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Typical atrioventricular nodal reentrant and orthodromic atrioventricular tachycardias: electrocardiographic, electrophysiological diagnosis and treatment

Rose Mary Ferreira Lisboa da Silva & Leonardo Roever

Paroxysmal supraventricular tachycardias with narrow QRS are defined as rhythms originating from above the His bundle, heart rate higher 100 bpm and QRS complex of less than 120 ms in adults or less than 90 ms in children. They present a prevalence of up to 8/1000 individuals. The main presentations of these regular tachycardias are atrioventricular nodal re-entrant tachycardia and orthodromic atrioventricular reentrant tachycardia due to an accessory pathway. These tachycardias present morbidity, with symptoms such as palpitations, dyspnea, chest pain, syncope, polyuria, and can be a cause of sudden cardiac death. Thus, their clinical and electrocardiographic diagnoses are the first step in the approach and treatment of the patient. This review will discuss the clinical aspects, electrocardiographic, electrophysiological diagnosis and treatment options in the acute phase and long-term management, in addition to nonpharmacological treatment.