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The management of tachycardia depends on its type (wide complex versus narrow complex), whether or not the person is stable or unstable, and whether the instability is due to the tachycardia. [10] Unstable means that either important organ functions are affected or cardiac arrest is about to occur. [ 10 ]
Junctional ectopic tachycardia (JET) is a rare tachycardia caused by increased automaticity of the AV node itself initiating frequent heartbeats. On the ECG, junctional tachycardia often presents with abnormal morphology P-waves that may fall anywhere in relation to a regular, narrow QRS complex. It is often due to drug toxicity. [22]
T-wave alternans and prolonged QT interval in a male patient found to be in a narrow-complex tachycardia and ruled in for an acute myocardial infarction.Administered Ibutilide and converted to sinus rhythm but subsequently had an episode of Torsades de Pointes which required DC cardioversion back into sinus rhythm.
WPW pattern with hemodynamically stability and orthodromic AVRT leading to a regular narrow complex tachycardia may be managed similarly to other regular narrow complex supraventricular tachycardias: first with vagal maneuvers followed by a trial of adenosine (first-line therapy).
Otherwise synchronized cardioversion is the treatment. [4] Future episodes can be prevented by catheter ablation. [3] About 2.3 per 1000 people have paroxysmal supraventricular tachycardia. [5] Problems typically begin in those 12 to 45 years old. [3] [5] Women are more often affected than men. [3]
Inappropriate sinus tachycardia, defined as 24-hour average HR > 90 bpm and HR > 100 bpm in a supine or sitting position, has a prevalence of 1.16% in the general population. [20] The epidemiology of Inappropriate sinus tachycardia is not well understood. IST can occur at any age, but it is most common in adolescents and young adults. [2]
[1] [5] [6] Treatment of TIC can involve treating the heart failure as well as the tachycardia or arrhythmia. [1] TIC has a good prognosis with treatment, with most people recovering some to all of their heart function. [1] The number of cases that occur is unclear. [5] TIC has been reported in all age groups. [6]
The electrocardiogram (ECG) would appear as a narrow-complex SVT. Between episodes of tachycardia the affected person is likely to be asymptomatic; however, the ECG would demonstrate the classic delta wave in Wolff–Parkinson–White syndrome. [2]
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