Guidelines

9/23/2015 1:46:00 PM

Guideline for the Management of Supraventricular Tachycardia

The American College of Cardiology, American Heart Association and Heart Rhythm Society recently released the 2015 guideline for the management of supraventricular tachycardia (SVT) - an umbrella term used to describe an abnormally rapid heart rate generated from the upper portion of the heart. Written by a team of experts in the field, this guideline summarizes the latest evidence on SVT and provides recommendations for diagnosis and treatment. This is what every patient should know about the latest SVT guidelines:

Definition: Supraventricular tachycardia (SVT) is an umbrella term used to describe certain types of abnormal heartbeats, which cause the heart to beat quickly and sometimes irregularly. SVT includes conditions like atrial flutter and atrial tachycardia. It’s important to note that SVT does not often include the most common type of abnormal heartbeat called atrial fibrillation. As such, the diagnosis and treatment of atrial fibrillation is not addressed here, but through its very own guideline. The 2015 guideline was also designed to address SVT in adults, not children, although SVT can affect children and adolescents.

Statistics: It’s estimated that SVT affects roughly 2 in 1,000 people in the United States. A certain type of SVT called paroxysmal supraventricular tachycardia currently affects 570,000 individuals and is most common in women and older adults. Patients with SVT account for approximately 50,000 emergency departments visits each year.

Risk Factors: Existing heart conditions like heart failure and congenital heart defects can increase risk for SVT. In fact, SVT affects anywhere from 10-20% of adults with congenital heart disease. Pregnancy can also increase risk for abnormal heartbeats or trigger abnormal heartbeats in patients with SVT. However, there are ways to help prevent and treat SVT in patients with increased cardiovascular risk.

Symptoms and Diagnosis: The most common symptoms of SVT include heart palpitations, chest pain, lightheadedness, shortness of breath, and fainting. Unfortunately, these symptoms are similar to those of panic and anxiety disorders, which can lead to misdiagnosis. Symptoms of SVT can begin as early as childhood, although one study found the average age of symptom onset in adults was 32 years old. Research also shows that women with SVT tend to experience more symptoms than men.

Diagnosis: Tests like electrocardiograms (ECG or EKG), which measure the electrical impulses of the heart, can help diagnose SVT. These tests can also help determine which type of SVT a patient has, which is critical for determining a treatment plan. What makes diagnosing SVT difficult is that it usually occurs only in short periods of time and often an ECG of these periods is not available. Additionally, there are many types of SVT to consider once an ECG is obtained. 

Treatment: Treatment for SVT varies significantly from patient to patient. Treatment depends on a number of factors such as the type of SVT a patient has, the frequency and duration of SVT episodes, and the severity of symptoms. Treatment also depends on patient preferences. Based on these factors, treatment may include a “watch and wait” approach, drug therapy or procedures like ablation. Typically, the goal of SVT treatment is to prevent abnormal heartbeats, minimize symptoms and reduce risk of complications. And as experts highlight, it’s important that patients are part of the decision-making process when it comes to treatment.

Read the full guidelines in the Journal of the American College of Cardiology