PHRM 211 Lecture Notes - Lecture 28: Av Nodal Reentrant Tachycardia, Atrioventricular Node, Cardiac Arrhythmia
Document Summary
Management is based on non-drug, supportive measures, pharmacological and/or electrical intervention. Pts with severe signs and symptoms emergently cardioverted. Re-entrant arrhythmia entirely within av node or within node and accessory pathway. 90% are within the av node av nodal reentrant tachycardia (avnrt) with narrow complex qrs. Most cost-effective long-term treatment: av node ablation (destroy tissue pathway) Adenosine diagnose afl, convert psvt to nsr. Mechanism sa/av nodes to diagnose afl/convert psvt. 6 mg iv over 1-2 secs (flush with 20cc ns), repeat with 12 mg in 1-2 mins if no response, can repeat x 12 mg more dose to total 30 mg. Avoid in 2/3 degree heart block or sss, asthma is a relative contraindication. Monitor ecg for flutter waves or non-conducted p wave, period of asystole. Lightheadedness, dizziness, flushing, tingling, numbness, chest pain/pressure, transient sob, bradycardia. Definition : an irregularly, irregular supraventricular arrhythmia (atrial rates of 350-450 bpm) Ecg findings : no p waves, irregular, narrow qrs.
