New ACC/AHA/HRS Guideline Addresses Management of SVT

To aid clinicians in treating SVT and distinguishing it from other disorders, on Sept. 23 the ACC, the American Heart Association (AHA) and the Heart Rhythm Society (HRS) released the “2015 Guideline for the Management of Adult Patients With Supraventricular Tachycardia” (SVT). The guideline was also published in the Journal of the American College of Cardiology.

The document, which supersedes the 2003 guideline, contains the most updated consensus of clinicians with broad expertise related to SVT and its treatment.

The guideline addresses all types of SVT, including regular narrow-QRS complex tachycardias and irregular SVTs, such as atrial flutter with irregular ventricular response and multifocal atrial tachycardia. However, the document does not include atrial fibrillation, which is included in the “2014 ACC/AHA/HRS Guideline for the Management of Atrial Fibrillation.”

According to the guideline, symptoms of SVT often begin in adulthood, with women at twice the risk of developing the condition. The diagnosis of SVT is often made in the emergency department, while a 12-lead electrocardiogram during tachycardia and sinus rhythm may help to determine the cause of tachycardia.

As the document explains, SVT can impact quality of life, depending on frequency, duration and whether the symptoms occur not only while exercising, but also while at rest. The guideline also differentiates SVT from other disorder that may cause similar symptoms, such as panic attacks, chest pain, shortness of breath and syncope or near syncope.

“The overall goal of the guideline is to provide clinicians with the tools needed to successfully diagnose and treat patients with supraventricular tachycardia upon presentation in the inpatient or outpatient setting,” said Richard L. Page, MD, FACC, chair of the writing committee. “This includes quick diagnosis and treatment, making any necessary referrals to cardiology and electrophysiology specialists, discussion and collaboration with the patient, and the prescription of appropriate treatment.”

The ACC has developed an SVT Diagnosis and Treatment Tool to help clinicians quickly diagnose the type of SVT a patient presents with and ensure they consistently follow a prescribed algorithm for treatment of the condition. Ultimately, this tool aims to reduce SVT patients’ discomfort in a timely manner. Additional SVT-related tools will be released in the coming months as part of the ACC’s SVT Toolkit. 

Keywords: Arrhythmias, Cardiac, Amiodarone, Anticoagulants, Atrial Fibrillation, Atrial Flutter, Benzazepines, Calcium Channel Blockers, Cardiac Electrophysiology, Catheter Ablation, Electrocardiography, Ambulatory Care, Postural Orthostatic Tachycardia Syndrome, Pre-Excitation Syndromes, Procainamide, Stroke, Syncope, Tachycardia, Tachycardia, Atrioventricular Nodal Reentry, Tachycardia, Tachycardia, Sinus, Tachycardia, Supraventricular, Wolff-Parkinson-White Syndrome


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