Supraventricular tachycardia natural history, complications and prognosis

Supraventricular tachycardia Microchapters
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Overview
Historical Perspective
Classification
Pathophysiology
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Differentiating Among the Different Types of Supraventricular Tachycardia
Differentiating Supraventricular Tachycardia from Ventricular Tachycardia
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
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Acute Treatment of SVT of Unknown Mechanism
Ongoing Management of SVT of Unknown Mechanism
Ongoing Management of IST
Acute Treatment of Suspected Focal Atrial Tachycardia
Acute Treatment of Multifocal Atria Tachycardia
Ongoing Management of Multifocal Atrial Tachycardia
Acute Treatment of AVNRT
Ongoing Management of AVNRT
Acute Treatment of Orthodromic AVRT
Ongoing Management of Orthodromic AVRT
Asymptomatic Patients With Pre-Excitation
Management of Symptomatic Patients With Manifest Accessory Pathways
Acute Treatment of Atrial Flutter
Ongoing Management of Atrial Flutter
Acute Treatment of Junctional Tachycardia
Ongoing Management of Junctional Tachycardia
Acute Treatment of SVT in ACHD Patients
Ongoing Management of SVT in ACHD Patients
Acute Treatment of SVT in Pregnant Patients
Acute Treatment and Ongoing Management of SVT in Older Population
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

SVTs may start and stop abruptly. Patients may develop syncope. The prognosis of an SVT is generally good in absence of underlying heart disease.

Natural History

The rhythm often ceases abruptly and spontaneously, particularly the most common form AVNRT. An episode generally last seconds to hours.

Complications

• Some patients will develop syncope during episodes of AVRNT. The mechanism of syncope may be due to a reduction of cardiac output and hemodynamic compromise as a result of the short ventricular filling time or alternatively it may be due to transient asystole due to tachycardia-mediated suppression of the sinus node when the rhythm terminates. Those patients who do become symptomatic during episodes of SVT (i.e. have syncope) should avoid activities where the occurrence of hemodynamic compromise would endanger their safety or that of others (like driving).
• In patients with underlying ischemic heart disease, demand-related myocardial ischemia, angina and even myocardial infarction and/or congestive heart failure can occur.
• Tachycardia mediated cardiomyopathy may develop if the SVT is chronic and does not terminate.

Prognosis

SVTs are rarely life threatening and in the absence of underlying structural heart disease, the prognosis is good. Radiofrequency ablation is curative in 95% of cases of AVNRT.

References

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