Atrioventricular Reciprocating Tachycardia

Aka: Atrioventricular Reciprocating Tachycardia, Re-entrant Atrioventricular Tachycardia, AVRT, Orthodromic Atrioventricular Re-entrant Tachycardia, Orthodromic AVRT, Antidromic AVRT, Antidromic atrioventricular re-entrant tachycardia

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II. Definition

  1. Form of Supraventricular Tachycardia (30% of cases) with an accessory pathway (outside the AV node)

III. Epidemiology

  1. Most common in children (represents 60% of SVT cases in first decade of life)
  2. Decreasing Prevalence with age (represents 9% of SVT cases over age 70 years)

IV. Pathophysiology

  1. Accessory pathway between the atrium and the ventricle that bypasses the AV Node

V. Findings: General

  1. Heart Rate 160 to 240 (up to 256)

VI. Types: General

  1. Orthodromic, narrow complex (87% of cases)
    1. Signal passes anterograde down the AV node and retrograde up the accesory path
    2. Represents up to 87% of AVRT cases
    3. Retrograde P Waves appear after the QRS in I, II, III, aVF, V1 (may be obscured by T Wave)
  2. Antidromic, wide complex
    1. Signal passes retrograde up the AV node and anterograde down the accessory path
    2. RP interval <100 msec
    3. Wide QRS Complex

VII. Types: Variants

  1. Wolff-Parkinson-White Syndrome
    1. Anterograde conduction down the accessory path reaches the ventricle before the AV Nodal signal
    2. Results in preexcitation of the ventricle, forming a slurred upstroke of the QRS (delta wave)
  2. Permanent (or persistent) Junctional Reciprocating Tachycardia
    1. Slow retrograde conduction via the accessory pathway
    2. Results in sustained Supraventricular Tachycardia
    3. Risk of Tachycardia induced Cardiomyopathy and Congestive Heart Failure

VIII. Course

  1. May degenerate into Atrial Fibrillation

IX. References

  1. Joshi and Dermark (2016) Crit Dec Emerg Med 30(8):3-12
  2. Colucci (2010) Am Fam Physician 82(8): 942-52 [PubMed]
  3. Delacretaz (2006) N Engl J Med 354(10): 1039-51 [PubMed]
  4. Helton (2015) Am Fam Physician 92(9): 793-800 [PubMed]
  5. Kumar (2006) Cardiol Clin 24(3): 427-37 [PubMed]

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Related Studies

Ontology: Re-entrant atrioventricular tachycardia (C0340477)

Definition (NCI_CDISC) An electrocardiographic finding of a regular supraventricular tachycardia which utilizes an atrioventricular bypass tract as its retrograde limb (orthodromic tachycardia) or as its antegrade limb (antidromic tachycardia). QRS complexes during sinus rhythm may show preexcitation. During orthodromic tachycardia the preexcitation is not present and a retrograde P wave may appear after the QRS complex. During antidromic tachycardia the QRS complex is preexcited.
Definition (NCI) An electrocardiographic finding of a regular supraventricular tachycardia which utilizes an atrioventricular bypass tract as its retrograde limb (orthodromic tachycardia) or as its antegrade limb (antidromic tachycardia). QRS complexes during sinus rhythm may show preexcitation. During orthodromic tachycardia the preexcitation is not present and a retrograde P wave may appear after the QRS complex. During antidromic tachycardia the QRS complex is preexcited. (CDISC)
Concepts Disease or Syndrome (T047)
SnomedCT 233897008
English AVRT- AV re-entrant tachy, Re-entrant AV tachycardia, AV Reentrant Tachycardia, AV reentrant tachycardia, Atrioventricular Reentrant Tachycardia, Atrioventricular Reentrant Tachycardia by EKG Finding, AV re-entrant tachycardia, AV RE-ENTRANT TACHYCARDIA, Atrioventricular Reentrant Tachycardia by ECG Finding, AVRT - Atrioventricular re-entrant tachycardia, Re-entrant atrioventricular tachycardia, Re-entrant atrioventricular tachycardia (disorder)
Dutch AV-re-entry-tachycardie
French Tachycardie par réentrée AV
German AV Reentry-Tachykardie
Italian Tachicardia da rientro atrioventricolare
Portuguese Taquicardia AV reentrante
Spanish Taquicardia por reentrada AV, taquicardia auriculoventricular por reentrada (trastorno), taquicardia auriculoventricular por reentrada
Japanese 房室リエントリー性頻脈, ﾎﾞｳｼﾂﾘｴﾝﾄﾘｰｾｲﾋﾝﾐｬｸ
Czech AV reentry tachykardie
Hungarian AV reentry tachycardia
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Orthodromic atrioventricular re-entrant tachycardia (C0340478)

Concepts Disease or Syndrome (T047)
SnomedCT 233898003
English Orthodrom a/v re-entrant tachy, Orthodromic atrioventricular re-entrant tachycardia, Orthodromic atrioventricular re-entrant tachycardia (disorder)
Spanish taquicardia reentrante auriculoventricular ortodrómica (trastorno), taquicardia reentrante auriculoventricular ortodrómica
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Antidromic atrioventricular re-entrant tachycardia (C0340479)

Concepts Disease or Syndrome (T047)
SnomedCT 233899006
English Antidromic a/v re-ent tachy, Antidromic atrioventricular re-entrant tachycardia, Antidromic atrioventricular re-entrant tachycardia (disorder)
Spanish taquicardia auriculoventricular reentrante antidrómica (trastorno), taquicardia auriculoventricular reentrante antidrómica
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Electrocardiogram

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