Supraventricular tachycardias: the underlying mechanisms and the choice of treatment options

Abstract

The lecture is devoted to one of the most pressing problems of cardiology – the paroxysmal heart rhythm disorders in clinical practice. Supraventricular tachycardias (SVTs) is a common group of cardiac arrhythmias that requires a diagnostic search to establish the mechanisms of formation and selection of optimal treatment tactics. The basic principles of determination of SVTs and their electrophysiological mechanisms are reviewed. The clinical picture and ECG diagnostics of certain forms of tachycardia are outlined. The causes of wide QRS complex tachycardias, and electrocardiographic criteria for the differential diagnosis between ventricular and supraventricular tachycardias with conduction aberration are presented. The key aspects of the diagnosis of wide QRS complex tachycardias are discussed. The emergency care and long-term therapy for SVTs with narrow and wide QRS complexes are presented. According to updated 2019 ESC Guidelines for the management of patients with SVTs, the treatment options and the algorithms for the management of patients with SVT are shown. What should and should not be done? What’s new in 2019 Guidelines? The antiarrhythmic drugs and their use are given, and the principles of catheter treatment of tachycardia are stated.