Recognition and Management of Supraventricular Arrhythmias and Atrial Fibrillation in the Acute Setting

Author:

Karcıoğlu Özgür

Abstract

Supraventricular tachycardia (SVT) is a type of tachyarrhythmia with a narrow QRS complex and regular rhythm. These patients are often symptomatic and present to the emergency department (ED) due to acute attacks called paroxysmal SVT. Attacks of SVT start suddenly with the reentry mechanism in most patients. Anginal chest pain and dyspnea occur in patients due to tachycardia. Vagal manoeuvers and adenosine is the treatments of choice for termination of SVT. In multifocal atrial tachycardia (MAT), at least three different P wave morphologies are observed in the ECG, along with variable PP, PR and RR intervals. Treatment is to correct the underlying disease. Patients with atrial flutter (AFl) tend to come to the ED with unstable findings. Atrial fibrillation (AF) is the term used to define the inactive ‘worm bag-like’ oscillations of the atria, with an absence of true atrium contraction. Ruling out atrial or ventricular thrombi with echocardiography is important to avoid embolization. Priority should be given to hemodynamic stability and the determination of factors triggering the underlying disease. IV beta-blocker and diltiazem can be used for rate control in AF with rapid ventricular response.

Publisher

IntechOpen

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