Orthodromic
Atrioventricular Re-entry Tachycardia (AVRT):
ECG features of AVRT with orthodromic conduction =
1. Rate usually 200-300 bpm
2. Retrograde P waves are usually visible, with a long RP interval
3. QRS < 120ms unless pre-existing bundle branch block, or rate-related aberrant conduction
4. QRS alternans: phasic variation in QRS amplitude associated with AVNT and AVRT, distinguished from electrical alternans by a normal QRS amplitude
5. Rate-related ischaemia is common
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Fellows, are you aware of the association between abnormal aortic arch geometry and late hypertension in patients despite anatomically successful CoA repair (no residual gradient even). Read the importance of “gothic” arch in coarctation. How to classify arch depending on shape?