The Acute Management of Paroxysmal Supraventricular Tachycardia in Children

1993 ◽  
Vol 14 (7) ◽  
pp. 273-274
Author(s):  
Lars C. Erickson ◽  
Mark W. Cocalis
Keyword(s):  
Supraventricular Tachycardia ◽  
Sinus Tachycardia ◽  
Sudden Onset ◽  
Electrical Cardioversion ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Av Node ◽  
Capillary Refill ◽  
Pediatric Clinic ◽  
Bypass Tract ◽  
Methodical Approach

Supraventricular tachycardia (SVT) in children is a common disturbance of cardiac rhythm that is usually managed without difficulty by using a methodical approach. Technically, the term SVT refers to any rapid rhythm originating in or involving the atria or atrioventricular (AV) node. The most common type of SVT treated in the pediatric clinic is a reentrant rhythm involving the AV node or a bypass tract (paroxysmal SVT [PSVT]). This type of SVT is characterized by sudden onset and cessation, very little beat-to-beat variability, and rates usually well beyond 220 beats/minute. Reentrant rhythms are susceptible to vagal maneuvers, pharmacologic intervention, and electrical cardioversion. Other types of SVT include atrial flutter (rare in children) and automatic tachycardias, which tend to vary in rate over time and start and stop more gradually. It is important to distinguish automatic tachycardias from PSVT because they do not resolve with vagal maneuvers or electrical cardioversion and because they are notoriously difficult to manage with medications. The automatic tachycardia most frequently confused with PSVT is sinus tachycardia, which usually requires no treatment. The first step in evaluation is to check the hemodynamic status. A small proportion of children who have PSVT may present with shock. If the child is hypotensive or has poor capillary refill, one must start immediate measures to restore effective perfusion, including securing reliable intravenous (IV) access and supine positioning.

Paroxysmal supraventricular tachycardia utilizing concealed bypass tract induced by ventricular pacemaker

1983 ◽  
Vol 52 (8) ◽  
pp. 1149-1151 ◽  
Author(s):  
Robert J. Hariman ◽  
Davor Kvaternik ◽  
Chia-Maou Chen ◽  
Antonio R. Caracta ◽  
Anthony N. Damato
Keyword(s):  
Supraventricular Tachycardia ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Bypass Tract

scholarly journals Panic Attacks in Patients with Supraventricular Tachycardia: Problems of Differential Diagnosis and Impact on Quality of Life

2022 ◽  
Vol 17 (6) ◽  
pp. 860-866
Author(s):  
D. A. Tsaregorodtsev ◽  
P. A. Shelukha ◽  
L. V. Romasenko ◽  
M. M. Beraya ◽  
A. V. Sokolov
Keyword(s):  
Quality Of Life ◽  
Differential Diagnosis ◽  
Supraventricular Tachycardia ◽  
Sinus Tachycardia ◽  
Depression Scale ◽  
Well Being ◽  
Panic Attacks ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Heart Attacks

Aim. To study the psychosomatic relationships and quality of life (QOL) of patients with paroxysmal supraventricular tachycardia (SVT) depending on the presence or absence of panic attacks (PA) in comparison with patients with heartbeat against the background of somatoform autonomic dysfunction.Material and methods. The study included patients with SVT and heart attacks due to sinus tachycardia in the context of somatoform autonomic disorder (SAD). All patients were interviewed to identify anxiety and depressive disorders (Hospital Anxiety and Depression Scale [HADS] and Hamilton's Depression Scale), QOL assessment (SF-36 questionnaire), and they were also consulted by a psychiatrist who established the presence or absence of PA. According to a visual analogue scale, in points from 0 to 6, we assessed the general state of our patients' health (0 points corresponded to complete health, and 6 points corresponded to a serious illness) and the effect of heartbeat on well-being (0 points - no arrhythmia, 6 points - arrhythmia «nterferes with life»).Results. The study included 96 patients: 60 with SVT (21 men, 39 women, average age was 51 [33; 61] years) and 36 with heart attacks caused by sinus tachycardia in the framework of somatoform autonomic disorder (10 men, 26 women, average age was 33 [27; 41] years). Panic disorder was diagnosed in the SVT group in 17 patients, accounting for 28.3%. Only 7 patients (41%) could clearly differentiate between SVT and PA attacks. The low sensitivity of the HADS questionnaire in patients with SVT determined the need to consult a psychiatrist for the diagnosis of panic disorders.Conclusion. PA is typical for 28.3% of patients with SVT. The combination of SVT with PA reduces the QOL of patients due to its mental components, including due to the more frequent occurrence of depressive symptoms. Patients with SAD subjectively perceive the heartbeat as a more significant factor affecting health, compared with patients with SVT. Difficulties in the differential diagnosis of PA and SVT paroxysms in real clinical practice often lead to the appointment of the same therapy without taking into account the differences in the genesis of heartbeats.

scholarly journals Supraventricular Tachycardia in Pregnancy

2021 ◽  
Vol 8 (3) ◽  
pp. 88-90
Author(s):  
Gauri Prabhu ◽  
Shubha SR ◽  
M.B. Bellad ◽  
Shridevi Metugud
Keyword(s):  
Heart Rate ◽  
Supraventricular Tachycardia ◽  
Treatment Options ◽  
Tertiary Care ◽  
Electrical Cardioversion ◽  
Reproductive Age ◽  
Paroxysmal Supraventricular Tachycardia ◽  
Tertiary Care Centre ◽  
Intravenous Amiodarone ◽  
Life Threatening

The commonest arrhythmia in women of reproductive age, is paroxysmal supraventricular tachycardia (SVT). We present a rare case of SVT who presented for the first time during pregnancy, who failed to respond to Electrical cardioversion(ECV), but reverted back to sinus rhythm by secondline pharmacotherapy. PROCEDURE: A 22 year old primigravidapresented at 37weeks in labour with complaints of breathlessness and severe palpitations when she was diagnosed to have supraventricular tachycardia(SVT) on ECG and was referred to a tertiary care centre for further management.Pharmacological cardioversion was attempted with intravenous diltiazem, but in vain. Decision was taken for electrical cardioversion with synchronized DC shocks of 50 joules and 100 joules successively, but was not successful too. As a last resort, bolus of intravenous Amiodarone 150 mg was given over 10 minutes followed by infusion at the rate of 24 mg per hour(2ml/hr), which finally brought down the heart rate to 98bpm. In view of non-reassuring fetal heart rate observed on CTG, patient was taken up for an emergency caesarean section under epidural anaesthesia with grave risk consent and shifted to ICCU post-operatively. RESULT: Patient delivered a male baby of birth weight 2.35kg. Patient tolerated the surgery well and did not experience any episodes of PSVT throughout the intra-operative period. Postoperatively patient was managed in consultation with cardiologist. Amiodarone infusion was continued for 24 hours at 24mg/ hour. Post-operative period was uneventful, patient was started on oral anti arrhythmic medications and discharged on the same. CONCLUSION : Accurate diagnosis, regular follow up and multidisciplinary approach during acute episode and during delivery can prevent life threatening risks that might be posed to the mother and fetus in a case of PSVT. Treatment options include nonpharmacological therapy, followed by adenosine and other drugs if required, and lastly electrical cardioversion

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