Discussing Supraventricular Tachycardia Monitor Results with a Patient Over the Phone
When discussing supraventricular tachycardia (SVT) monitor results with a patient over the phone, provide clear information about the diagnosis, implications, and next steps while ensuring symptom-rhythm correlation. 1
Preparation Before the Call
Before calling the patient:
- Review the complete monitor results, noting:
- Type of SVT detected (AVNRT, AVRT, atrial tachycardia)
- Heart rate during episodes
- Duration and frequency of episodes
- Symptom correlation with recorded events
- Any associated hemodynamic changes
Structured Phone Discussion Approach
1. Introduction and Verification
- Identify yourself and your role
- Verify the patient's identity using two identifiers
- Ensure the patient is in a comfortable setting to discuss medical information
- Ask if this is a good time to talk about their heart monitor results
2. Explain the Findings
- Use simple, non-technical language to explain SVT:
- "The monitor shows episodes of a fast heart rhythm called supraventricular tachycardia"
- Explain the heart rate recorded during episodes
- Describe how this differs from normal rhythm
3. Correlate with Symptoms
- Ask the patient to recall any symptoms they experienced during the monitoring period
- Confirm whether their reported symptoms (palpitations, dizziness, chest discomfort) corresponded with the recorded SVT episodes 2
- If there's a mismatch between symptoms and recorded events, acknowledge this and explain its significance
4. Discuss Clinical Significance
- Explain what SVT means for their health:
- Most SVTs are not immediately life-threatening but can affect quality of life
- Discuss potential triggers identified
- Explain that treatment options exist that can effectively manage or cure the condition
5. Management Plan
- Outline the next steps:
- Need for in-person evaluation (if not already completed)
- Potential referral to a cardiologist or electrophysiologist
- Possible diagnostic tests (12-lead ECG, echocardiogram)
- Treatment options based on frequency and severity of symptoms:
- Vagal maneuvers for acute episodes
- Medication options (beta-blockers, calcium channel blockers)
- Catheter ablation for definitive treatment 3
6. Home Management Instructions
- Teach the patient how to perform vagal maneuvers safely
- Review warning signs that should prompt immediate medical attention
- Discuss lifestyle modifications that may help reduce episodes:
- Avoiding caffeine, alcohol, and other triggers
- Stress management techniques
- Adequate hydration 1
7. Documentation and Follow-up
- Document the conversation in the patient's medical record
- Schedule appropriate follow-up:
- In-person appointment with primary care or cardiology
- Timeline for specialist referral if needed
- Instructions for continued monitoring if required
Important Considerations
Technology Limitations
- Be aware that telemetry systems may have latency issues that affect real-time rhythm assessment 1
- If discussing results from mobile cardiac outpatient telemetry:
- Acknowledge the benefits of extended monitoring
- Explain how the continuous recording helped capture the arrhythmia 1
Common Pitfalls to Avoid
- Avoid using excessive medical terminology
- Don't minimize patient symptoms even if the arrhythmia appears benign
- Don't make definitive treatment decisions without in-person evaluation
- Ensure the patient understands the difference between SVT and more serious arrhythmias
- Remember that telephone discussions about cardiac findings may cause anxiety - provide reassurance when appropriate
By following this structured approach, you can effectively communicate SVT monitor results to patients, ensuring they understand their condition and the next steps in their care pathway.