Table 27. Electrocardiographic characteristics of sinus and supraventricular tachycardias in the pediatric population 570 , 571 .
| Type | P wave behavior | PR>RP’ | HR (bpm) | AV block | Type | Age at onset | Particular features |
|---|---|---|---|---|---|---|---|
| Sinus tachycardia | Sinus | — | >HRmax predicted for age | No | NP | Any | HRmax reference values in Table 24 . |
| IST | Sinus pattern | — | >100 | No | P or PE | >15 years | Chief complaint of palpitations; associated with anxiety, dizziness, pre-syncope, and syncope. |
| Focal atrial tachycardia / EAT | Inverted and notched P wave in V1 with P wave duration >90 ms | No | Atrial rate >150% predicted mean HR | Yes | I | ≈7 years | May progress to tachycardiomyopathy, which is generally reversible with control of the arrhythmia. 572 , 573 |
| Multifocal atrial tachycardia | Various morphologies | — | >100 | No | P | Any | Presence of at least 3 P wave morphologies and 3 different PR intervals. |
| Junctional tachycardia * | May present with no visible P waves (within or after the QRS) | — | >100 | No | P or I | ≈1 year | Rarely congenital; is in patients with no history of cardiac surgery, can be treatment-refractory, with high morbidity and mortality rates. Occurs in up to 5% of patients after cardiac surgery. 574 |
| SANRT | Sinus pattern | No | 170-300 | Yes | P | Any | — |
| AAVRT | Not visible | Yes | 170-200 | No | P | >6 years | Resting ECG usually shows delta wave. QRS during tachycardia is widened, aberrant, and may mimic ventricular tachycardia. |
| Orthodromic atrioventricular reentry | Diverse morphology depending on the location of the accessory pathway | Yes | 220-360 | No | P | <3 months or >6 years | QRS of tachycardia is usually narrow and the P wave is retrograde. |
| PJRT | Negative in inferior leads | No | <170 | No | I | ≈6 years | — |
| Intra-atrial reentrant | Flutter-like | — | 160-220 | Yes | I | ≈12 years | — |
SANRT: sinoatrial nodal reentrant tachycardia; AAVRT: antidromic atrioventricular reentrant tachycardia; PJRT: permanent junctional reciprocating tachycardia; EAT: ectopic atrial tachycardia; NP: non-paroxysmal (accelerates and ends gradually); P: paroxysmal; I: incessant; PE: persistent.
*
Also known as junctional ectopic tachycardia (JET).