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Pathology
Abnormal heart rhythm arising from improper electrical activity in the atria
These are divided into 2 groups
Atrioventricular nodal re-entrant tachycardia (AVNRT)
Atrioventricular re-entrant tachycardia (AVRT)
Aetiology
AVNRT: Extra pathway within or close to the AV node, usually presents in late
teens, can be precipitated by stress, emotion, exertion, caffeine, alcohol,
hyperthyroidism and electrolyte abnormalities
AVRT: Accessory pathway between atria and ventricles (Wolff-Parkinson-White)
Signs
Rapid regular pulse, hypotension in some casesRefvis
Symptoms
Regular palpitations sometimes radiating into neck and ears, dizziness, syncope
Investigations
ECG: narrow complex tachycardia at approximately 200beats per minute
Echo: To assess for structural abnormality
Treatment
Vagal manoeuvres e.g. Valsalva, carotid sinus massage, ice cold drink
IV adenosine (transiently blocks the AV node)
DCCV
Accessory pathway ablation
Prognosis
Sudden death in Wolff-Parkinson White Syndrome occurs in approximately 0.4%
of patients however if patients are symptomatic the risk is increased therefore ablation of the accessory pathway is the treatment of choice
Excellent when treated
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