房室回帰頻拍
WordNet
- abnormally rapid heartbeat (over 100 beats per minute)
- relating to or affecting the atria and ventricles of the heart; "atrioventricular disease" (同)auriculoventricular
PrepTutorEJDIC
- 心拍急速(心臓の異常に速い拍動) 頻拍 頻脈
Wikipedia preview
出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/09/03 22:32:30」(JST)
[Wiki en表示]
Not to be confused with AV nodal reentrant tachycardia.
| Atrioventricular reentrant tachycardia |
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Conduction pathway in atrioventricular reentrant tachycardia, a form of supraventricular tachycardia
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| Classification and external resources |
| Specialty |
cardiology |
| ICD-10 |
I47.1 |
| ICD-9-CM |
427.89, 427.0 |
| MeSH |
D013617 |
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[edit on Wikidata]
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Atrioventricular reentrant tachycardia, atrioventricular reciprocating tachycardia or AVRT, is a supraventricular tachycardia (SVT) most commonly associated with Wolff-Parkinson-White syndrome, in which an accessory pathway allows electrical signal from the ventricles to enter the atria and cause premature contraction and repeat stimulation of the atrioventricular node.[1]
Contents
- 1 Signs and symptoms
- 2 Pathophysiology
- 3 Treatment
- 4 See also
- 5 References
Signs and symptoms
12 lead electrocardiogram of an individual with Wolff–Parkinson–White syndrome exhibiting 'slurred upstrokes' or 'delta waves' before the QRS complexes
An episode of SVT may present with palpitations, dizziness, shortness of breath, or syncope. The electrocardiogram would appear as a narrow-complex SVT. Between episodes of tachycardia the patient is likely to be asymptomatic, however the electrocardiogram would demonstrate the classic delta wave in Wolff–Parkinson–White syndrome.[2]
Pathophysiology
Two distinct pathways are involved: the normal atrioventricular conduction system, and an accessory pathway. During AVRT, electrical signal passes in the normal manner from the AV node into the ventricles. It then, pathologically, passes back into the atria via the accessory pathway, causing atrial contraction, and returns to the AV node to complete the reentrant circuit; see figure. Once initiated, the cycle may continue causing an episode of tachycardia.
Initiation of the tachycardia may be through a premature impulse of atrial, junctional, or ventricular origin.[3]
Treatment
Acute management is as for SVT in general. The aim is to interrupt the circuit. In the shocked patient, DC cardioversion may be necessary. In the absence of shock, inhibition at the AV node is attempted. This is achieved first by a trial of vagal maneuvers, then if this fails using intravenous adenosine;[4] the latter causes complete electrical blockade at the AV node. Long-term management includes beta blocker therapy and radiofrequency ablation of the accessory pathway.
See also
- AV nodal reentrant tachycardia
- Electrical conduction system of the heart
- Wolff-Parkinson-White syndrome
References
- ^ Josephson ME. Preexcitation syndromes. In: Clinical Cardiac Electrophysiology, 4th, Lippincot Williams & Wilkins, Philadelphia 2008. p.339
- ^ Hampton J. The ECG Made Easy. Elsevier 2008
- ^ UpToDate: Atrioventricular reentrant tachycardia (AVRT) associated with an accessory pathway
- ^ UK Resuscitation Council. Adult tachycardia algorithm. 2010.
