tele nurses help

[joohwangee]

I'm a new nurse on tele unit

What is PAT and PSVT and how do they occur and when to let doctor know?

my pt was NSR all throughout then had 9-11sec of PAT and PSVT. no symptoms at all. just found on the strips.

please teach me more about it tele experts! thank you !

[MunoRN, RN]

PAT is a type of SVT, whether that deserves a call depends on what your Physicians expect to be called for, but I've yet to come across a doctor who wanted to know about non-sustained SVT as it's not really a clinically significant finding.

[Cowboyardee]

In both, the 'P' stands for "paroxysmal," which means the rhythm starts abruptly. "SVT" stands for supraventricular tachycardia, which always means a fast rhythm that originates above the ventricles (differentiating it from v-tach). Depending on who is using the term, "PSVT" may mean either any fast, supraventricular rhythm that starts abruptly and that you cannot further identify (this could possibly include some hard-to-identify rhythms like 2:1 atrial flutter prior to confirmation as well as uncommon narrow, paroxysmal tachycardias of various origins), or it may mean more specifically that it is one of a group of the more common causes of PSVT - namely paroxysmal atrial tachycardia, AVNRT, and AVRT.

PAT, as mentioned above, is one variant of PSVT by either definition. Its origin is an ectopic atrial pacemaker, and so typically it will have a relatively consistent P wave before the QRS complex, but that P wave will usually have a different morphology and/or axis from the normal sinus P waves.

Physicians will often not worry much about PAT or PSVT that is brief and self-limiting in a patient who appears otherwise fine. However, always consider what's going on with the patient in the first place. For example, if the patient is in the hospital being worked up for unexplained syncope or chest pain, even limited runs of PAT or PSVT would be very relevant findings to report.