A narrow-complex tachycardia with abrupt onset and termination and no visible P waves most likely represents which diagnosis?

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Multiple Choice

A narrow-complex tachycardia with abrupt onset and termination and no visible P waves most likely represents which diagnosis?

Paroxysmal, narrow-complex tachycardia with abrupt onset and termination and no visible P waves points to a reentrant mechanism around the AV node. Atrioventricular nodal reentrant tachycardia fits best because the tachycardia is usually sudden in start and stop, and the atrial activation is often concealed within or immediately after the QRS complex, making P waves hard to see. The QRS is narrow because ventricular depolarization proceeds through the normal His-Purkinje system. This pattern helps distinguish it from other possibilities: atrial flutter would typically show visible atrial activity (flutter waves) rather than absent P waves; sinus tachycardia would have P waves preceding each beat and a more gradual change in rate rather than abrupt episodes; ventricular tachycardia usually produces wide QRS complexes due to a ventricular origin.

Paroxysmal, narrow-complex tachycardia with abrupt onset and termination and no visible P waves points to a reentrant mechanism around the AV node. Atrioventricular nodal reentrant tachycardia fits best because the tachycardia is usually sudden in start and stop, and the atrial activation is often concealed within or immediately after the QRS complex, making P waves hard to see. The QRS is narrow because ventricular depolarization proceeds through the normal His-Purkinje system.

This pattern helps distinguish it from other possibilities: atrial flutter would typically show visible atrial activity (flutter waves) rather than absent P waves; sinus tachycardia would have P waves preceding each beat and a more gradual change in rate rather than abrupt episodes; ventricular tachycardia usually produces wide QRS complexes due to a ventricular origin.

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