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Tachycardia: Difference between revisions
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→Atrial Tachycardia
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AT have a wide range clinical presentation. They can occur in paroxysms or can be the permanent underlying rhythm. Complaints of palpitation and a fast regular heart rate are common and as a result of the tachycardia complaints of dizziness, dyspnoea and syncope can be experienced. On the ECG an atrial tachycardia can be detected through the P-wave morphology. The P-wave has an other morpholgy depending on the foci of the atrial tachycardia. A ECG in resting condition can help distinguish different morphologies. Vagal manouvres or administration of adenosine can block the AV-conduction and reveal firing from the atrium, thereby clearly identifying the atrial source of the tachycardia. However sometimes only a electrophysiological study can differentiate between the different mechanisms of AT and localize the precise loacation or circuit of the AT. | AT have a wide range clinical presentation. They can occur in paroxysms or can be the permanent underlying rhythm. Complaints of palpitation and a fast regular heart rate are common and as a result of the tachycardia complaints of dizziness, dyspnoea and syncope can be experienced. On the ECG an atrial tachycardia can be detected through the P-wave morphology. The P-wave has an other morpholgy depending on the foci of the atrial tachycardia. A ECG in resting condition can help distinguish different morphologies. Vagal manouvres or administration of adenosine can block the AV-conduction and reveal firing from the atrium, thereby clearly identifying the atrial source of the tachycardia. However sometimes only a electrophysiological study can differentiate between the different mechanisms of AT and localize the precise loacation or circuit of the AT. | ||
====Management:==== | ====Management:==== | ||
The treatment of choice for symptomatic AT is catheter ablation. In an experienced center up to 90% of the AT can be ablated. Vagal manoeuvres or adenosine can be effective in terminating focal AT. If AT persist DC cardioversion can be indicated. Recurrent episodes of AT can be prevented with anti-arrhythmic medication, for instance with beta-blockers or calcium antagonists. However not all AT are sensitive to medication and success rate of medication is usually low. | |||
===Atrial Flutter=== | ===Atrial Flutter=== | ||