Clinical & Experimental Cardiology
Open Access

The Management of Various Types of Tachycardia

Raluca Serban^{* *}Correspondence: Raluca Serban, Department of Cardiology, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania, Email:

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Description

Supraventricular Tachycardia (SVT), a common cause for hospitalisations, can significantly inflict pain and misery on patients. Atrioventricular Nodal Re-Entrant Tachycardia (AVNRT), atrioventricular re-entrant tachycardia, and atrial tachycardia are the three most prevalent SVTs. Electrocardiography during tachycardia, comparing it with sinus rhythm, and analysing the start and offset of tachycardia may often be used to infer the underlying cause. In the acute diagnosis and therapy of SVT, most recent European Society of Cardiology recommendations continue to support the use of vagal movements and adenosine as first-line therapies. Calcium channel blockers and beta-blockers are examples of alternative therapy. A cardiac rhythm specialist's opinion should be sought for all patients treated with SVT.

The frequency of symptoms, risk assessment, and patient preferences all play a role in long-term treatment. If the patient has few symptoms and is at low risk, the course of treatment might range from conservative through catheter ablation, which is typically curative. Supraventricular Tachycardias (SVTs) are a frequent reason for patients to seek primary and secondary care services and can be quite uncomfortable and upsetting for them. All patients who appear with a narrow complex tachycardia should have a 12-lead Electrocardiogram (ECG) done, and a copy should be supplied to them. Diagnostic tools include close examination of the ECG, comparison with ECGs in sinus rhythm, and recordings of the onset and offset of tachycardia. Re-entrant tachycardias involving the atrioventricular node, such as atrioventricular nodal re-entrant tachycardia and atrioventricular re-entrant tachycardia, are extremely susceptible to termination by vagal movements and adenosine administration. Due to an existing bundle branch block or one that is triggered by rate, any SVT might appear as a wide complex tachycardia. Because of the potential for diagnostic ambiguity, wide complex tachycardia should always be considered in the differential diagnosis with Ventricular Tachycardia (VT). The frequency of symptoms, underlying mechanisms, and patient preferences all affect long-term treatment. Because of its high likelihood of cure and minimal risk of serious consequences, catheter ablation is frequently preferred as the first choice of therapy over long-term medicinal maintenance. In the general population, Atrioventricular Re- Entrant Tachycardia (AVNRT) is the most prevalent SVT, and more than 60% of individuals undergoing invasive cardiac electrophysiological studies have this condition.

Re-entrant tachycardias involving the atrioventricular node, such as atrioventricular nodal re-entrant tachycardia and atrioventricular re-entrant tachycardia, are extremely sensitive to termination by vagal movements and adenosine administration. Due to an existing bundle branch block or one that is triggered by rate, any SVT can appear as a broad complex tachycardia. Because of the potential for diagnostic ambiguity, broad complex tachycardia should always be considered in the differential diagnosis with VT. The frequency of symptoms, underlying mechanisms, and patient preferences all affect long-term management. Because of its high rate of cure and low risk of serious consequences, catheter ablation is frequently preferred as the first choice of treatment over long-term medicinal maintenance. In the general population, AVNRT is the most prevalent SVT, and more than 60% of individuals undergoing invasive cardiac electrophysiological studies have this condition.

Previous investigations have found that the existence of a pseudo S' deflection has a greater specificity and positive predictive value for AVNRT, even if a pseudo r' wave is more sensitive and thus valued more. The underlying cause, the frequency of symptoms, the patient's safety, and preference all influence long-term care. Catheter ablation is a particularly desirable option as first line therapy for all SVTs, especially in AVNRT and AVRT where documented cure rates can exceed 95% with an associated risk of 1% for major complications. However, the potential for significant improvements in quality of life, decreased hospital attendances, and cost burden make catheter ablation a particularly desirable option. It's critical to evaluate the risk of sudden cardiac death in AVRT because there is a clear pathway present and symptoms are uncommon. A low-risk pathway may be indicated by sporadic or rapid loss of pre-excitation observed during continuous ambulatory monitoring or an exercise test. If not, invasive cardiac electrophysiology testing may be necessary to characterise the electrophysiological characteristics of the route for risk assessment. If a high-risk route is identified, catheter ablation is strongly advised.