Back to the basic stuff (case discussion)

[WheezyBaby]

Indeed, although the baseline rate could also be a problem if he converts with amio as well. With this pt best not to do anything too provocative pharmocologically until the pads are on and you have pacing and cardioversion capability.

Agreed

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[PTPoeny]

That being said, I don’t eff with heart blocks or ventricular arrhythmias; that can quickly become a crisis. TBH, don’t see as many SVTs, so not sure how they progress. Do they stay stable like afib pts or deteriorate to more lethal arrhythmias? Also, I’m more used to seeing SVT with HR 200s. HR <150s I usually think more atrial arrhythmias. What do y’all think?

I agree with you that this is the terminology that I am used to using, but I think there is a lot of variability as to what rhythms people are including in "SVT" in this thread. There are lots of tachycardias that originate above the ventricle, but I'm used to only using the name SVT for AVRT/AVNRT. These generally have rates well over 200. Everything else gets an actual name by custom where I trained, but clearly other places use SVT to refer to a larger variety of rhythms.

 

[WheezyBaby]

I agree with you that this is the terminology that I am used to using, but I think there is a lot of variability as to what rhythms people are including in "SVT" in this thread. There are lots of tachycardias that originate above the ventricle, but I'm used to only using the name SVT for AVRT/AVNRT. These generally have rates well over 200. Everything else gets an actual name by custom where I trained, but clearly other places use SVT to refer to a larger variety of rhythms.

Yea I hate the term SVT. I associate the same pathology with the term as you do, but it's not really right. The only other thing I'd say as far as AVRT/AVNRT go is the rate can be significantly lower than that, like 120-140. Its not hard and fast by any means, but generally I expect faster rates in younger patients. I imagine conduction through the accessory pathway degrades with age just like physiologic conduction pathways but I'm not an EP.

 

[Ready_User_1]

I really like these threads... I hope they continue.