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Tachycardia: Difference between revisions
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* Antidrome AV re-entry tachycardia: This is a broad-complex tachycardia, where the broad QRS complex is followed by a retrograde P-wave originating from the AV-node. | * Antidrome AV re-entry tachycardia: This is a broad-complex tachycardia, where the broad QRS complex is followed by a retrograde P-wave originating from the AV-node. | ||
====Management:==== | ====Management:==== | ||
The circuit of the arrhythmia uses the AV node, therefore vagal maneuvers are able to terminate the AVRT. However adenosine should be used with care, as it may induce AF and cause 1:1 conduction. Anti-arrhythmic drugs (Class IC, II, III, IV) can be useful to prevent paroxysms of arrhythmia, and a pill-in-the-pocket approach can be used for patients with infrequent episodes. Catheter ablation can target the accessory pathway and destroy the bundle. The success of the procedure is dependent on the location of the bundle as not all anatomical positions are easily targeted with ablation. It is controversial if patients with an asymptomatic WPW ECG pattern should have an ablation. The characteristics of the bundle and the life-style\profession of the patient should guide treatment in these cases. | The circuit of the arrhythmia uses the AV node, therefore vagal maneuvers are able to terminate the AVRT. However adenosine should be used with care, as it may induce AF and cause 1:1 conduction. Anti-arrhythmic drugs (Class IC, II, III, IV) can be useful to prevent paroxysms of arrhythmia, and a pill-in-the-pocket approach can be used for patients with infrequent episodes. Catheter ablation can target the accessory pathway and destroy the bundle. The success of the procedure is dependent on the location of the bundle as not all anatomical positions are easily targeted with ablation. It is controversial if patients with an asymptomatic WPW ECG pattern and no co-morbidities should have an ablation. To determine the risk of 1:1 conduction, an exercise test can be performed to determine the response of the accessory bundle to an increased atria rate. If the pre-exitations persists an electrophysiological procedure can be performed to assess the conduction properties of the accessory bundle. The characteristics of the bundle and the life-style\profession of the patient should guide treatment in these cases.<cite>cohen</cite> | ||
==Ventricular tachycardia== | ==Ventricular tachycardia== | ||