![]() ![]() Ventricular rate variable, depending on degree of AV block.Atrial rhythm regular, rate, 250 to 400 bpm.If patient has an ejection fraction less than 40%, consider amiodarone.If patient has normal ejection fraction, consider calcium channel blockers, beta-adrenergic blocks or amiodarone.bolus injection to rapidly convert arrhythmia. If patient is stable, vagal stimulation, or Valsalva’s maneuver, carotid sinus massage.If patient is unstable prepare for immediate cardioversion.Use of caffeine, marijuana, or central nervous system stimulants.Intrinsic abnormality of AV conduction system.Physical exertion, emotion, stimulants, rheumatic heart diseases.When a normal P wave is present, it’s called paroxysmal atrial tachycardia when a normal P wave isn’t present, it’s called paroxysmal junctional tachycardia.Sudden onset and termination of arrhythmia.P waves regular but aberrant difficult to differentiate from preceding T wave.Regular atrial and ventricular rhythms.Beta-adrenergic blockers or calcium channel blockers for symptomatic patients.Atropine, epinephrine, quinidine, caffeine, nicotine, and alcohol use. ![]() May accompany shock, left-sided heart failure, cardiac tamponade, hyperthyroidism, and anemia.Normal physiologic response to fever, exercise, anxiety, dehydration, or pain.Atrial and ventricular rhythms are regular.Atropine if rate decreases below 40 bpm.Can be seen in digoxin toxicity and inferior wall MI. ![]()
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