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Unstable tachyarrhythmia is treated with synchronized cardioversion - initially 0.5-1 J/kg but can increase to 2 J/kg if smaller dose is not working. Stable tachyarrhythmia treatment is subcategorized based on narrow QRS vs. wide QRS. If narrow QRS/ SVT, perform vagal maneuvers and give adenosine.
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]
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]
Paroxysmal tachycardia is a form of tachycardia which begins and ends in an acute (or paroxysmal) manner. It is also known as Bouveret-Hoffmann syndrome. [1] [2] [3]
An idioventricular rhythm is a cardiac rhythm characterized by a rate of <50 beats per minute (bpm), absence of conducted P waves and widening of the QRS complex. [1] In cases where the heart rate is between 50 and 110 bpm, it is known as accelerated idioventricular rhythm and ventricular tachycardia if the rate exceeds 120 bpm.
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]
Precordial thump is a medical procedure used in the treatment of ventricular fibrillation or pulseless ventricular tachycardia under certain conditions. The procedure has a very low success rate, but may be used in those with witnessed, monitored onset of one of the "shockable" cardiac rhythms if a defibrillator is not immediately available.
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