【体外膜肺ECMO精品课件】 Supraventricular Tachycardia in Infancy and Childhood.pptVIP

下载本文档

1
0
约5.4千字
约 47页
2018-03-14 发布于天津
举报
版权申诉

【体外膜肺ECMO精品课件】 Supraventricular Tachycardia in Infancy and Childhood.ppt

1、原创力文档（book118）网站文档一经付费（服务费），不意味着购买了该文档的版权，仅供个人/单位学习、研究之用，不得用于商业用途，未经授权，严禁复制、发行、汇编、翻译或者网络传播等，侵权必究。。
2、本站所有内容均由合作方或网友上传，本站不对文档的完整性、权威性及其观点立场正确性做任何保证或承诺！文档内容仅供研究参考，付费前请自行鉴别。如您付费，意味着您自己接受本站规则且自行承担风险，本站不退款、不进行额外附加服务；查看《如何避免下载的几个坑》。如果您已付费下载过本站文档，您可以点击这里二次下载。
3、如文档侵犯商业秘密、侵犯著作权、侵犯人身权等，请点击“版权申诉”（推荐），也可以打举报电话：400-050-0827(电话支持时间：9:00-18:30)。
4、该文档为VIP文档，如果想要下载，成为VIP会员后，下载免费。
5、成为VIP后，下载本文档将扣除1次下载权益。下载后，不支持退款、换文档。如有疑问请联系我们。
6、成为VIP后，您将拥有八大权益，权益包括：VIP文档下载权益、阅读免打扰、文档格式转换、高级专利检索、专属身份标志、高级客服、多端互通、版权登记。
7、VIP文档为合作方或网友上传，每下载1次，网站将根据用户上传文档的质量评分、类型等，对文档贡献者给予高额补贴、流量扶持。如果你也想贡献VIP文档。上传文档

Reentrant rhythms – Wolff-Parkinson-White Syndrome Reentrant rhythms – Wolff-Parkinson-White Syndrome Clinical symptoms Palpitations SVT Note narrow QRS and lack of delta wave! Reentrant rhythms – Wolff-Parkinson-White Syndrome Sudden death(!) Atrial fibrillation Rapid conduction over bypass tract Ventricular fibrillation Risk 0.1-0.6% per year Reentrant rhythms – Wolff-Parkinson-White Syndrome Tx Tachycardia control Recognition ±Drugs (patient/family choice) Digoxin generally contraindicated Risk stratification Holter Exercise testing Invasive electrophysiology testing Catheter ablation Supraventricular Tachycardiain Infancy and Childhood Terrence Chun, MD Pediatric Electrophysiology and Pacing Cardiac electrical anatomy SVT - Overview Rapid rhythm that involves or is driven by structures in the upper heart Incidence up to 1:250 children Generally well-tolerated, even fast rates Risk of life-threatening arrhythmias is uncommon Narrow vs. Wide QRS Not all narrow QRS complex tachycardia is supraventricular tachycardia Not all wide QRS complex tachycardia is ventricular tachycardia SVT Mechanisms - Overview Reentrant rhythms Automatic rhythms SVT mechanisms –Automatic Rhythms Originate from a particular focus “Warm-up” and “cool-down” behavior Respond to drugs and maneuvers that affect myocardial automaticity May be suppressed by faster rates Usually do not respond to cardioversion (typically pause, then restart) SVT mechanisms –Automatic Rhythms Left atrial focus 2:1 AVN conduction SVT mechanisms –Reentrant rhythms Requires a “circuit” of tissue to create repetitive activation Must have appropriate conditions to perpetuate reentrant rhythm Usually abrupt onset and termination Regular, with little variation in rate Often will respond to cardioversion Diagnostic methods Record a rhythm strip ECG clues to diagnosis Wide vs. narrow complex Regular vs. irregular Abrupt vs. gradual P wave relationship to QRS Parade of Rhythms Automatic Arrhythmias Automatic