Cardiology In Critical Care

Arrhythmia Recognition

Atrial Tachycardia (AT)

Impulses originate in an atrial pacemaker at a rate 140-250/min.  Atrial activity may be represented by upright P in L2 or by P superimposed on T or ST segment of the preceding beat.  At very rapid rates only every second P may be followed by QRS (2:1 AV block) with the resulting ventricular rate half the atrial.  QRS usually less than 0.11 sec; wide and bizarre QRS mat be due to preexisting BBB or WPWS or due to aberrancy common at rapid rates.  Onset and termination of AT is often abrupt.  Vagal stimulation frequently terminates AT.

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