the p wa

ve during the arrhythmia, and the rate generally increases gradually (warms up) over the first few seconds. Automatic ATs are catecholamine sensitive Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

and cannot be induced or terminated by programmed electrical stimulation (PES). ATs resulting from triggered activity can arise anywhere in the atria

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

but most commonly originate from the’crista termi-nalis. tricuspid annulus, and mitral annulus. T ese ATs can be induced and terminated with PES. T e

ATRIAL TACHYCARDIAAtrial tachycardia (AT) is defined as a regular atrial rhythm originating from the atrium at 100 bpm to 240 bpm. T e presence of an

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2, but its reentrant mechanism can be elucidated after a careful electrophysiology study includingentrainment. Macroreentrant AT and AFL are discussed

in detail in Chapter s.ATRIAL TACHYCARDIAT e location of the focal source of an AT is determined by p wave morphology and vector on 12-lead ECG (Figur Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

es 7-1 and 7-2). Focal AT can arise anywhere in the atrium, pulmonary veins (PVs), and venae cavae (Figures 7-3 through 7-9). Focal ATs usually have d

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

iscrete p waves at rates of 110 to 240 bpm. but AT AFL arising from PVs can be as fast as 300 bpm. Antiarrhythmic drugs can slow the AT.'AFL rate by d

ATRIAL TACHYCARDIAAtrial tachycardia (AT) is defined as a regular atrial rhythm originating from the atrium at 100 bpm to 240 bpm. T e presence of an

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2en Shorter atrial activation with a shorter p wave duration and longer diastolic intervals on the ECG distinguishes a focal from a macroreentrant AT w

ith 90*0 sensitivity and specificity. Careful analysis of the 12-lead ECG and rhythm strips as well as vagal maneuvers and drug inter ventions (adenos Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

ine and atrioventricular (AV] nodal blockers) help in determining the mechanism of an AT An electrophysiology study is helpful in determining the focu

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

s of an AT or the isthmus of a reentrant AT (Figures 7-10 through 7-18).p AND QRS RELATIONSHIP DURING ATRIAL TACHYCARDIA1AB usually have a long R-P' t

ATRIAL TACHYCARDIAAtrial tachycardia (AT) is defined as a regular atrial rhythm originating from the atrium at 100 bpm to 240 bpm. T e presence of an

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2al physiology with AV conduction via the slow pathway.2T e atrial to ventricular relationship depends on the ability of the AV node conduction during

tachycardia. It is usually 1 1 conduction during ẰTs: however. Wenckebach pattern or 2 1 AV block can occur. T e presence of AV block during supravent Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

ricular tachycardia strongly suggests AT and excludes an AV reentrant tachycardia. Rarely, an AV nodal reentrant tachycardia with lower common pathway

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

block or His-Puikinje187188 CHAPTER 7 ATRIAL TACHYCARDIATABLE 7-1 Classification of atrial tachycardia and atrial flutterTYPEMECHANISMMAPPING PROPERT

ATRIAL TACHYCARDIAAtrial tachycardia (AT) is defined as a regular atrial rhythm originating from the atrium at 100 bpm to 240 bpm. T e presence of an

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2, calcium blockerMicroreentryA focal in ongin but careful mapping shows an area of continuous or mid diastolic potentialPAG PESPESMacroreentrant AT an

d AFLCavotricuspid dependent right AFL Noncavotrkuspid isthmus dependentTypical counterclockwise Typical clockwise Lower-loop reentry Double-loop reen Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

try Intra-isthmus reentry Upper-loop reentry (see Chapter 8) Leslonal (incision related) Scar related (congenital heart disease, cardiac surgery, card

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

iomyopathy)PES. PAC. PVC (rarely)PE5 PE5Left atrial or biatrialPostablation Around scar or anatomic structuresPostatrial fibrillation catheter ablatio

