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{{Supraventricular tachycardia}}
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==Overview==
==Overview==
The best method to diagnose [[supraventricular tachycardia]] is through electrocardiography. Presentation on EKG will vary depending on the subtype. In general, [[QRS complex]]es tend to be tall and narrow, [[P waves]] are absent, and rate is greater than 100 beats per minute.  [[Asystole]] may occur due to tachycardia-mediated suppression of the sinus node when the rhythm is in AVNRT.
==Electrocardiogram==
==Electrocardiogram==
The EKG below is an interesting recording that shows a supraventricular tachycardia. The heart rate is around 185 bpm. It is somewhat unusual presentation for someone with [[angina]].  The [[arrhythmia]] terminated with [[adenosine]] which has a powerful [[cholinergic]] effect that blocks conduction through the [[AV node]].
Shown below is an EKG example of supraventricular tachycardia. The heart rate is around 185 bpm. It is somewhat unusual presentation for someone with [[angina]].  The [[arrhythmia]] terminated with [[adenosine]] which has a powerful [[cholinergic]] effect that blocks conduction through the [[AV node]].


[[Image:Svtadenosine.jpg|center|800px]]
[[Image:Svtadenosine.jpg|center|500px]]
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:E345.jpg
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:E345.jpg
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The EKG below is an example showing tachycardia at a rate of 190/min with narrow QRS complexes indicating supraventricular tachycardia.
Shown below is an EKG depicting a tachycardia at a rate of 190/min with narrow QRS complexes indicating supraventricular tachycardia.


[[Image:SVT.jpg|center|800px]]
[[Image:SVT.jpg|center|500px]]
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:De-AW00011.jpg
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:De-AW00011.jpg
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The EKG below is the recording of the patient who goes from sinus rhythm to a wide complex tachycardia at about 130/min. The wide QRS though disappears after nine complexes and is replaced by narrow complexes at a slightly slower rate. No p wave activity is seen. This is a supraventricular tachycardia with a form of abberancy. In this case we are probably seeing a rate dependent left bundle branch block or the effect of a left bundle branch block which persists for the nine complexes because of continued block in the left bundle from the depolarizations from the intact right bundle.
Shown below is an EKG recording of a patient who goes from sinus rhythm to a [[wide complex tachycardia]] at about 130/min. The [[wide QRS]] though disappears after nine complexes and is replaced by narrow complexes at a slightly slower rate. No [[P wave]] activity is seen. This is a supraventricular tachycardia with a form of aberrancy. In this case we are probably seeing a rate dependent left bundle branch block or the effect of a left bundle branch block which persists for the nine complexes because of continued block in the left bundle from the depolarizations from the intact right bundle.
[[Image: Supraventricular tachycardia.jpg|center|800px]]
[[Image: Supraventricular tachycardia.jpg|center|500px]]
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/Main_Page
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/Main_Page
----
----


The EKG below is an example demonstrating a rapid heart rate at the rate of nearly 300 beats per minute indicating a paroxysmal supraventricular tachycardia.
Shown below is an example of a EKG demonstrating a rapid heart rate at the rate of nearly 300 beats per minute indicating a [[paroxysmal supraventricular tachycardia]].


[[Image:Paroxysmal_supraventricular_tachycardia.jpg|center|800px]]
[[Image:Paroxysmal_supraventricular_tachycardia.jpg|center|500px]]
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:De-AW00012.jpg
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:De-AW00012.jpg
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----


Shown below is an example of an EKG showing a supraventricular tachycardia with group ventricular beating with clusters of regular rhythm at about 215/min. The regularity and group beating suggest that this is an organized rhythm and not atrial fibrillation. Look carefully at the interval between the 6th and 7th beats in lead II. Clearly atrial activity is seen at about 215/min. This is an interesting case where the diltiazem has slowed down the SVT which has allowed faster conduction down the A/V node and hence an increase in the ventricular rate.
;For more EKG examples of supraventricular tachycardia, click [[Supraventricular_tachycardia_EKG_examples|here]]
[[Image:Supraventricular_tachycardia1.jpg|center|800px]]
 
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Shown below is the recording shows the intiation of supraventricular tachycardia. There appears to be a p wave on the last part of the last sinus t wave suggesting that this may be an ectopic atrial tachycardia or possibly an atypical form of A/V nodal reentry where one sees the retrograde p wave before the QRS.
 
