TREATMENT
■ Atropine
■ Often requires emergent temporary transcutaneous or transvenous pacing
■ Permanent pacemaker insertion is definitive therapy.
SINUSTACHYCARDIA
DIAGNOSIS ANDCAUSES
A diagnosis of exclusion
There are many causes of sinus tachycardia, including:
■ HR increase to maintain cardiac output
■ Decreased effective circulating volume (bleeding, volume loss, anemia,
or abnormal hemoglobin function)
■ Impaired cardiac function (MI, ACS, valvular disease, tamponade)
■ PE
■ Hypoxia
■ Metabolic/endocrine derangements
■ DKA
■ Hyperthyroidism
■ Adrenal insufficiency
■ Fever/sepsis
■ SIRS
■ Drug ingestions (sympathomimetics)
■ Drug/alcohol withdrawal
■ Anxiety or pain
ECG FINDINGS
■ P waves precede all QRS complexes.
■ Regular rhythm
TREATMENT
■ Treat underlying condition.
ATRIALTACHYCARDIA
Atrial tachycardia results when an ectopic atrial focus takes over either due to
increased autonomic activity or intra-atrial reentry. These atrial impulses are
conducted to the ventricles.
CAUSES
Causes include:
■ Triggered by a PAC
■ Electrolyte imbalance
■ Drugs (think Digoxin!)
■ Fever
■ Hypoxia
ECG FINDINGS
■ Regular narrow complex tachycardia
■ P wave before each QRS
RESUSCITATIONSinus arrest or sinus block is
often the result of untreated
sick sinus syndrome.