Classification of supraventricular tachyarrhythmias

Classify supraventricular tachyarrhythmias, taking into account the localization and features of the electrophysiological mechanism and clinical-electrocardiographic manifestations.

• Supraventricular extrasystole is divided into a typical extrasystole and parasystole.
• Extrasystolia is divided into the atrial (left and right) and nodal.
• Isolate monomorphic (one morphology of the ventricular complex) and polymorphic (polytopic) extrasystole.
• In terms of severity, single, pair (two consecutive extrasystoles), interpolated, or intercalary (extrasystoles occur in the middle between two sinus contractions in the absence of compensatory pause), allorrhythmia (extrasystole occurs after a certain number of sinus complexes) -bigimia (every second contraction is an extrasystole ) and trembling (every third contraction is extrasystoles), etc.
• According to the clinical classification, a frequent extrasystole is given (it accounts for more than 10% of all registered complexes on a standard ECG or more than 5,000 for 24 hours in Holter monitoring).
• Given the circadian representation, the extrasystole is divided into day, night and mixed.
• Supraventricular contractions and rhythms: slipping atrial rhythms, accelerated atrial rhythms, rhythms from AV-connection (nodal rhythms).
• Sinus tachycardia is a typical sinus tachycardia, chronic sinus tachycardia and paroxysmal sinus tachycardia (sinoatrial re-entry-tachycardia). By the nature of the flow, the reactive and chronic forms of sinus tachycardia are isolated.
• Supraventricular heterotopic tachycardia is divided into re-entry and automatic.
• Re-entry-supraventricular tachycardia:
  • AV-reciprocal supraventricular tachycardia is caused by the presence of at least two electrical messages between the atria and the ventricles along the AV node and the additional atrioventricular connection - the manifesting Wolff-Parkinson-White syndrome with antegrade conduction in the additional atrioventricular junction (antidromic), latent syndrome pre-excitation with retrograde conduction on additional atrioventricular junction (ortodromic), nodoventricular tachycardia;
  • AV-node reciprocal supraventricular tachycardia with excitation circulation inside the AV connection (typical "slow-fast", atypical "fast-slow", atypical "slow-slow");
  • flutter, atrial fibrillation;
  • atrial re-entry-tachycardia.
• Automatic supraventricular tachycardia is atrial ectopic; AB-node; chaotic, or multifocus. Isolate paroxysmal and non-paroxysmal forms of supraventricular tachycardia.
• Paroxysmal occurs with severe clinical symptoms and is characterized by a sudden onset and stopping of a heart attack lasting from several seconds to several hours (less often a day).
• Non-paroxysmal supraventricular tachycardia is characterized by the constant existence of abnormal rhythm of high frequency. It is characterized by the duration of the flow (often more than 10 years), the lack of typical clinical symptoms, the difficulty of drug relief and the development of such a serious complication, as arrhythmogenic cardiomyopathy. The isolation of two electrocardiographic forms of non-paroxysmal supraventricular tachycardia is clinically justified: constant (with tachycardia virtually not interrupted by any sinus contraction) and recurrent (characterized by a change in the sinus and heterotopic rhythm). The ratio of recurrent and permanent forms of non-paroxysmal supraventricular tachycardia in children is 2.5: 1.

[1], [2], [3], [4], [5], [6], [7]