AVNRT

The funniest thing about this is that it takes 30 years to show up!

Typical symptoms include a pounding in the neck, chest heaviness, dizziness and polyuria.

Fast and regular rhythm strip without P waves

This is simply called an SVT.

You can conceptualize the types by visualizing the area around the AV node.

Thus, the types are:

- AV node dependent

• AVNRT, this being a nodal reentry
  

• Accessory Pathway (aka AVRT/AV reciprocating tachycardia)

- AV node independent = Atrial tachycardia, this being either automatic or atrial reentry/AF/AFlutter

- Sinus tachycardia

• physiologic
• sinus node reentry/inappropriate sinus tachycardia

So, you can summarize it as Reentry, Accessory, Automatic, Physiologic, Flutter...like the 5 fingers.

If you're a betting man then you'd put your money on Nodal Reentry, followed by Accessory pathway.

Only some paced beats on the rhythm strip

The best way to express this is to say "underlying SR with intermittent pacing".
Remember that if the PR interval is short enough, you will see fusion beats.

Just wide complexes on the rhythm strip

Slow and wide...call it Idioventricular
Fast and wide...call it SVT with aberrancy or VT

The rhythm strip that is irregular but you see sinus beats

This could either be sinus arrhythmia or NSR with ectopics.
Some of these ectopics will be so early that they will be blocked - this creates the longer intervals seen on the ECG.
The surprising thing about atrial ectopics is that they can occur even before the qrst is finished! Thus, you can see them in the ST segment and superimposed on the T wave!

The rhythm strip in which you only see 1 or 2 P waves

The options for this are:

1. It's AF

2. It's NSR with a LOT of atrial ectopics (aka "runs of atrial tachycardia")

Tall R wave in V1

The differnetial is pretty easy to break down:

1. It aint RVH unless there is also RAD

2.