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Tachycardia (Narrow)
From WikEM
Contents
Evaluation
| Differential | A.Rhythm | A.rate | A.morphology | Vagal/adenosine |
| A fib | Irregular | >350 | Fibrillatory (V1) | Incr. AV block |
| A Flutter | Regular | >250, <350 | Sawtooth (II, III, AVF) | Incr. AV block |
| A Tach | Regular | >100 | Neg in II, III, AVF | Nothing |
| AVNRT (SVT) | Regular | >160 | No p's | → NSR |
| Junctional | Regular | >100, <150 | No p's or retrograde p's | Nothing |
| MAT | Irregular | >100 | >3 p shapes | Transient slowing |
| Sinus | Regular |
>100 <180 |
Normal | Transient slowing |
Flutter vs coarse AFib: determine atrial regularity by taking big bites
Management
See also ACLS: Tachycardia
A fib/flutter
- Rate control: Dilt, MTP, Digoxin
- Dig usually only helpful when already with a block (e.g. 2:1)
- Cardioversion: Sotalol, electric
- See Atrial Fibrillation (RVR)
AVNRT (SVT)
- Vagal, adenosine, beta-blockers, calcium-channel blockers, dixogin, electric, procainamide, amio, sotalol
Junctional
Remove the cause, Amiodarone, beta-blockers, calcium-channel blockers
MAT
- Diltiazem
- Beta blockers often contraindicated (MAT occurs frequently with pulmonary disease)
