Supraventricular tachycardias: the underlying mechanisms and the choice of treatment options
Article Sidebar
This work is licensed under a Creative Commons Attribution 4.0 International License.
Main Article Content
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.
Article Details
Keywords:
References
Жарінов О.Й., Куць В.О., Грицай О.М., Вережнікова Г.П. Суправентрикулярні тахікардії [Електронний ресурс]. Медицина світу. 2013. URL: http://msvitu.com/archive/2013/september/article-1.php
Нарушения сердечного ритма и проводимости. Руководство для врачей / под ред. В.Н. Коваленко, О.С. Сычева. Киев, 2009. 654 с.
Обзор рекомендаций Американской коллегии кардиологов / Американской ассоциации сердца / Общества ритма сердца 2015 г. по ведению пациентов с наджелудочковыми тахикардиями. Аритмологія. 2016. Т. 20, № 4. С. 30–35.
Основы кардиологии: Принципы и практика / под ред. проф. Клива Розендорффа. 2-е изд. Львов: Медицина світу, 2007. 1064 с.
Серцево-судинні захворювання. Рекомендації з діагностики, профілактики та лікування / за ред. В.М. Коваленка, М.І. Лутая. Київ: МОРІОН, 2011. 408 с.
Соловьян А.Н., Михалева Т.В. Суправентрикулярные тахикардии: современные методы диагностики и лечения. Ліки України. 2016. Т. 206, № 10. С. 12–21.
Al-Khatib SM, Arshad A, Balk EM. et al. Risk stratification for arrhythmic events in patients with asymptomatic pre-exitation: a systematic review for the 2015 ACC/AHA/HRS guideline for the management of adult patients with supraventricular tachycardia: a report of the American College of Cardiology / American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2016;67:1617–29. doi: https://doi.org/10.1016/j.jacc.2015.09.018.
Allessie MA, Bonke FI, Kirhhof CJ. Atrial re-entry. Cardiac Electrophysiologic. Textbook / M Rosen, MJ Janse, AL Wit [eds.]. Mount Kisco, NY: Futura Publishing Compani INC, 1990: 555–71.
Antzelevitch C. Brugada syndrome: clinical, genetic, molecular, cellular and ionic aspects. Expert Rev Cardiovasc Ther. 2003;1:177–85. doi: https://doi.org/10.1586/14779072.1.2.177.
Antzelevitch C. Cellular basis and mechanism underlying normal and abnormal myocardial repolarization and arrhythmogenesis. Ann Med. 2004;36,Suppl.1:5–14. doi: https://doi.org/10.1080/17431380410032553.
Beldner S, Lin D, Marchlinski FE. Flecainide and propafenone induced ST-segment elevation in patients with atrial fibrillation: clue to specificity of Brugada-type electrocardiographic changes. Am J Cardiol. 2004;94:1184–5. doi: https://doi.org/10.1016/j.amjcard.2004.07.091.
Blomstörm-Lundqwist C, Scheinman MM, Aliot EM, et al. ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias – executive summary: a report of the American College of Cardiology / American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients with Supraventricular Arrhythmias). Developed in collaboration with NASPE – Heart Rhythm Society. J Am Coll Cardiol. 2003;42:1493–531. doi: https://doi.org/10.1016/j.jacc.2003.08.013.
Blomström-Lundqvist C, Scheinman M, Aliot E, et al. ACC/AHA/ESC Guidelines for the management of patients with supraventricular arrhythmias – executive summary: a report of the American College of Cardiology / American Heart Association. Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Supraventricular Arrhythmias) Circulation. 2003;108:1871–909. doi: https://doi.org/10.1161/01.CIR.0000091380.04100.84.
Brugada J, Katritsis DG, Arbelo E. et al. 2019 ESC Guidelines for the management of patients with supraventricular tachycardia. The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC): Developed in collaboration with the Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J. 2020;41:655–720. doi: https://doi.org/10.1093/eurheartj/ehz467.
Epstein AE, Dimarco JP, Ellenboger KA, et al. ACC/AHA/HRS 2008 guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: executive summary. Heart Rhythm 2008;5:934–55. doi: https://doi.org/10.1016/j.hrthm.2008.04.015.
Issa Z, Miller J, Zipes D. Clinical arrhythmology and electrophysiology: A comparison to Braunwaldʼs Heart Disease. Saunders, 2012. 744 p.
Jacobs AK, Kushner FG, Ettinger SM, et al. ACCF/AHA clinical practice guideline methodology summit report: a report of the American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013;61:213–65. doi: https://doi.org/10.1016/j.jacc.2012.09.025.
Lerman BB. Response of nonreentrant catecholamine-mediated ventricular tachycardia to endogenous adenosine and acetylcholine. Evidence for myocardial receptor-mediated effects. Circulation 1993;87:382–90. doi: https://doi.org/10.1161/01.cir.87.2.382.
Lim SH, Anantharaman V, Teo WS, Chan Y. Slow infusion of calcium channel blockers compared with intravenous adenosine in the emergency treatment of supraventricular tachycardia. Resuscitation 2009;80:523–8. doi:https://doi.org/10.1016/j.resuscitation.2009.01.017.
Markowitz S, Stein K, Mittal S, et al. Differential effects of adenosine on focal and macroreentrant atrial tachycardia. J Cardiovasc Electrophysiol. 1999;10:489–502. doi: https://doi.org/10.1111/j.1540–8167.1999.tb00705.x.
Page RL, Joglar JA, Caldwell MA, Calkins H, Conti JB, Deal BJ, Estes NAM, Field ME, Goldberger ZD, Hammill SC, Indik JH, Lindsay BD, Olshansky B, Russo AM, Shen WK, Tracy CM, Al-Khatib SM. 2015 ACC/AHA/HRS Guidelines for the management of adult patients with supraventricular tachycardia. J Am Coll Cardiol. 2016;67:e27–115. doi: https://doi.org/10.1016/j.jacc.2015.08.856.
Podrid P, Kowey P. Cardiac Arrhythmia: mechanisms, diagnosis, and management. LWW, 2001. 973 p. Priori SG, Blomström-Lundqvist C, Mazzanti A, et al. Рекомендації Європейського товариства кардіологів 2015 року щодо лікування пацієнтів зі шлуночковими аритміями та запобігання раптової смерті. Аритмологія. 2016. Т. 18, № 2. С. 5–36.
Spector P, Reinolds MR, Calkins H, et al. Meta-analysis of ablation of atrial flutter and supraventricular tachycardia. Am J Cardiol. 2009;104:671–7. doi: https://doi.org/10.1016/j.amjcard.2009.04.040.
Triedman J, Perry JG, Pappone C. et al. Risk stratification for prophylactic ablation in asymptomatic Wolff–Parkinson–White Syndrome. New Engl J Med. 2005;352:92–3. doi: https://doi.org/10.1056/NEJM200501063520118.
Tubaro M, Vranckx P, Price S, Vrints C. The ESC Textbook of Intensive and Acute Cardiovascular Care (The European Society of Cardiology). Oxford University Press, 2015. 882 p.
Zipes DP, Camm AJ, Borggrefe M. et al. 2006 ACC/AHA/ESC Guidelines for the Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death – Executive Summary. J Am Coll Cardiol. 2006;48:1064–108. doi: https://doi.org/10.1016/j.jacc.2006.07.010.