Pediatric Advance Life Support: SVT Part 3

Evaluate Rhythm

·         Obtain 12 lead EKG

·         Determine if QRS complex is ≥0.12 second

·         Determine treatment options.

Note:  Stable patients may await expert consultation because treatment has the potential for harm

Narrow Complex Tachycardias

·         Atrial flutter

·         AV nodal reentry

·         Accessory pathway–mediated tachycardia

·         Atrial tachycardia (including automatic and reentry forms)

·         Multifocal atrial tachycardia (MAT)

·         Junctional tachycardia (rare in adults)

Note:  Irregular narrow-complex tachycardias are likely MAT or a variable atrial flutter 

Atrial flutter

Junctional tachycardia

Atrial Tachycardia

 Wide Complex Tachycardias

·         Ventricular tachycardia (VT)

·         SVT with aberrancy

·         Pre-excited tachycardias (Wolff-Parkinson-White [WPW] syndrome)

Note:  Because ACLS providers may be unable to distinguish between supraventricular and ventricular rhythms, they should be aware that most wide-complex (broad-complex) tachycardias are ventricular in origin.

Ventricular tachycardia

Wide Complex Tachycardia