Tachycardia [antikvár]

Introduction Electrophysiological studies have taught us much about the mechanisms of paroxysmal tachycardias. While there is still much to be discovered, especially the detailed microscopic and cellular basis of arrhythmias, many practical rules have been derived and validated. These rules are helpful in elucidating the mechanism of paroxysmal tachycardias. An understanding of tachycardia mechanism—and how programmed electrical stimulation of the heart can prove the mechanism—can lead to a planned approach to rational therapy, be it emergency therapy or long term, and whether it be by pharmacologic means, by ablative or surgical means, or by the use of antitachycar-dia pacemakers or implantable antitachycardia devices with a broad range of programmable functions. While successful therapy is the ultimate goal, accurate diagnosis should always be sought first, with the techniques immediately available to the emergency physician or with the more sophisticated techniques used more elec-tively by the electrophysiologist. This small text is not meant to be a primer in clinical cardiac electrophysiology. It is, rather, a somewhat organized, programmed text by which a stepwise approach can be made to the diagnosis of a paroxysmal tachycardia. Not all of the diagnostic steps can necessarily be taken during the acute presentation of a patient severely com-