From the Guidelines
Paroxysmal supraventricular tachycardia (PSVT) is more likely to occur in women than in men, with a twofold increased risk, and the risk also increases with age, particularly in individuals over 65 years old. The main risk factors for PSVT include:
- Age, with a five-fold greater risk in individuals over 65 years old compared to younger people 1
- Gender, with women having a twofold increased risk of developing paroxysmal SVT compared to men 1
- Other potential risk factors may include congenital heart abnormalities, structural heart disease, and triggers such as caffeine consumption, alcohol use, and stress, although these are not explicitly mentioned in the most recent and highest quality study 1 It is essential to note that the most recent and highest quality study 1 provides the most reliable information on the risk factors for PSVT, and the risk of developing paroxysmal SVT is twice as high in women than in men, and increases with age. Some studies suggest that other factors, such as family history, thyroid disorders, and electrolyte imbalances, may also contribute to the risk of PSVT 1, but these findings are not as strongly supported by the most recent evidence. In clinical practice, it is crucial to consider the patient's individual characteristics, medical history, and symptoms when assessing the risk of PSVT. The clinical history and physical examination are essential in identifying the pattern of arrhythmia and potential triggers, which can help guide diagnosis and treatment 1. However, the most critical risk factors for PSVT, as supported by the most recent and highest quality study, are age and gender.
From the Research
Risk Factors for Paroxysmal SVT
There are several risk factors associated with paroxysmal supraventricular tachycardia (PSVT), including:
- Age: Approximately 50% of patients with PSVT are aged 45 to 64 years 2
- Sex: 67.5% of patients with PSVT are female 2
- Symptoms: Most common symptoms include palpitations, chest discomfort, and dyspnea 2
Pathophysiology
PSVT is caused by re-entry due to the presence of inhomogeneous, accessory, or concealed conducting pathways 3
Diagnosis and Management
Diagnosis is made on electrocardiogram during an arrhythmic event or using ambulatory monitoring 2 First-line acute therapy for hemodynamically stable patients includes vagal maneuvers and intravenous adenosine 2, 4 Emergent cardioversion is recommended for patients who are hemodynamically unstable 2, 3 Catheter ablation is safe, highly effective, and recommended as first-line therapy to prevent recurrence of PSVT 2
Treatment Options
Treatment options for PSVT include:
- Vagal maneuvers: such as the modified Valsalva maneuver 2, 5
- Intravenous adenosine: 91% effective in converting PSVT to sinus rhythm 2, 4
- Calcium channel blockers: such as verapamil and diltiazem 3, 5
- Beta-blockers: such as propranolol and metoprolol 5
- Catheter ablation: highly effective in preventing recurrence of PSVT 2