Ebook Management of cardiac arrhythmias (2nd edition): Part 2
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Ebook Management of cardiac arrhythmias (2nd edition): Part 2
IV Specific ArrhythmiasSupraventricular ArrhythmiasKhalid Almuti, Babak Bozorgnia, and Steven A. RothmanContentsIntroductionnoninvasive Diagnosis of s Ebook Management of cardiac arrhythmias (2nd edition): Part 2svtMechanisms of svtNon-Invasive and Pharmacologic Therapies for SVTPharmacotherapyElectrophysiologic Testing and Tachycardia ablationCatheter Ablation of avnrtatrial TachycardiaSummaryReferencesAbstractParoxysmal supraventricular tachycardia is a common arrhythmia with multiple etiologies, includin Ebook Management of cardiac arrhythmias (2nd edition): Part 2g atrio-ventricular nodal reentrant tachycardia, atrio-ventricular reentrant tachycardia, and atrial tachycardia. Treatment of these arrhythmias depenEbook Management of cardiac arrhythmias (2nd edition): Part 2
ds greatly upon the proper diagnosis as well US an understanding of the arrhythmia’s mechanism. A preliminary diagnosis can be often be inferred from IV Specific ArrhythmiasSupraventricular ArrhythmiasKhalid Almuti, Babak Bozorgnia, and Steven A. RothmanContentsIntroductionnoninvasive Diagnosis of s Ebook Management of cardiac arrhythmias (2nd edition): Part 2d by side effects, compliance, and marginal efficacy. More definitive treatment of the arrhythmia requires an invasive electrophysiology study to confirm the diagnosis followed by catheter ablation of the arrhythmogenic substrate. The success nite for catheter ablation can approach 95% depending on Ebook Management of cardiac arrhythmias (2nd edition): Part 2the mechanism of the arrhythmia and is the treatment of choice for patients with severe symptoms.Key Words: Activation mapping; adenosine: afterdepolaEbook Management of cardiac arrhythmias (2nd edition): Part 2
rizations; amiodarone; antidromic atrioventricular reentrant tachycardia; atrial extrastimuli; atrial tachycardia; atrio-ventricular nodal reentrant tIV Specific ArrhythmiasSupraventricular ArrhythmiasKhalid Almuti, Babak Bozorgnia, and Steven A. RothmanContentsIntroductionnoninvasive Diagnosis of s Ebook Management of cardiac arrhythmias (2nd edition): Part 2soproterenol; macroreentry; metoprolol; microreentry; orthodromic atrioventricular reentrant tachycardia; pace mapping; para-Hisian pacing; pharmacotherapy; proarrhythmia: procainamide: propafeone: propranolol: radiofrequency catheter ablation: sotalol: supraventricular tachycardia: triggered activi Ebook Management of cardiac arrhythmias (2nd edition): Part 2ty; ventricular extrastimuli; verapamil; Wolff-Parkinson-White syndrome.From: Contemporary Cardiology: Management of Candiac Arrhythmias Edited by: GaEbook Management of cardiac arrhythmias (2nd edition): Part 2
n-Xin Yan. Peter R Kowey, DOI 10.1007/978-1-60761-161 -5_7 © Springer Scicncc+Busincss Media. LLC 2011141142 Part IV / specific ArrhythmiasINTRODUCTIOIV Specific ArrhythmiasSupraventricular ArrhythmiasKhalid Almuti, Babak Bozorgnia, and Steven A. RothmanContentsIntroductionnoninvasive Diagnosis of s Ebook Management of cardiac arrhythmias (2nd edition): Part 2sinus tachycardia and atrial fibrillation (AF). but in practice, the term "supraventricular tachycardia" is mostly used to refer to a finite number of abnormal rhythms that are paroxysmal in nature and include atrio-ventricular nodal reentrant tachycardia (AVNRT). atrioventricular reentrant tachycar Ebook Management of cardiac arrhythmias (2nd edition): Part 2dia (AVRT). atrial tachycardia (AT), and. less commonly, junctional ectopic tachycardia and sinoatrial reentrant tachycardia. The prevalence of theseEbook Management of cardiac arrhythmias (2nd edition): Part 2