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Cardiovascular disease I00–I52, 390–429
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| Ischaemic |
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Coronary disease
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- Coronary artery disease (CAD)
- Coronary artery aneurysm
- Coronary artery dissection
- Coronary thrombosis
- Coronary vasospasm
- Myocardial bridge
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Active ischemia
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- Angina pectoris
- Prinzmetal's angina
- Stable angina
- Acute coronary syndrome
- Myocardial infarction
- Unstable angina
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Sequelae
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- hours
- Hibernating myocardium
- Myocardial stunning
- days
- weeks
- Aneurysm of heart / Ventricular aneurysm
- Dressler syndrome
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| Layers |
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Pericardium
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- Pericarditis
- Acute
- Chronic / Constrictive
- Pericardial effusion
- Cardiac tamponade
- Hemopericardium
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Myocardium
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- Myocarditis
- Cardiomyopathy: Dilated (Alcoholic), Hypertrophic, and Restrictive
- Loeffler endocarditis
- Cardiac amyloidosis
- Endocardial fibroelastosis
- Arrhythmogenic right ventricular dysplasia
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Endocardium /
valves
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Endocarditis
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- infective endocarditis
- Subacute bacterial endocarditis
- non-infective endocarditis
- Libman–Sacks endocarditis
- Nonbacterial thrombotic endocarditis
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Valves
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- mitral
- regurgitation
- prolapse
- stenosis
- aortic
- tricuspid
- pulmonary
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Conduction /
arrhythmia |
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Bradycardia
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- Sinus bradycardia
- Sick sinus syndrome
- Heart block: Sinoatrial
- AV
- Intraventricular
- Bundle branch block
- Right
- Left
- Left anterior fascicle
- Left posterior fascicle
- Bifascicular
- Trifascicular
- Adams–Stokes syndrome
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Tachycardia
(paroxysmal and sinus)
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Supraventricular
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- Atrial
- Junctional
- AV nodal reentrant
- Junctional ectopic
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Ventricular
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- Accelerated idioventricular rhythm
- Catecholaminergic polymorphic
- Torsades de pointes
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Premature contraction
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- Atrial
- Junctional
- Ventricular
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Pre-excitation syndrome
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- Lown–Ganong–Levine
- Wolff–Parkinson–White
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Flutter / fibrillation
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- Atrial flutter
- Ventricular flutter
- Atrial fibrillation
- Ventricular fibrillation
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Pacemaker
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- Ectopic pacemaker / Ectopic beat
- Multifocal atrial tachycardia
- Pacemaker syndrome
- Parasystole
- Wandering pacemaker
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Long QT syndrome
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- Andersen–Tawil
- Jervell and Lange-Nielsen
- Romano–Ward
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Cardiac arrest
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- Sudden cardiac death
- Asystole
- Pulseless electrical activity
- Sinoatrial arrest
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Other / ungrouped
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- hexaxial reference system
- Right axis deviation
- Left axis deviation
- QT
- T
- ST
- Osborn wave
- ST elevation
- ST depression
- Strain pattern
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| Cardiomegaly |
- Ventricular hypertrophy
- Left
- Right / Cor pulmonale
- Atrial enlargement
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| Other |
- Cardiac fibrosis
- Heart failure
- Diastolic heart failure
- Cardiac asthma
- Rheumatic fever
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UpToDate Contents
全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.
English Journal
- Supraventricular Tachycardia Termination After Atrial Non-Capture: What is the Mechanism?
- Dewland TA, Scheinman MM, Marcus GM.SourceDivision of Cardiology, Section of Electrophysiology, University of California, San Francisco.
- Heart rhythm : the official journal of the Heart Rhythm Society.Heart Rhythm.2013 Sep 25. pii: S1547-5271(13)01076-X. doi: 10.1016/j.hrthm.2013.09.066. [Epub ahead of print]
- PMID 24076447
- Permanent junctional reciprocating tachycardia in a dog.
- Santilli RA, Santos LF, Perego M.SourceClinica Veterinaria Malpensa, Viale Marconi 27, 21017 Samarate, Varese, Italy. Electronic address: r.santilli@ecgontheweb.com.
- Journal of veterinary cardiology : the official journal of the European Society of Veterinary Cardiology.J Vet Cardiol.2013 Sep;15(3):225-30. doi: 10.1016/j.jvc.2013.06.002. Epub 2013 Aug 17.
- A 5-year-old male English Bulldog was presented with a 1-year history of paroxysmal supraventricular tachycardia (SVT) partially responsive to amiodarone. At admission the surface ECG showed sustained runs of a narrow QRS complex tachycardia, with a ventricular cycle length (R-R interval) of 260 ms
- PMID 23962684
- Prevalence, risk, and benefits of radiofrequency catheter ablation at the aortic cusp for the treatment of mid to anteroseptal supra-ventricular tachyarrhythmias.
- Park J, Wi J, Joung B, Lee MH, Kim YH, Hwang C, Pak HN.SourceYonsei University Health System, Seoul, Republic of Korea.
- International journal of cardiology.Int J Cardiol.2013 Aug 10;167(3):981-6. doi: 10.1016/j.ijcard.2012.03.082. Epub 2012 Mar 28.
