Stopping digoxin medication is sufficient in patients using the drug. Management of all other patients follows the management for atrial fibrillation and atrial flutter (refer to these articles). Ischemic heart disease (coronary artery disease).Lung disease (COPD, pulmonary hypertension, etc).Causes of ectopic atrial tachycardia and ectopic atrial rhythm Refer to ECG examples in Figure 1, 2 and 3 below. The ventricular rate is regular, ranging between 100 and 250 beats per minute in atrial tachycardia, and less than 100 beats per minute in atrial rhythm.AV block is unusual unless the patient is treated with digoxin. All P-waves are followed by QRS complexes.The isoelectric line (baseline) does not have a saw-tooth pattern, which it does during atrial flutter.If the P-waves are positive in lead II, it is usually necessary to compare the P-wave contour during tachycardia with the P-waves during sinus rhythm. If the P-waves in lead II are retrograde (negative), the diagnosis is simple because sinus P-waves can never be negative in lead II. A regular rhythm with P-waves that differ (in terms of contour/appearance) from the sinus P-waves.The ECG in ectopic atrial rhythm and atrial tachycardia Note that the term “ectopic” is often dropped when referring to these arrhythmias. These embryological remnants may have very high automaticity. As for any other long-standing tachycardia, there is a risk of developing tachycardia-induced cardiomyopathy.Ĭhildren may be affected by a special type of atrial tachycardia caused by embryological rests in the atria. In most cases it is self-terminating, but it may recur and in some cases persist for longer periods. Atrial tachycardia is characterized by occurring in short and rapid bursts. The tachycardia starts abruptly, although it sometimes has an initial warm-up period of 5 to 10 seconds. Presence of lung disease, use of theophyllamine, and catecholamines may induce atrial tachycardia. If the ventricular rate is lower, then it is classified as ectopic atrial rhythm.Įctopic atrial tachycardia primarily affects individuals with heart disease but it occasionally occurs in otherwise healthy individuals. The atrial rate ranges from 120 to 250 beats per minute. Note that the ventricular rate must exceed 100 beats per minute for it to be classified as ectopic atrial tachycardia. This is due to abnormal automaticity or re-entry (triggered activity is much less common) taking place in the ectopic focus. Atrial rhythms: ectopic atrial rhythm, atrial tachycardia and multifocal atrial tachycardiaĮctopic atrial tachycardia (or simply atrial tachycardia) occur when an ectopic focus in one of the atria discharges impulses at a higher rate than the sinoatrial node.
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