Wednesday, September 3, 2014

One Hour Lecture: Supraventricular Tachycardias (including ED management of atrial fibrillation)

This is a lecture on ED diagnosis and management of supraventricular tachycardias:

Sinus Tach
Paroxysmal SVT
Atrial Fibrillation
Atrial Flutter
Multifocal Atrial Tachycardia
Atrial Tachycardia

It is pretty much everything an emergency physician needs to know about this.  It is not a TED talk.  It won't give you new insight into yourself or humanity, but it will help you diagnose and manage patients!

There is a lot of detail that you might not find elsewhere.


  1. What do you think of using "Lewis leads" to make atrial flutter easier to identify?

  2. I love Lewis leads and had intended to mention them, but forgot. Here are two posts on the topic:

  3. Love it! Regarding your final slide that lightly touched on the ED workup on patients with supraventricular arrhythmias, what are your thoughts or experiences on "fishing" for PE in such patients. At my shop the physicians seem to like to look for PE's as a potential precipitant of SVT's, but I really doubt there's much to find unless there's something in the history already suggestive of the diagnosis. Thanks for the great video!

    1. Thanks, Vince. I do not consider it strongly at all in suggesting PE. Only if other symptoms, especially after conversion if there are persistent signs and symptoms for a long time (there are always residual s/sx's after conversion for a short time.

  4. Looking forward to seeing more such videos. I wish you do more such videos. Reallly really helpful. Thank you very much dr.Smith for enlightening us.

  5. What do you mean by beat-to-beat variability min 06:27? Is it same electrical elternans?

    1. Just that sinus is not perfectly regular as re-entrant rhythms are.

  6. there is saying if a person saves one human life GOD will give him reward for as if he has saved whole humanity
    sir u r source of knowledge go on dispersing this goodness in u so that whole humanity will be helped


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