Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN.
Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN; Department of Pediatrics and Adolescent Medicine, Mayo Clinic, Rochester, MN.
Mayo Clin Proc. 2018 Dec;93(12):1825-1841. doi: 10.1016/j.mayocp.2018.07.019. Epub 2018 Nov 7.
Supraventricular arrhythmias can cause uncomfortable symptoms for patients. Often, the first point of contact is in the primary care setting, and thus, it is imperative for the general internist to have a clinical framework in place to recognize this cluster of cardiac arrhythmias, be familiar with immediate and long-term management of supraventricular tachycardias, and understand when cardiac electrophysiologic consultation is necessary. The electrocardiographic characteristics can have subtle but important clues to the diagnosis and initial management. An understanding of the mechanisms of these arrhythmias is essential to provide proper therapy to the patient. In addition, there are common practice strategies that should be emphasized to avoid common misperceptions that could pose risk to the patient. In this review, we provide a framework to more easily recognize and classify these arrhythmias. We also illustrate the mechanism for these arrhythmias to provide an understanding of the interventions generally used.
室上性心律失常可导致患者不适。通常,患者首先会在初级保健机构就诊,因此,全科医生必须建立一个临床框架,以识别这组心律失常,熟悉室上性心动过速的即刻和长期管理,并了解何时需要进行心脏电生理咨询。心电图特征可能对诊断和初始管理具有微妙但重要的线索。了解这些心律失常的机制对于为患者提供适当的治疗至关重要。此外,还应强调一些常见的实践策略,以避免可能对患者造成风险的常见误解。在本次综述中,我们提供了一个更易于识别和分类这些心律失常的框架。我们还说明了这些心律失常的机制,以帮助理解通常使用的干预措施。