EDUCATION IN HEART

Electrophysiology

Which patient should be referred to an electrophysiologist: supraventricular tachycardia

Richard J Schilling

Correspondence to:
Correspondence to:
Dr Richard Schilling, Cardiology Department, St Barts Hospital, West Smithfield. London EC1 7BE, UK;
richard.schilling@bartsandthelondon.nhs.uk

Keywords: supraventricular tachycardia; atrioventricular nodal re-entry tachycardia; atrioventricular re-entry tachycardias; atrial fibrillation; atrial flutter

Abbreviations: AF: atrial fibrillation; AT: atrial tachycardia; AV: atrioventricular; AVNRT: atrioventricular nodal re-entry tachycardia; AVRT: atrioventricular re-entry tachycardia; EPS: electrophysiological study; RF: radiofrequency; SVT: supraventricular tachycardia

The management of supraventricular tachycardia (SVT) has changed considerably over the last 10 years, and some of the techniques that interventional electrophysiologists were using last year are now outdated. This rapid evolution means that many cardiologists who do not specialise in this field find it difficult to keep up to date with the optimum strategies for the investigation and treatment of arrhythmia. This review aims to give an update on the available treatment options and their outcomes, and provide a guide to appropriate referral to specialist interventional cardiac electrophysiologists.

CLASSIFICATION AND AETIOLOGY OF SUPRAVENTRICULAR ARRHYTHMIAS

Most tachycardia has a re-entry mechanism (fig 1) and the classification of most arrhythmias is based on the location of this re-entry circuit. Tachycardia can be categorised as ventricular (involving the ventricle ± the His-Purkinje system only) and supraventricular (involving the supra-hisian structures with or without ventricular tissue). They can then be subdivided into regular or irregular tachycardia. Irregular . . . [Full text of this article]

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