The supraventricular tachycardia uptodate
The supraventricular tachycardia uptodate Supraventricular tachycardia (SVT) is a common arrhythmia characterized by an abnormally fast heart rate that originates above the ventricles, involving the atria or the atrioventricular (AV) node. It can affect individuals across various age groups, from children to older adults, and often presents with abrupt onset and termination of rapid palpitations. Understanding SVT is vital for accurate diagnosis and effective management, as it can significantly impact quality of life and, in some cases, pose serious health risks.
The pathophysiology of SVT generally involves abnormal electrical pathways or circuits within the atria or the AV node. The most prevalent forms include atrioventricular nodal reentrant tachycardia (AVNRT), atrioventricular reentrant tachycardia (AVRT), often associated with accessory pathways such as in Wolff-Parkinson-White (WPW) syndrome, and atrial tachycardia. These mechanisms facilitate rapid electrical impulses looping within the heart, producing a fast, regular rhythm often exceeding 150 beats per minute. The supraventricular tachycardia uptodate
The supraventricular tachycardia uptodate Clinically, patients with SVT may experience sudden episodes of palpitations, chest discomfort, shortness of breath, dizziness, or even syncope in severe cases. Often, episodes last from seconds to hours and can be triggered by stress, caffeine, alcohol, or strenuous activity. The episodic nature of SVT can sometimes lead to misdiagnosis, especially if episodes are brief or infrequent. Electrocardiogram (ECG) remains the cornerstone for diagnosis, typically revealing narrow QRS complexes with a rapid heart rate. In some instances, maneuvers like vagal stimulation (e.g., carotid sinus massage) can terminate the episodes, which also serve as diagnostic tools.
Management of SVT involves both acute and long-term strategies. Acute episodes often respond well to vagal maneuvers, which increase parasympathetic tone and can interrupt reentrant circuits. Pharmacologic therapy, including adenosine, beta-blockers, or calcium channel blockers, is used if vagal maneuvers are ineffective. Adenosine, in particular, is effective for rapid, short-term termination due to its ability to transiently block AV nodal conduction.
For recurrent or persistent SVT, catheter ablation has become a highly effective and curative option. This minimally invasive procedure involves mapping the electrical pathways in the heart to identify and destroy the abnormal circuits responsible for the arrhythmia. Success rates are high, and many patients experience complete resolution of symptoms after ablation. The supraventricular tachycardia uptodate
While SVT is often benign, it warrants careful evaluation to exclude underlying structural heart disease or other arrhythmias. In rare cases, SVT can lead to tachycardia-induced cardiomyopathy if episodes are frequent and prolonged. Therefore, patient education on recognizing symptoms and seeking prompt medical care is essential. The supraventricular tachycardia uptodate
The supraventricular tachycardia uptodate Overall, advances in electrophysiology and catheter ablation techniques have greatly improved the prognosis for patients with SVT. With proper diagnosis and tailored treatment, most individuals can lead normal, active lives, minimizing the impact of this arrhythmia.