ATRIAL TACHYCARDIAAtrial tachycardia (AT) is defined as a regular atrial rhythm originating from the atrium at 100 bpm to 240 bpm. T e presence of an

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2al complex; AES, programmed electrical stimulation. Pvt. premature ventricular complexdisease may show AV block and variable relation of p waves with

QRS.3Termination of a supraventricular tachycardia without a following QRS practically rules out an AT.EFFECT OF DRUG THERAPY ON ATRIAL TACHYCARDIA AN Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

D ATRIAL FLUTTERWith AV nodal disease or AV' nodal drug therapy. 4:1 or variable AV block is seen. In the presence of antiarrhythmic drug therapy, the

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

cycle length of AFL can prolong or atrial fibrillation can organize to a relatively slower flutter that allows the AV node to conduct 1 1. resulting

ATRIAL TACHYCARDIAAtrial tachycardia (AT) is defined as a regular atrial rhythm originating from the atrium at 100 bpm to 240 bpm. T e presence of an

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2ered activity.LOCALIZATION OF FOCAL ATRIAL TACHYCARDIASSeveral algorithms have been proposed for ECG localization of focal AT using the p wave morphol

ogy and axis on a 12-lead ECG (see Figures 7-1 and 7-2). However, sometimes p wave morphology can be difficult to determine on account of the partial Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

masking by ST segment/T wave. Simple vagal maneuvers or intravenous adenosine administration during 12-lead ECG rhythm strip recording can separate th

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

e p wave from T wave Alternatively, a postpremature ventricular contraction compensatory pause can separate the p wave from the T wave and delineate p

ATRIAL TACHYCARDIAAtrial tachycardia (AT) is defined as a regular atrial rhythm originating from the atrium at 100 bpm to 240 bpm. T e presence of an

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2 structure, and the left atrium (LA) is a posterior structure. T e lead VI is located to the right and anteriorly in relation to the atria. T erefore

p wave morphology in lead V] plays a vital role in determining the origin of focal ATs A right AT originating from the tricuspid annulus or crista ter Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

minalis has negative p waves in lead V1 because the atrial activation travels away from lead V1 .u p waves in lead VI are positive for ATs originating

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

from the PVs because of the posterior location in the chest. In general, negative p waves in the anterior precordial leads suggest an anterior RA or

ATRIAL TACHYCARDIAAtrial tachycardia (AT) is defined as a regular atrial rhythm originating from the atrium at 100 bpm to 240 bpm. T e presence of an

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2re significantly faster (mean cycle lengths: 289 ± 45 ms and 280 ± 48 ms in patients without and with pv ablation for atrial fibrillation, respectivel

y) compared with left ATs (mean cycle lengths: 392 ± 106 ms and 407 ± 87 ms. patients without and with pv ablation for atrial fibrillation, respective Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

ly).5 p waves in focal pv ATs usually have longer duration'll 10 ms) A prior catheter ablation of atrial fibrillation or reentrant AT. maze procedure,

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

and surgery for congenital heart disease can affect the localization of the AT AFL focus or circuit.RIGHT ATRIAL TACHYCARDIAA negative or biphasic (p

ATRIAL TACHYCARDIAAtrial tachycardia (AT) is defined as a regular atrial rhythm originating from the atrium at 100 bpm to 240 bpm. T e presence of an

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2 see also Figures 7-9 through 7-18). p waves during ATs arising near the septum are generally narrower than thoseCHARTarising in the RA or LA free wal

l because of a relatively rapid activation from the midline to both atria, whereas the impulse from Al's with a right or left lateral atrial origin ha Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

s to travel a longer distance to excite the whole contralateral atria.SINUS NODE REENTRY TACHYCARDIASinus node reentry is defined as a reentrant tachy

Ebook Electrocardiography of arrhythmias - A comprehensive review: Part 2

cardia involving the Sintis node and perinodal tissue that is induced and terminated with PES and is adenosine sensitive. However, there has not been

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