From the Guidelines
Short RP tachycardia is a type of supraventricular tachycardia characterized by a short interval between the R wave and P wave on an electrocardiogram (ECG), typically indicating retrograde atrial activation occurs rapidly after ventricular activation, as described in the 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia 1.
Key Characteristics
- The short RP interval is typically less than 90 milliseconds, which is a key diagnostic feature.
- This pattern is commonly seen in atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) using an accessory pathway.
- In AVNRT, the reentry circuit involves fast and slow pathways within the AV node itself, as noted in the guideline 1.
Causes and Treatment
- The most common causes of short RP tachycardia include AVNRT, AVRT, and junctional tachycardia.
- Treatment typically involves vagal maneuvers like the Valsalva maneuver as first-line therapy, followed by adenosine (6-12 mg IV push) for acute termination, as recommended in the guideline 1.
- Long-term management may include calcium channel blockers like verapamil (120-360 mg daily) or beta-blockers such as metoprolol (25-100 mg twice daily).
- For recurrent episodes, catheter ablation offers a definitive treatment with success rates exceeding 95% for AVNRT, highlighting the importance of accurate diagnosis and treatment planning based on the latest clinical guidelines 1.
Importance of Recognition
- Recognizing short RP tachycardia is crucial because it helps narrow the differential diagnosis and guides appropriate treatment strategies for these specific arrhythmias.
- Accurate diagnosis and treatment can significantly improve patient outcomes, reducing morbidity, mortality, and enhancing quality of life, which is the primary goal of clinical management 1.
From the Research
Definition of Short RP Tachycardia
- Short RP tachycardia refers to a type of supraventricular tachycardia (SVT) characterized by a short interval between the onset of the P wave and the onset of the QRS complex (RP interval) 2.
- This condition is often associated with atrioventricular reentrant tachycardia, which is one of the common types of paroxysmal SVT 2.
Characteristics of Short RP Tachycardia
- Short RP tachycardia typically presents with symptoms such as palpitations, chest discomfort, dyspnea, fatigue, and lightheadedness 2.
- Diagnostic evaluation of short RP tachycardia involves a comprehensive history and physical examination, electrocardiography, and laboratory workup, as well as extended cardiac monitoring with a Holter monitor or event recorder 2.
Management of Short RP Tachycardia
- Acute management of short RP tachycardia is similar to other types of paroxysmal SVT and may involve vagal maneuvers, medication management with beta blockers and/or calcium channel blockers, or synchronized cardioversion in hemodynamically unstable patients 2.
- Long-term management of recurrent, symptomatic short RP tachycardia may involve catheter ablation, which has a high success rate and is recommended as the first-line method for long-term management 2.