What question did this study set out to answer?

To characterize the hemodynamic and circulatory changes that occur during episodes of induced supraventricular tachycardia in symptomatic patients.

November 1, 1976Circulation

The hemodynamic effects of induced supraventricular tachycardia in man.

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Why the study?

What are the hemodynamic effects of induced supraventricular tachycardia compared to sinus rhythm in patients with symptomatic SVT?

Population

8 patients who reported disabling symptoms during paroxysms of supraventricular tachycardia (SVT)

Comparison

Induced supraventricular tachycardia by rapid… vs Sinus rhythm (baseline)

Design

Case_series

Authors

BGBruce N. GoldreyerUniversity of Southern California JKJohn A. KastorUniversity of Maryland, Baltimore KKKenneth L. KershbaumPennsylvania Hospital

Discussion

Member takes

Implication

Induced SVT may cause marked hemodynamic compromise explaining symptoms in select patients; leaves open mechanisms and management implications beyond this case series.

Key Points

To characterize the hemodynamic and circulatory changes that occur during episodes of induced supraventricular tachycardia in symptomatic patients.
Interventional physiological evaluation in 8 patients reporting disabling symptoms during paroxysms of supraventricular tachycardia (SVT).
SVT was induced via rapid atrial pacing or atrial premature stimuli, with simultaneous recordings of hemodynamic parameters in sinus rhythm versus SVT.
Coronary arteriography was performed in 4 patients to evaluate coronary artery patency during chest pain episodes.
During SVT (heart rate increasing from 79 to 183 beats/min), mean brachial artery pressure fell from 141 to 99 mmHg and cardiac index declined from 3.6 to 2.2 L/min/m².
Right-sided pressures increased, with pulmonary artery pressure rising from 18/7 to 26/15 mmHg and peak right atrial pressure increasing from 4 to 17 mmHg due to atrial contraction against closed tricuspid valves, alongside pulsus alternans in all cases.
Coronary arteriography demonstrated normally patent coronary arteries in all 4 evaluated patients despite the presence of chest pain during SVT.

Structured PICO

What are the hemodynamic effects of induced supraventricular tachycardia compared to sinus rhythm in patients with symptomatic SVT?

Population

8 patients who reported disabling symptoms during paroxysms of supraventricular tachycardia (SVT)

Intervention

Induced supraventricular tachycardia (SVT) by rapid atrial pacing or with atrial premature stimuli

Comparator

Sinus rhythm (baseline)

Outcome

Hemodynamic parameters including heart rate, P-R interval, brachial artery pressure, cardiac index, pulmonary artery pressure, and right atrial pressuresurrogate

Induced supraventricular tachycardia causes marked hemodynamic compromise, including reduced cardiac index and blood pressure, which explains the disabling symptoms experienced by patients during paroxysms.

Cite This Study

Goldreyer et al. (1976) studied this question.

synapsesocial.com/papers/6a70f2cb75498292b70a7105 https://doi.org/10.1161/01.cir.54.5.783

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Implication

Induced SVT may cause marked hemodynamic compromise explaining symptoms in select patients; leaves open mechanisms and management implications beyond this case series.

The hemodynamic effects of induced supraventricular tachycardia in man.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

The hemodynamic effects of induced supraventricular tachycardia in man.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider