Supraventricular Arrhythmias and Their Management in the Emergency Setting: PSVT and AF
Pp. 186-214 (29)
Supraventricular tachycardia (SVT) is a type of tachyarrhythmia with a
narrow QRS complex and regular rhythm (heart rate >100 bpm). These patients are
often symptomatic and present to the emergency department (ED) in acute attacks
called paroxysmal SVT (PSVT). Most SVTs are regular rhythms. It starts suddenly
with the reentry mechanism in the majority of patients. 60% of the patients have
reentry with Atrioventricular (AV) node, and 20% have reentry via bypass pathways.
Coronary artery disease, anginal chest pain and dyspnea occur in patients due to
tachycardia. Heart failure and pulmonary edema may occur with left ventricular
dysfunction. Vagal maneuvers and adenosine appear to be the treatments of choice for
termination of stable SVT.
Adenosine, Paroxysmal supraventricular tachycardia,
Supraventricular tachycardia, Tachyarrhythmia, Vagal maneuvers.