Av Junctional Tachycardia

From Anvita Health Wiki

Contents 1 Introduction 2 Etiology 3 Diagnostic-procedures 4 Management 5 More General Terms 6 References

Introduction

• A non paroxysmal condition with narrow complex & regular rhythm

• @ 60-130/min thought to arise from increased automaticity of the AV node.

Etiology

• myocardial infarction
• catecholamine excess
• digitalis toxicity
• post cardiac surgery
• rheumatic fever

Diagnostic-procedures

• electrocardiogram:

• atrial rate generally 60-130/min
• intact retrograde conduction

• p-waves

• inverted
• occur during or immediately after the QRS complex

• retrograde conduction block

• competitive AV dissociation
• normal p-waves non-conducted at a rate slower than ventricular rate

• ventricular rate 60-130/min

• QRS may be normal
• QRS may reflect bundle-branch block secondary to increased rate

Management

• arrhythmia generally resolves with correction of underlying precipitating factors

• discontinue offending pharmacologic agents
• exogenous catecholamines
• digitalis

• anti-arrhythmic agents

• phenytoin or lidocaine for digitalis toxicity
• beta blocker, Ca+2 channel blocker
• amiodarone is drug of choice is LCEF < 40%

• NO DC cardioversion
• K+ for digitalis toxicity
• Mg+2 supplementation
• atrial overdrive pacing in patients with hemodynamic compromise in setting of competitive AV dissociation
• catheter ablation

More General Terms

• AV junctional rhythm
• narrow complex tachycardia

References

1. Manual of Medical Therapeutics, 28th ed, Ewald & McKenzie (eds), Little, Brown & Co, Boston, 1995, pg 142
2. Saunders Manual of Medical Practice, Rakel (ed), WB Saunders, Philadelphia, 1996, pg 273
3. American Heart Association

AV junctional tachycardia