Whinnett et al used a diagnostic tree to evaluate a patient with supraventricular tachycardia (SVT) and a narrow QRS. The authors are from St. Mary’s Hospital and the Imperial College Healthcare Trust in London.
Patient selection: supraventricular tachycardia with a narrow QRS complex (QRS < 120 millliseconds)
Parameters:
(1) regularity of heart rate
(2) P waves
(3) number of P waves versus QRS complexes
(4) shape of P waves
(5) RP interval
|
Heart Rate |
P waves |
P waves and QRS |
P wave shape |
RP interval |
Likely Diagnosis |
|
irregular |
NA |
NA |
NA |
NA |
AFib |
|
regular |
none seen |
NA |
NA |
NA |
AVNRT or AVRT |
|
regular |
visible |
more P than QRS |
saw-tooth |
NA |
AFlut |
|
regular |
visible |
more P than QRS |
clearly defined |
NA |
AT |
|
regular |
visible |
QRS for each P |
NA |
short |
AVNRT or AVRT |
|
regular |
visible |
QRS for each P |
NA |
long |
AT, ST, rarely atypical AVNRT or atypical AVRT |
AFib = atrial fibrillation
AVNRT = atrioventricular nodal re-entry tachycardia
AVRT = atrioventricular re-entry tachycardia (includes Wolff-Parkinson-White syndrome)
AFlut = atrial flutter
AT = atrial tachycardia
ST = sinus tachycardia
Specialty: Cardiology
ICD-10: ,
