Avtor/Urednik		Klemenčič, Alenka; Peterlin, Lidija; Kovač, Miha
Naslov		Parkoksizmalna supraventrikularna tahikardija v ambulanti splošne nujne medicinske pomoči v Ljublani
Prevedeni naslov		Paroxysmal supraventricular tachycardia observed at emergency medical service in Ljubljana
Tip		članek
Vir		In: Gričar M, Vajd R, editors. Urgentna medicina: izbrana poglavja 2007. Zbornik 14. mednarodni simpozij o urgentni medicini; 2007 jun 20-23; Portorož. Ljubljana: Slovensko združenje za urgentno medicino,
Leto izdaje		2007
Obseg		str. 213-6
Jezik		slo
Abstrakt		At Emergency medical service (EMS) we frequently treat patients with various arrhythmias.The most common are tachyarrhythmias (86% of all arrhythmias) of which we see a lot of atral fibrillation (58 ofall arrhythmias). We see paroxysmal supraventricular tachycardia (PSVT) in 20% of all arrhythmias or in 23,6% of all tachyarrhythmias. 9815 patients visited our department in frst three months of the year 2007; 264 patients had arrhythmia diagnosed by EKG and 24 (9%) patients actually had PSVT. 66,6% of these patients were successfully treated and they were sent home. Other 33,3% of them were examined and treated by specialist of internal medicine the same day. The cause was either unsuccessful conversion, still present chest pain or other internitstic disesases. PSVT is a very common arrhythmia. The rhythm is regular, it ranges between 120-250 beats per minute. In most cases it is associated with an AV nodal reentry mechanism and less so with an accessory bypass tract, the well know is Wolff-Parkinson-White syndrom (WPW). The treatment in prehospital setting depends on the patient. Many episodes stop spontaneously before our treatment. Vagotonic maneuvers (eg. Valsava maneuver, unilateral carotid massage), particularly if used early, may terminate the tachyarrhythmia. If these maneuvers are ineffective and we know that the patient doesn't have a diagnose WPW we use adenosine, which is the first choice to interrupt the reentrant cycle. If this drug is ineffective, the patient is referred to the specialist of internal medicine immediatly. When hemodynamic compromise, chest pain or ECG evidence of ischemia is present synchronized cardioversion is used to terminate the arrhythmia. Adverse reactions to adenosine are common but minor and brief, except in WPW were it can cause the life threthening arrhythmias. In the prehospita) unit we often treat patients with PSVT and in many cases we can treat them successfully.