Cardiovascular Medicine Book

AtrialFlutter

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Atrioventricular Nodal Reentry

Aka: Atrioventricular Nodal Reentry, AVNRT
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  1. See Also
    1. Supraventricular Tachycardia
  2. Definition
    1. Form of Supraventricular Tachycardia (60% of cases) in which reentry occurs with the AV Node
  3. Epidemiology
    1. Most common in young women
    2. Typically there is no underlying heart disease
  4. Findings: General
    1. Heart Rate typically 160 to 190 (up to 260) with no P Waves seen
  5. Types: Typical (slow/fast): 90% of AVNRT
    1. Course
      1. Starts with PAC passed down slow accesory path
      2. Signal travels retrograde up fast path
      3. Signal cycles back down slow accesory pathway
    2. EKG findings
      1. PR interval > RP Interval
      2. Negative P Waves in III and avF
  6. Types: Atypical (fast/slow): 10% of AVNRT
    1. Course: Reverse of typical pathway
    2. EKG findings
      1. PR interval < RP Interval
      2. Pseudo-S Wave in leads I, II, aVF
  7. References
    1. Colucci (2010) Am Fam Physician 82(8): 942-52
    2. Delacretaz (2006) N Engl J Med 354(10): 1039-51
    3. Kumar (2006) Cardiol Clin 24(3): 427-37

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