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Tachycardia: Difference between revisions
→AV Nodal Re-entry Tachycardia (AVNRT)
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Termination of acute episodes is possible by vagal manoeuvres (blowing on the wrist, carotid sinus massage) or medication (adenosine, verapamil, diltiazem). If manoeuvres or medication fails electrocardioversion can be performed. As in AT and AFT catheter ablation of the slow pathway is the preferred treatment of AVNRT. Electrophysiological studies can demonstrate dual AV-node physiology and evoke the arrhythmia in these patients. Success rate is high (up to 98%) and the risk of inducing AV-block is low (<0,5%). Patients which are unable to have an catheter ablation benefit from IC anti-arrhythmic drugs as these have an strong effect on the slow pathway. | Termination of acute episodes is possible by vagal manoeuvres (blowing on the wrist, carotid sinus massage) or medication (adenosine, verapamil, diltiazem). If manoeuvres or medication fails electrocardioversion can be performed. As in AT and AFT catheter ablation of the slow pathway is the preferred treatment of AVNRT. Electrophysiological studies can demonstrate dual AV-node physiology and evoke the arrhythmia in these patients. Success rate is high (up to 98%) and the risk of inducing AV-block is low (<0,5%). Patients which are unable to have an catheter ablation benefit from IC anti-arrhythmic drugs as these have an strong effect on the slow pathway. | ||
===AV | ===AV Re-entry Tachycardia (AVRT)=== | ||
====Pathophysiology:==== | ====Pathophysiology:==== | ||
AVRT are tachycardias with a re-entry circuit compromising the entire heart. Atria, AV-node, ventricle and an extra bundle are an essential part of this circuit. The pre-requisite of an AVRT is the existence of an extra bundle between the atria and ventricle. This bundle can bypass the AV-node. | AVRT are tachycardias with a re-entry circuit compromising the entire heart. Atria, AV-node, ventricle and an extra bundle are an essential part of this circuit. The pre-requisite of an AVRT is the existence of an extra bundle between the atria and ventricle. This bundle can bypass the AV-node. | ||