Understanding the modern-era management of cardiac tachyarrhythmias

Abstract

Diagnosis and treatment modalities of supraventricular arrhythmias have been changed over the past decade. This article mainly outlines advances in diagnosis and modern-day management of supraventricular tachycardia as well as an overview of the management of wide complex tachyarrhythmias. The role of cardiac electrophysiology study and radiofrequency catheter ablation in the diagnosis and management of a wide variety of supraventricular arrhythmias is also discussed. This article also emphasizes the current evidence-based management of atrial-origin tachyarrhythmias such as atrial flutter and fibrillation.The management of cardiac arrhythmias has changed over the past decade, which is mainly due to improvements in catheter ablation including 3D mapping catheter ablation, improvements in device therapy such as implantable cardioverter defibrillator (ICD) and biventricular pacing therapy (CRT) which have evolved to treat many conditions. Catheter ablation has moved from being a treatment considered only for patients with refractory arrhythmias to a first-line treatment. In the new era, catheter ablation is also used to treat atrial origin tachyarrhythmias such as atrial fibrillation (AF) and atrial flutter as well as ventricular tachycardia (epicardial VT ablation). Improvement of imaging modalities such as 2D/3D echocardiogram and cardiac MRI also play a vital role in the prognosis of ablation particularly in AF and epicardial VT ablation. Improvement in device implantation such as ICD and biventricular pacing also helpful in managing tachyarrhythmia. Modern advancements in cardiac electrophysiology help patients to improve their quality of life and prevent sudden cardiac deaths due to cardiac arrhythmia.