Narrow QRS complex tachycardia is a common dysrhythmia in Emergency Medicine practice. Diagnosis and mechanism often can be made by 12-lead electrocardiographic (EKG) analysis but may subsequently require electrophysiologic testing. The clinical manifestations are varied and dependent upon heart rate, prior cardiac disease, and general physiologic status. Patient management is directed towards the etiology and mechanism of the dysrhythmia and includes vagal maneuvers, pharmacologic therapy, and cardioversion. Hemodynamically compromised patients must be promptly treated. Patients are often admitted to the hospital but selected patients can be safely discharged from the Emergency Department for outpatient evaluation and management. Pediatric and pregnant patients are, in general, treated the same as adults. Several case examples and EKGs are presented.
aDepartment of Emergency Medicine, York Hospital, York, Pennsylvania, USA
bDepartment of Emergency Medicine, University of Virginia Health Sciences Center, Charlottesville, Virginia, USA
cDepartment of Emergency Medicine, University of California San Diego Medical Center, San Diego, California, USA
Reprint Address: Marc L. Pollack, MD, PhD, Department of Emergency Medicine, York Hospital, 1001 South George Street, York, PA 17405, USA
☆Selected Topics: Cardiology Commentary is coordinated by Theodore Chan, MD, of the University of California San Diego Medical Center, San Diego, California and William Brady, MD, of the University of Virginia, Charlottesville, Virginia.
ABSTRACT