Narrow QRS Complex Tachycardias

Narrow QRS complex tachycardias are either atrioventricular (AV) nodal passive or AV nodal active. AV nodal passive tachycardias do not require the participation of the AV node in maintenance of the tachycardia. Examples are atrial tachycardia, atrial flutter, and atrial fibrillation. Treatment is directed at ventricular rate control with calcium channel blockers or β-blockers. AV nodal active tachycardias require active participation of the AV node in maintaining the tachycardia. Examples include AV nodal reentry tachycardia and circus movement tachycardia using an accessory pathway. Treatment with a vagal maneuver or adenosine usually terminates the tachycardia. Recognition of these tachycardias is reviewed.