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Narrow Complex TachycardiaAka: Supraventricular Tachycardia, Atrial Tachycardia, Multifocal Atrial Tachycardia, Paroxysmal Supraventricular Tachycardia, PSVT

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  1. See Also
    1. Guidelines 2000 CPR and Emergency Cardiovascular Care
    2. Unstable Tachycardia
    3. Sinus Tachycardia
    4. Atrial Fibrillation
    5. Wide Complex Tachycardia
  2. Causes (Mnemonic: 4H 4T P)
    1. Hypoxemia
    2. Hypovolemia
    3. Hyperthermia
    4. Hyperkalemia or Hypokalemia
    5. Tamponade (Cardiac Tamponade)
    6. Tension Pneumothorax
    7. Toxins, medications and drugs
      1. Caffeine
      2. Tobacco
      3. Alcohol
      4. Pseudophedrine
    8. Thromboembolism
    9. Pain or Stress
  3. Types: Narrow complex tachycardia
    1. Sinus Tachycardia
    2. Supraventricular Tachycardia
      1. Atrial Fibrillation (irregular)
      2. Atrial flutter (regular)
      3. Paroxysmal Supraventricular tachycardia (regular)
        1. Atrioventricular nodal reentry (most common)
          1. Starts with PAC passed down slow accesory path
          2. Signal travels retrograde up fast path
          3. Signal cycles back down slow accesory pathway
          4. Heart Rate of 160 to 190 with no P Waves seen
        2. Accessory pathway (e.g. Wolff-Parkinson-White)
          1. Heart Rate 160 to 240
          2. Delta waves not seen (normal pathway used)
        3. Increased automaticity
          1. Results in multifocal atrial tachycardia
          2. Heart Rate 130 to 180
          3. Causes: enlarged atrium
            1. Chronic lung disease
            2. Congestive Heart Failure
          4. Causes: other
            1. Electrolyte abnormalities
            2. Acid-base disturbance
  4. Signs
    1. Sinus Tachycardia
      1. P Waves present and normal
      2. Variable R-R with constant PR interval
      3. Rate lower than PSVT
        1. Infants < 220
        2. Children < 180
        3. Adults < 160
    2. Supraventricular Tachycardia
      1. P Waves absent or abnormal
      2. Abrupt rate change
      3. Rate higher than Sinus Tachycardia
        1. Infants > 220
        2. Children > 180
        3. Adults > 160
  5. Management: Stable Patients
    1. New emphasis on use of one Antiarrhythmic
      1. Contrast to prior Antiarrhythmic soups
      2. Pro-arrhythmic effects increase with poly-drugs
    2. Supraventricular Tachycardia Management in the Adult
    3. Supraventricular Tachycardia Management in the Child
  6. Management: Unstable Patients
    1. See Unstable Tachycardia
  7. References
    1. Hebbar (2002) Am Fam Physician 65(12):2479
    2. (2000) Circulation, 102(Suppl I):86-9
    3. http://www.circulationaha.org

Paroxysmal supraventricular tachycardia (C0030590)

Definition (NCI)An episodic form of supraventricular tachycardia, with abrupt onset and termination.
ConceptsDisease or Syndrome (T047)
ICD9427.0
EnglishPAROX ATRIAL TACHYCARDIA, Paroxysmal sup. tachy., Paroxysmal supraventricular tachycardia, Supravent. tach. parox., Tachycardia - parox.sup
Spanishtaquicardia supraventricular paroxistica
Parent Conceptscardiac arrhythmia (C0003811), Tachycardia, Paroxysmal (C0039236), Supraventricular tachycardia (C0039240), Paroxysmal supraventricular tachycardia (C0030590)
SourcesCCS, DXP, ICD9CM, MTH, NCI, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Supraventricular tachycardia (C0039240)

Definition (MSH)A generic expression for any tachycardia that originates above the BUNDLE OF HIS.
ConceptsDisease or Syndrome (T047)
MSHD013617
EnglishSupraventricular tachycardia, Supraventricular Tachycardias, SVT, SVT - Supraventricular tachycardia, TACHYCARDIA SUPRAVENTRICULAR
Spanishtaquicardia supraventricular
Parent Conceptscardiac arrhythmia (C0003811), Tachycardia (C0039231), Supraventricular arrhythmia (C0428974), Supraventricular tachycardia (C0039240), Tachyarrhythmia (C0080203)
SourcesCOSTAR, CST, DXP, MSH, MTH, NCI, NDFRT, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Multifocal atrial tachycardia (C0221158)

ConceptsDisease or Syndrome (T047)
EnglishMultifocal atrial tachycardia
Spanishtaquicardia auricular multifocal
Parent ConceptsAtrial Premature Complexes (C0033036), Atrial tachycardia (C0546959)
SourcesCOSTAR, DXP, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Atrial tachycardia (C0546959)

Definition (NCI)Any rapid heart rhythm originating in the atria. Atrial fibrillation and atrial flutter are varieties of atrial tachycardia.
ConceptsPathologic Function (T046)
EnglishAtrial tachycardia, TACHYCARDIA ATRIAL
Spanishtaquicardia auricular
Parent ConceptsSupraventricular tachycardia (C0039240), Atrial arrhythmia (C0085611), Ambiguous concept (C1274012)
SourcesCST, NCI, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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