Supraventricular tachycardia natural history, complications and prognosis
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Supraventricular tachycardia Microchapters |
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Differentiating Among the Different Types of Supraventricular Tachycardia |
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Differentiating Supraventricular Tachycardia from Ventricular Tachycardia |
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Diagnosis |
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Treatment |
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2015 ACC/AHA Guideline Recommendations |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Supraventricular tachycardias 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.