Tachycardia resident survival guide

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: M.Umer Tariq [2]; Priyamvada Singh, M.D. [3]

Tachycardia resident survival guide Microchapters
Overview
Classification
Causes
FIRE
Diagnosis
Treatment
Do's
Dont's

Overview

Tachycardia is a form of cardiac arrhythmia which refers to a rapid beating of the heart. By convention the term refers to heart rates greater than 100 beats per minute in the adult patient.

Classification

Tachycardia

Narrow complex tachycardia (SVT)

Wide complex tachycardia

The origin of the impulse: Atria

The origin of the impulse: AV junction

The origin of the impulse: Atria or AV junction

The origin of the impulse: AV junction

The origin of the impulse: Atria, AV junction or ventricles Presence of an accessory pathway

The origin of the impulse: Pacemaker

Atrial fibrillation Atrial flutter Ectopic atrial rhythm Multifocal atrial tachycardia (MAT) Paroxysmal atrial tachycardia (PAT) with block Premature atrial contractions (PAC) Sinus tachycardia Wandering atrial pacemaker Sick sinus syndrome

AVNRT AVRT (accessory pathway): - Wolff-Parkinson-White syndrome (WPW) - Lown-Ganong-Levine syndrome (LGL)

Accelerated junctional rhythm

SVTAC (SVT with aberrant conduction): Left bundle branch block Left anterior hemi-block Lefo posterior hemi-block Right bundle branch block Trifascicular block

Ventricular tachycardia Ventricular fibrillation Ventricular parasystole

Wolff-Parkinson-White syndrome (WPW) Lown-Ganong-Levine syndrome (LGL)

Pacemaker-mediated tachycardia Runaway pacemaker syndrome Sensor induced tachycardia

Algorithm based on the 2003 ACLS guidelines for the management of tachycardia.

FIRE: Focused Initial Rapid Evaluation

A Focused Initial Rapid Evaluation (FIRE) should be performed to identify patients in need of immediate intervention.

Tachycardia

Pulse

No Pulse

ACLS

====Check signs for hemodynamic instability====

C01

C02

D01

E01

E02

E03

F01

F02

F03

G01

G02

References