About-Cardio
-
We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Atrioventricular Reentrant Tachycardia (AVRT) and ECG Findings
Introduction
Atrioventricular Reentrant Tachycardia (AVRT) is a type of supraventricular tachycardia (SVT) seen in conditions like Wolff-Parkinson-White (WPW) syndrome. It occurs due to an accessory pathway (extra electrical connection) between the atria and ventricles, leading to a reentrant circuit and causing rapid heart rhythms.
ECG Characteristics of AVRT
AVRT can present in different forms:
1. Orthodromic AVRT (90-95% of cases):
- Narrow QRS complexes (because conduction occurs normally through the AV node and His-Purkinje system).
- No delta wave (unlike WPW during sinus rhythm).
- Retrograde P waves (often buried in or shortly after the QRS complex).
- Regular, fast rhythm (150-250 bpm).
2. Antidromic AVRT (5-10% of cases):
- Wide QRS complexes (because conduction occurs through the accessory pathway first).
- May resemble ventricular tachycardia (VT) on ECG.
- Delta wave may be present if pre-excitation occurs.
- Fast heart rate (150-250 bpm).
Clinical Considerations and Management
- Acute treatment: Vagal maneuvers (e.g., carotid massage, Valsalva maneuver), adenosine (for orthodromic AVRT), or electrical cardioversion if unstable.
- Chronic management: Beta-blockers, calcium channel blockers, or catheter ablation of the accessory pathway to prevent recurrence.
- Avoid AV nodal blockers (adenosine, beta-blockers, diltiazem, verapamil) in antidromic AVRT due to the risk of increased conduction through the accessory pathway and potential ventricular fibrillation.
Conclusion
Recognizing AVRT on ECG is crucial for proper diagnosis and treatment. Distinguishing between orthodromic and antidromic AVRT helps guide appropriate management strategies.
References
- American Heart Association (AHA) and European Society of Cardiology (ESC) guidelines provide management recommendations for supraventricular tachycardia, including AVRT.
Source recommendations
1. 2020 American Heart Association (AHA) Guidelines for the Management of Supraventricular Tachycardia
- https://www.ahajournals.org/doi/10.1161/cir.0000000000000311
- https://pubmed.ncbi.nlm.nih.gov/33215931/
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
- https://cpr.heart.org/en/resuscitation-science/cpr-and-ecc-guidelines/algorithms
- https://professional.heart.org/en/science-news/2020-aha-guidelines-for-cpr-and-ecc
2. 2019 European Society of Cardiology (ESC) Guidelines for the Management of Supraventricular Tachycardia
- https://academic.oup.com/eurheartj/article/41/5/655/5556821
- https://pubmed.ncbi.nlm.nih.gov/31504425/
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Supraventricular-Tachycardia
- https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2019/09/10/12/36/2019-ESC-Guidelines-for-Supraventricular-Tachycardia
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6955050/
-
If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
Our advantages:
Best practices from USA, EU and Japan
Our answers to your questions are based on the clinical recommendations of countries with the most developed healthcare systems in the field of cardiology in the USA, the EU and Japan.
Always up-to-date information
On a daily basis, we monitor for you all new scientific research publications in leading scientific journals on medical issues of interest to you.
We monitor all innovations and changes in the field of cardiac disease treatment on a daily basis.
We monitor all innovations and changes in the field of cardiac disease treatment on a daily basis.
Get second opinion
Here you can learn everything that even your doctor may not know about cardiology (if he does not speak English and he does not read 117 leading medical journals on cardiology every month).
The most comprehensive and up-to-date collection of free cardiology materials
Our website contains the most comprehensive and up-to-date collection of free cardiology materials in your country.
Every 3-5 years, half of the scientific approaches to treatment in the field of cardiology are reviewed as a result of specialized scientific discoveries. With us, you don't have to wait these years to learn about the best ways to treat you and your loved ones.
Every 3-5 years, half of the scientific approaches to treatment in the field of cardiology are reviewed as a result of specialized scientific discoveries. With us, you don't have to wait these years to learn about the best ways to treat you and your loved ones.