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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.
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 ]
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]
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]
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]
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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]