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Paroxysmal supraventricular tachycardia

Paroxysmal supraventricular tachycardia

Definition
The term designates a group of various cardiac arrhythmias. They all share an unreasonably rapid pulse of more than 100 beats per minute and an origin of the arrhythmia above the ventricles. It mostly affects younger patients, women more often than men.

AV nodal reentrant tachycardia

Definition
Awesome attack occurring supraventricular tachycardia (ie, from atrial outgoing accelerated heart rates), the origin of the AV node. Additional trigger from the atrium to the chamber reaching (atrioventricular) conduction pathways be (also called Kent bundles). In addition to several rare forms is the most common representative of the AV nodal reentrant tachycardia, the Wolff-Parkinson-White (WPW) syndrome. However, there are just as forms in which no additional conduction paths are found, but generally, the AV node itself is equipped with abnormal conduction properties. The majority of patients are healthy and have no underlying heart disease.




Symptoms of tachycardia
Awesome attack occurred during the tachycardia occurring tachycardia, in which a regular pulse is palpable, and which ends as quickly as it began. The attacks can last minutes to hours. After the phases can cause a sudden urge to urinate and a Harnflut. In otherwise healthy patients usually come to no other symptoms. In pre-heart failure (heart failure), however, there may be a critical limitation of the pumping function of chest pain (angina pectoris), and dizziness to syncope (fainting).

Cause
Cause of the tachycardia are congenital anomalies of the conduction system of the heart. Prerequisite is the existence of two mutually insulated from electrical pathways between the atrium and ventricle. Normally, the only compound of the AV node.
So either there is an additional line bundle (bundle of Kent) or the AV node itself is split almost in half and takes two isolated pathways. In general, the pathways differ in the speed with which they can derive the potentials of the sinus node (the one is slower, the other faster). As a result, emotions circulate, i.e. which led to the faster train potential fall almost back into the slower beam and walk back to the AV node, where they are re-routed via the faster bunch more in the wrong direction.

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Tachycardia diagnosis
Secured the diagnosis of tachycardia on an ECG or Holter monitoring. In the classical WPW syndrome on ECG is called a delta wave visible symptom-free even at the time. Otherwise, only a diagnosis of possible attack, it looks like a regular acceleration of heart rate above 100 beats per minute with narrow QRS complexes.

Therapy
When circulation was stable patients may be tried by the attacks of facial immersion in cold water to stop or by a Valsalva-press test (deep inhalation and then pressed with mouth closed). It does not succeed to stop the seizures have a drug therapy can begin. Medium of choice is adenosine, which triggers a short-term blocking of AV conduction.

A maintenance treatment is useful when the tachycardia occur frequently, and not by the patient as may be terminated by a Valsalva maneuver press, and is thus a substantial reduction in quality of life by the symptoms. Catheter ablation therapy of choice is a one of the two pathways. There are additional pathways (Kent bundle) should be done in any case, a catheter

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