Narrow-complex tachycardia
Diagnosis
| 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
Treatment
A fib/flutter
- Rate control: Dilt, MTP, Digoxin
- Dig usually only helpful when already w/ a block (e.g. 2:1)
- Cardioversion: Sotalol, electric
AVNRT (SVT)
- Vagal, adenosine, BBs, CCBs, dixogin, electric, procainamide, amio, sotalol
Junctional
Remove the cause, Amiodarone, BBs, CCBs
MAT
- Dilt
- BBs often contraindicated (MAT occurs frequently w/ pulm dz)