Supraventricular Tachycardia (SVT)

Introduction

Supraventricular tachycardia (SVT) refers to a group of arrhythmias originating above the ventricles, typically in the atria or the AV node. It is characterized by a rapid heart rate, usually between 150-250 beats per minute (bpm).

Causes and Mechanisms

SVT occurs due to abnormal electrical activity in the heart, often involving:
- Atrioventricular nodal reentry tachycardia (AVNRT) – the most common type, caused by reentry circuits in the AV node.
- Atrioventricular reciprocating tachycardia (AVRT) – involves an accessory pathway (e.g., Wolff-Parkinson-White syndrome).
- Atrial tachycardia – results from an ectopic focus in the atria firing at a high rate.

Symptoms

Common symptoms include:
- Palpitations (rapid or irregular heartbeat).
- Dizziness, lightheadedness.
- Shortness of breath.
- Chest discomfort.
- Anxiety.

Diagnosis

Diagnosis of SVT is based on:
1. Electrocardiogram (ECG) – Identifies the type of SVT.
2. Holter Monitoring – Used when episodes are intermittent.
3. Electrophysiological Study (EPS) – Helps pinpoint reentry pathways.

Treatment Options

Acute Management

  • Vagal maneuvers (e.g., Valsalva maneuver, carotid sinus massage).
  • Adenosine – A first-line pharmacological intervention.
  • Beta-blockers or calcium channel blockers – If adenosine is ineffective.
  • Cardioversion – If the patient is unstable.

Long-term Management

  • Lifestyle changes – Avoid caffeine, alcohol, and stress.
  • Medications – Beta-blockers or antiarrhythmic drugs.
  • Catheter ablation – A curative approach targeting arrhythmic pathways.

Conclusion

SVT is a common yet treatable arrhythmia affecting daily life. Early diagnosis and appropriate management improve patient outcomes. If you experience symptoms suggestive of SVT, consult a cardiologist promptly.

References

  • American College of Cardiology (ACC)/American Heart Association (AHA) Guidelines for the Management of Supraventricular Arrhythmias
  • European Society of Cardiology (ESC) Guidelines on the Management of Supraventricular Arrhythmias

Source recommendations

1. American College of Cardiology (ACC)/American Heart Association (AHA) Guidelines for the Management of Supraventricular Arrhythmias

  1. https://www.ahajournals.org/doi/10.1161/cir.0000000000000311
  2. https://pubmed.ncbi.nlm.nih.gov/14557344/
  3. https://www.ahajournals.org/doi/10.1161/01.cir.0000091380.04100.84
  4. https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2015/09/23/09/13/2015-ACC-AHA-HRS-Guideline-for-the-Management-of-Adult-Patients-With-SVT
  5. https://www.heartrhythmjournal.com/article/s1547-5271(15)01189-3/fulltext

2. European Society of Cardiology (ESC) Guidelines on the Management of Supraventricular Arrhythmias

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Supraventricular-Tachycardia
  2. https://academic.oup.com/eurheartj/article/41/5/655/5556821
  3. https://pubmed.ncbi.nlm.nih.gov/14557344/
  4. https://www.ahajournals.org/doi/10.1161/01.cir.0000091380.04100.84
  5. https://pubmed.ncbi.nlm.nih.gov/31504425/

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