paroxysmal SVT's is 2.25 per 1000 persons with a female preponderance especially before age 65 years (/). In this chapter, the most common paroxysmal IV Specific ArrhythmiasSupraventricular ArrhythmiasKhalid Almuti, Babak Bozorgnia, and Steven A. RothmanContentsIntroductionnoninvasive Diagnosis of s Ebook Management of cardiac arrhythmias (2nd edition): Part 2SIVE DIAGNOSIS OF S\THistoryIn the absence of an electrocardiographic documentation of an SVT. history can be extremely helpful in differentiating SVT from other cardiac arrhythmias. If an SVT is documented on an ECG (or a cardiac monitor) then a detailed history can predict the mechanism of the SVT Ebook Management of cardiac arrhythmias (2nd edition): Part 2 in a high percentage of patients (2). Useful information includes descriptions of the onset and termination of the episode, instigating and terminatiEbook Management of cardiac arrhythmias (2nd edition): Part 2
ng factors, symptoms during the episode, and age at the onset of symptoms (3).Reentrant SVTs such as AVNRT and AVRT are usually abrupt in onset and ofIV Specific ArrhythmiasSupraventricular ArrhythmiasKhalid Almuti, Babak Bozorgnia, and Steven A. RothmanContentsIntroductionnoninvasive Diagnosis of s Ebook Management of cardiac arrhythmias (2nd edition): Part 2dizziness, shortness of breath, and chest tightness. Some patients may experience diaphoresis, numbness in the extremities, and flushing. If asked, the patient will usually be able to tap out a rapid but regular demonstration of the episode. Many patients may also feel pulsations in the neck represe Ebook Management of cardiac arrhythmias (2nd edition): Part 2nting contraction of the atria against a closed AV valve. This phenomenon is more common in AVNRT (2). More severe symptoms, such as syncope, are lessEbook Management of cardiac arrhythmias (2nd edition): Part 2
frequent, but can occur in up to 20% of patients (4).Aside from the description of SVT episodes, history should also include any underlying cardiac dIV Specific ArrhythmiasSupraventricular ArrhythmiasKhalid Almuti, Babak Bozorgnia, and Steven A. RothmanContentsIntroductionnoninvasive Diagnosis of s Ebook Management of cardiac arrhythmias (2nd edition): Part 2c substrate and makes a diagnosis of AT or atrial flutter more likely (5). A history of prior catheter-based ablation therapy is also important to obtain for the same reason. The age and gender of the patient may. in some cases, help narrow the differential diagnosis of the SVT. For example. AVNRT t Ebook Management of cardiac arrhythmias (2nd edition): Part 2ends to have a female preponderance with a bimodal age distribution (2).ECG FeaturesSeveral features on the cardiac electrocardiogram can be useful inEbook Management of cardiac arrhythmias (2nd edition): Part 2
determining the mechanism of SVT. Most important of these is the p wave location (Fig. I). If discernable p waves are visible, then determining the lIV Specific ArrhythmiasSupraventricular ArrhythmiasKhalid Almuti, Babak Bozorgnia, and Steven A. RothmanContentsIntroductionnoninvasive Diagnosis of s Ebook Management of cardiac arrhythmias (2nd edition): Part 2wave to the preceding QRS complex is shorter than the interval from the same p wave to the subsequent ỌRS complex, then the tachycardia is described as a short-RP tachycardia. The converse is true for a long-RP tachycardia (6).143Chapter 7 / Stipravennicular ArrhythmiasSinus RythmTachycardia Descrip Ebook Management of cardiac arrhythmias (2nd edition): Part 2tionDifferential DiagnosisLong RP TachycardiaIV Specific ArrhythmiasSupraventricular ArrhythmiasKhalid Almuti, Babak Bozorgnia, and Steven A. RothmanContentsIntroductionnoninvasive Diagnosis of sIV Specific ArrhythmiasSupraventricular ArrhythmiasKhalid Almuti, Babak Bozorgnia, and Steven A. RothmanContentsIntroductionnoninvasive Diagnosis of sGọi ngay
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