Supraventricular tachycardia: An overview of diagnosis and management

Supraventricular tachycardia (SVT) is a common cause of hospital admissions and can cause significant patient discomfort and distress. The most common SVTs include atrioventricular nodal re-entrant tachycardia, atrioventricular re-entrant tachycardia and atrial tachycardia. In many cases, the underlying mechanism can be deduced from electrocardiography during tachycardia, comparing it with sinus rhythm, and assessing the onset and offset of tachycardia. Recent European Society of Cardiology guidelines continue to advocate the use of vagal manoeuvres and adenosine as first-line therapies in the acute diagnosis and management of SVT. Alternative therapies include the use of beta-blockers and calcium channel blockers. All patients treated for SVT should be referred for a heart rhythm specialist opinion. Long-term treatment is dependent on several factors including frequency of symptoms, risk stratification, and patient preference. Management can range from conservative, if symptoms are rare and the patient is low risk, to catheter ablation which is curative in the majority of patients.