Clinical profile of patients diagnosed with supraventricular tachycardia: a descriptive study at a tertiary care hospital
Keywords:Atrial fibrillation, Supraventricular tachycardia, Treatment, Echocardiography
Background: Supraventricular tachycardia is a clinical syndrome characterized by a rapid tachycardia with an abrupt onset and termination. The objective of our study was to determine and assess the clinical profile, electrocardiographic and echocardiographic of patients diagnosed with supraventricular tachycardia.
Methods: This cross-sectional study was conducted in the department of general medicine, Dr DY Patil medical college and hospital, Navi Mumbai from April 2020 till October 2021, in which we included patients diagnosed with any type of supra-ventricular tachycardia and excluded hemodynamically unstable patients.
Results: In the present study, of the 45 cases, atrial fibrillation was the most common mechanism of SVT, diagnosed in 47% of the patients. Next most common was AVNRT (22%) and AVRT (18%). In addition, atrial tachycardia was diagnosed in 9% of the patients and atrial flutter was diagnosed in 4%. Mean age of the patients was 34.5 years, ranging from 13 to 68 years and 56% were males. It was observed that palpitation was the most common symptoms (91%). On ECG, no abnormalities were detected in 64%, while left ventricular hypertrophy (18%) and prolonged corrected QT (18%) were the most common abnormalities. On echocardiography, no abnormality was detected in 78% of the patients. Furthermore, 49% of the patients achieved normal sinus rhythm with a single dose of adenosine infusion and 33% of the patients required another dose of adenosine infusion.
Conclusions: Palpitation is common presentation symptom. Most of patients had good response to medication treatment especially adenosine therapy, additional treatment was required in few patients.
Michaud GF, Tada H, Chough S. Differentiation of atypical atrioventricular node re-entrant tachycardia from orthodromic reciprocating tachycardia using a septal accessory pathway by the response to ventricular pacing. J Am Coll Cardiol. 2001;38(4): 1163-7.
Kerr CR, Gallagher JJ, German LD. Changes in ventriculoatrial intervals with bundle branch block aberration during reciprocating tachycardia in patients with accessory atrioventricular pathways. Circulation. 1982;66(1):196-201.
Knight BP, Ebinger M, Oral H. Diagnostic value of tachycardia features and pacing maneuvers during paroxysmal supraventricular tachycardia. J Am Coll Cardiol. 2000;36(2):574-82.
Pandee U, Arj-Ong S. Supraventricular tachycardia at the emergency room. Asian J Epidemiol. 2015;8(2): 42.
Premkumar S, Sundararajan P, Sangaralingam T. Clinical profile of cardiac arrhythmias in children attending the out patient depart- ment of a tertiary paediatric care centre in Chennai. J Clin Diagn Res. 2016;10(12):SC06-8.
Porter MJ, Morton JB, Denman R. Influence of age and gender on the mechanism of supraventricular tachycardia. Heart Rhythm. 2004;1:393-6.
Rehorn M, Sacks NC, Emden MR, Healey B, Preib MT, Cyr PL, et al. Prevalence and Incidence of Patients with Paroxysmal Supraventricular Tachycardia in the United States. J Cardiovasc Electrophysiol. 2021;4:51-9.
O’Connor BK. Clinical paediatric arrhythmias. In: Gillette PC, Garson A, editors. Arrhythmias in Long QT and WPW syndrome. 2nd ed. WB Saun- ders company: Philadelphia; 1999;306-16.
Lee JJ, Lee JH, Jeong JW, Chung JY. Fragmented QRS and abnormal cre- atine kinase-MB are predictors of coronary artery disease in patients with angina and normal electrocardiographys. Korean J Intern Med. 2017;32(3):469-77.
Magioncalda A, Sartini M, Costaguta C, Castellaneta M, Schenone E, Tognoni E, et al. The utility of assaying the N-terminal of brain na- triuretic peptide precursor (NT pro-BNP) to predict the clinical out- come in patients with supraventricular tachyarrhythmias observed and treated in the emergency room. Recenti Prog Med. 2008;99(3):141-5.
L'Italien K, Conlon S, Kertesz N, Bezold L, Kamp A. Usefulness of echocardiography in children with new-onset supraventricular tachycardia. J Am Soc Echocardio. 2018;31(10):1146-50.