[[Image: Supraventricular tachycardia 1.jpg|center|800px]]
Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/Main_Page
----
 
==Sources==
Copyleft images obtained courtesy of ECGpedia,  http://en.ecgpedia.org/index.php?title=Special:NewFiles&offset=&limit=500


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


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Latest revision as of 18:31, 14 January 2013

Supraventricular tachycardia Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Among the Different Types of Supraventricular Tachycardia

Differentiating Supraventricular Tachycardia from Ventricular Tachycardia

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

EKG Examples

Chest X Ray

Echocardiography

Cardiac Catheterization

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

2015 ACC/AHA Guideline Recommendations

Acute Treatment of SVT of Unknown Mechanism
Ongoing Management of SVT of Unknown Mechanism
Ongoing Management of IST
Acute Treatment of Suspected Focal Atrial Tachycardia
Acute Treatment of Multifocal Atria Tachycardia
Ongoing Management of Multifocal Atrial Tachycardia
Acute Treatment of AVNRT
Ongoing Management of AVNRT
Acute Treatment of Orthodromic AVRT
Ongoing Management of Orthodromic AVRT
Asymptomatic Patients With Pre-Excitation
Management of Symptomatic Patients With Manifest Accessory Pathways
Acute Treatment of Atrial Flutter
Ongoing Management of Atrial Flutter
Acute Treatment of Junctional Tachycardia
Ongoing Management of Junctional Tachycardia
Acute Treatment of SVT in ACHD Patients
Ongoing Management of SVT in ACHD Patients
Acute Treatment of SVT in Pregnant Patients
Acute Treatment and Ongoing Management of SVT in Older Population

Prevention

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Future or Investigational Therapies

Case Studies

Case #1

Supraventricular tachycardia electrocardiogram On the Web

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Risk calculators and risk factors for Supraventricular tachycardia electrocardiogram

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The best method to diagnose supraventricular tachycardia is through electrocardiography. Presentation on EKG will vary depending on the subtype. In general, QRS complexes tend to be tall and narrow, P waves are absent, and rate is greater than 100 beats per minute. Asystole may occur due to tachycardia-mediated suppression of the sinus node when the rhythm is in AVNRT.

Electrocardiogram

Shown below is an EKG example of supraventricular tachycardia. The heart rate is around 185 bpm. It is somewhat unusual presentation for someone with angina. The arrhythmia terminated with adenosine which has a powerful cholinergic effect that blocks conduction through the AV node.

Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:E345.jpg


Shown below is an EKG depicting a tachycardia at a rate of 190/min with narrow QRS complexes indicating supraventricular tachycardia.

Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:De-AW00011.jpg


Shown below is an EKG recording of a patient who goes from sinus rhythm to a wide complex tachycardia at about 130/min. The wide QRS though disappears after nine complexes and is replaced by narrow complexes at a slightly slower rate. No P wave activity is seen. This is a supraventricular tachycardia with a form of aberrancy. In this case we are probably seeing a rate dependent left bundle branch block or the effect of a left bundle branch block which persists for the nine complexes because of continued block in the left bundle from the depolarizations from the intact right bundle.

Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/Main_Page


Shown below is an example of a EKG demonstrating a rapid heart rate at the rate of nearly 300 beats per minute indicating a paroxysmal supraventricular tachycardia.

Copyleft image obtained courtesy of ECGpedia, http://en.ecgpedia.org/wiki/File:De-AW00012.jpg


For more EKG examples of supraventricular tachycardia, click here

References


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