Supraventricular Tachycardia

Question 1

Define supraventricular tachycardia.

Answer 1

Supraventricular tachycardia is characterised as a rapid regular rhythm arising from a discrete area within the atria. It occurs in a wide range of clinical conditions, including catecholamine excess, digoxin toxicity, paediatric congenital heart disease, and cardiomyopathy.

Question 2

Explain the aetiology/risk factors of supraventricular tachycardia.

Answer 2

Supraventricular tachycardia has a variety of causes. It may occur in healthy people, although often there is underlying cardiac pathology. Associated conditions include cardiomyopathies, ischaemic heart disease, previous cardiac surgery, and hyperthyroidism.

Question 3

Summarise the epidemiology of supraventricular tachycardia.

Answer 3

Focal atrial tachycardia is a relatively uncommon arrhythmia that occurs in all age groups and represents approximately 3% to 17% of the patients referred for supraventricular tachycardia ablation. There is no particular pattern in relation to sex or ancestry.

Question 4

Recognise the presenting symptoms of supraventricular tachycardia.

Answer 4

Palpitations
Fatigue, weakness
SOB

Question 5

Recognise the signs of supraventricular tachycardia on physical examination.

Answer 5

Rales
Oedema

Question 6

Identify appropriate investigations for supraventricular tachycardia and interpret the results.

Answer 6

ECG
Digoxin level
Theophylline level
CXR
Electrolytes
Toxicology screen

Question 7

Generate a management plan for supraventricular tachycardia.

Answer 7

1. Beta-blocker or calcium-channel blocker
2. Ibutilide or amiodarone
3. Third-line pharmacotherapy or direct current (DC) cardioversion + cardiology consult

Question 8

Identify the possible complications of supraventricular tachycardia and its management.

Answer 8

Congestive heart failure
Resistance to therapy
Cardiomyopathy

Question 9

Summarise the prognosis for patients with supraventricular tachycardia.

Answer 9

Prognosis depends on the ability to control the arrhythmia. This is further influenced by the patient’s age, underlying cause of the arrhythmia, tolerance of adverse effects of the chosen treatment, and comorbidities.