User:Mr. Ibrahem/Atrioventricular reentrant tachycardia
| Atrioventricular reentrant tachycardia | |
|---|---|
| Other names | Atrioventricular reciprocating tachycardia, atrioventricular reentry tachycardia |
 | |
| Conduction pathway in atrioventricular reentrant tachycardia, a form of supraventricular tachycardia | |
| Specialty | Cardiology |
| Symptoms | Palpitations, lightheadedness, chest discomfort[1][2] |
| Usual onset | Sudden[1] |
| Duration | Episodic[1] |
| Types | Orthodromic (90%), antidromic (10%)[2] |
| Causes | Wolff–Parkinson–White syndrome[2] |
| Risk factors | Genetics[3] |
| Diagnostic method | Electrocardiogram (ECG)[2] |
| Differential diagnosis | Orthodromic: AVNRT, sinus tachycardia, atrial flutter[2] Antidromic: Ventricular tachycardia[2] |
| Treatment | Vagal maneuvers, adenosine, procainamide, electrical cardioversion, ablation[2] |
| Frequency | Uncommon[2] |
Atrioventricular reentrant tachycardia (AVRT), is a type of abnormal fast heart rhythm.[4] Symptoms may include episodes of palpitations, lightheadedness, and chest discomfort.[1][2] Onset is generally sudden with a heart rate of 150 to 250 beats per minute.[1][2] Complications are rare.[2] It is a type of paroxysmal supraventricular tachycardia (PSVT).[1]
Causes include Wolff–Parkinson–White syndrome (WPW).[2] The underlying mechanism involves an accessory pathway which allows electrical signals to travel between the upper and lower chambers of the heart, outside the AV node.[2] There are two types: orthodromic in which the signal travels through the accessory pathway from the ventricle to the atria and the QRS complex is generally narrow; and antidromic in which the signal travels from the atria to the ventricle and the QRS complex is wide.[1] Permanent junctional reentrant tachycardia (PJRT) is a type of orthodromic AVRT.[1]
Initial treatment, in those who are otherwise stable, is often with vagal maneuvers.[2] If this is not effective adenosine may be used.[1] Other measures may include verapamil, procainamide, or beta blockers.[2] If this is not effective or the person is unstable electrical cardioversion may be carried out.[1] Recurrent attacks may be prevented with radiofrequency ablation.[4] In those who cannot have ablation flecainide may be used.[2]
AVRT is uncommon, affecting less than 1 % of people.[2] While about 0.2% of people have WPW on their ECG, not all develop a fast heart rate such as AVRT.[1] It is the second most common type of PSVT after AV nodal reentrant tachycardia (AVNRT).[4] Onset is often around the age of 9 to 37.[1] While an accessory pathway was first described in 1893 by Stanley Kent, symptomatic cases were not described until 1930 by Louis Wolff, John Parkinson, and Paul Dudley White.[3]
References[edit]
- ^ a b c d e f g h i j k l Page, Richard L.; Joglar, José A.; Caldwell, Mary A.; Calkins, Hugh; Conti, Jamie B.; Deal, Barbara J.; Estes, N. A. Mark; Field, Michael E.; Goldberger, Zachary D. (May 2016). "2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society". Journal of the American College of Cardiology. 67 (13): e27–e115. doi:10.1016/j.jacc.2015.08.856. ISSN 1558-3597. PMID 26409259.
- ^ a b c d e f g h i j k l m n o p q Jabbour, F; Grossman, SA (January 2020). "Atrioventricular Reciprocating Tachycardia". PMID 30969587.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b Tsiperfal, Angela; Ottoboni, Linda K.; Beheiry, Salwa; Al-Ahmad, Amin; Natale, Andrea; Wang, Paul J. (2011). Cardiac Arrhythmia Management: A Practical Guide for Nurses and Allied Professionals. John Wiley & Sons. p. 59. ISBN 978-0-470-95932-9. Archived from the original on 2021-08-27. Retrieved 2021-02-09.
- ^ a b c Helton, MR (1 November 2015). "Diagnosis and Management of Common Types of Supraventricular Tachycardia". American family physician. 92 (9): 793–800. PMID 26554472.