From the Guidelines
Supraventricular tachycardia (SVT) is commonly predisposed by several underlying conditions, including congenital heart defects, cardiovascular diseases, metabolic imbalances, and lifestyle factors, with age being a significant factor as SVT becomes more common as people get older due to age-related changes in cardiac tissue 1.
Conditions Predisposing to SVT
The conditions that predispose to SVT can be categorized into several groups:
- Congenital heart defects: such as Wolff-Parkinson-White syndrome, Ebstein's anomaly, and atrial septal defects, which create abnormal electrical pathways 1.
- Cardiovascular diseases: like coronary artery disease, heart failure, valvular heart disease, cardiomyopathy, and previous heart surgery, which can damage heart tissue and disrupt normal electrical conduction.
- Metabolic imbalances: including hyperthyroidism, electrolyte abnormalities (particularly potassium and magnesium), and dehydration, which may trigger SVT episodes.
- Lifestyle factors: that increase risk include excessive caffeine or alcohol consumption, stimulant drug use, extreme fatigue, and psychological stress.
- Autonomic nervous system influences: play a role, with both increased sympathetic tone during exercise and increased vagal tone during rest potentially triggering episodes in susceptible individuals.
Management and Prevention
Identifying and managing these underlying conditions is essential for effective SVT treatment and prevention of recurrent episodes. According to the 2020 ESC guidelines for the management of patients with supraventricular tachycardia, the incidence of SVT increases with age, and individuals aged >65 years have a five-fold greater risk of SVT than younger people 1. Additionally, the risk of developing paroxysmal SVT is twice as high in women than in men.
Clinical Features and Treatment
SVT is observed in 10% to 20% of adults with congenital heart diseases (ACHD) patients, and is associated with a significantly increased risk of heart failure, stroke, and sudden cardiac death 1. The management of SVT in ACHD patients should be undertaken only in collaboration with a cardiologist who has specialized training or experience in managing such patients. Therefore, it is crucial to prioritize the management of underlying conditions and lifestyle factors to reduce the risk of SVT and its associated morbidity and mortality 1.
From the FDA Drug Label
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From the Research
Conditions Predisposing to Supraventricular Tachycardia (SVT)
The following conditions can predispose to supraventricular tachycardia (SVT):
- Structurally abnormal hearts, although it is unusual for SVT to be caused by this condition 2
- Wolff-Parkinson-White syndrome, which can be treated with catheter ablation 2, 3, 4
- Atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia, and atrial tachycardia, which are common types of SVT 3, 5, 4
- Reentry phenomena or automaticity at or above the atrioventricular node 4
- Anxiety or panic disorder, which can be misdiagnosed as SVT 2
Symptoms and Diagnosis
Symptoms of SVT may include:
- Palpitations (pulsation in the neck) 2, 3, 4, 6
- Chest pain or discomfort 2, 3, 5, 4
- Lightheadedness or dizziness 2, 3, 4
- Dyspnea (shortness of breath) 2, 3, 5, 4
- Fatigue 3, 4
- Anxiety 2, 6 Diagnosis of SVT can be made with a high degree of certainty from patient history alone, and may involve electrocardiography, Holter monitor or event recorder, and laboratory workup 2, 3, 5, 4, 6