- BACKGROUND: Some outflow tract ventricular tachycardias (VTs) are known to be successfully ablated from the aortic cusp (AC). However, radiofrequency catheter ablation (RFCA) at the AC for the treatment of supraventricular tachyarrhythmia (SVT) has limited experience.METHODS: We performed RFCA at th
- PMID 22459399
Japanese Journal
- Effects of Landiolol Hydrochloride on Intractable Tachyarrhythmia After Pediatric Cardiac Surgery
- Tokunaga Chiho,Hiramatsu Yuji,Kanemoto Shinya,Takahashi-Igari Miho,Abe Masakazu,Horigome Hitoshi,Sakakibara Yuzuru,徳永 千穂,平松 祐司,金本 真也,高橋 実穂,堀米 仁志,榊原 謙
- The annals of thoracic surgery 95(5), 1685-1688, 2013-05-00
- … Five junctional ectopic tachycardia, 2 atrial flutters, 1 paroxysmal supraventricular tachycardia, 1 atrial fibrillation, 1 atrioventricular reciprocating tachycardia with Wolff-Parkinson-White syndrome and 2 excessive sinus tachycardia were treated.ResultsThe mean loading and maintenance doses were 11.3 ± 4.0 and 6.8 ± 0.9 μg/kg per minute, respectively. …
- NAID 120005296346
- Electrophysiological Studies in Patients of Complex Congenital Heart Disease with Twin Atrioventricular Nodes before Total-Cavo Pulmonary Connection
- Toyohara Keiko,Takeuchi Daiji,Nakanishi Toshio,Shoda Morio
- Journal of Arrhythmia 27(Supplement), PJ3_024-PJ3_024, 2011
- … Histologic studies confirm the coexistence of two distinct atrioventricular nodes (AVNs) in a number of patients with complex congenital heart disease who require total-cavo pulmonary connection (TCPC). … Five patients (3 male) with an age of 24±19 months old had congenital heart disease, asplenia syndrome with common atriovnetricular valve: 3, atrioventricular discordance: 1, atrioventricular concordance: 1. …
- NAID 130002130306
- Ablation of Right-Sided Accessory Pathway with Atrial Insertion Site Located at Right Atrial Appendage Using Noncontact Mapping System
- Nishida Taku,Takitsume Akihiro,Nakajima Tamio,Kamon Daisuke,Uemura Shiro,Saito Yoshihiko
- Journal of Arrhythmia 27(Supplement), PE3_044-PE3_044, 2011
- … The 12-lead electrocardiogram suggested a right anterior or anterolateral accessory atrioventricular connection. … Programmed electrical stimulation from the right atrium induced the orthodromic atrioventricular reciprocating tachycardia with a heart rate of 220 beats per minute and the blood pressure fell down to 65/30 mmHg. …
- NAID 130002130272
Related Links
- Definition of atrioventricular reciprocating tachycardia in the Medical Dictionary. atrioventricular reciprocating tachycardia explanation. Information about atrioventricular reciprocating tachycardia in Free online English dictionary ...
- Atrioventricular reciprocating tachycardia (AVRT) is the second most common type of supraventricular tachycardia (SVT), accounting for about 30% of all SVTs.
★リンクテーブル★
[★]
- 英
- paroxysmal supraventricular tachycardia, PSVT
- 同
- 房室回帰頻拍 atrioventricular reciprocating tachycardia
- 関
- 上室性頻拍症
[show details]
概念
- 房室結節リエントリー、房室回帰、心房内リエントリー、異所性自動能亢進が機序となる．
- 発作性上室頻拍の約90％は房室結節リエントリー性頻拍 AVNRT あるいはWPW症候群に伴う房室回帰性頻拍 AVRT
症状
- 心拍数：150-200/分
- 動悸、胸部不快感など
- 血圧低下
検査
[show details]
治療のターゲット
治療
緊急
非緊急
- Valsalva手技以外の手技の有効性はそれほど高いものではない（Valsalva手技54％，右頚動脈洞マッサージ15％，顔面浸水15％など)
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- ATP
- ベラパミル：比較的心拍数が遅い発作(心拍数＜186/分)に有効
- ジルチアゼム：心拍数が速い発作(＞166/分)に有効
参考
- 1. 不整脈薬物治療に関するガイドライン（2009年改訂版）
- [display]http://www.j-circ.or.jp/guideline/pdf/JCS2009_kodama_h.pdf
国試
[★]
- 関
- tachyarrhythmia
[show details]
[★]
- 関
- AV