Typical Heart Rate Range for Supraventricular Tachycardia (SVT)
The typical heart rate range for supraventricular tachycardia (SVT) is generally between 150-250 beats per minute (bpm), with most cases exceeding 100 bpm by definition. 1, 2
Definition and Characteristics
- SVT refers to tachycardias (heart rates exceeding 100 bpm at rest) where the mechanism involves tissue from the His bundle or above 1
- SVT is characterized by a rapid, regular rhythm that typically presents with abrupt onset and termination 1, 2
- By definition, sinus tachycardia (a type of SVT) occurs when the sinus rate exceeds 100 bpm 1
Specific Heart Rate Ranges by SVT Type
Paroxysmal Supraventricular Tachycardia (PSVT)
- Heart rates typically range from 150-250 bpm in adults 2
- In the MESA population study, patients with "lone" PSVT (no structural heart disease) had mean heart rates of 186 bpm 1
- Patients with PSVT and other cardiovascular disease had somewhat lower mean rates of 155 bpm 1
- In pediatric patients, PSVT generally exceeds 180 bpm in children and 220 bpm in adolescents 3
Atrioventricular Nodal Reentrant Tachycardia (AVNRT) and Atrioventricular Reentrant Tachycardia (AVRT)
- Rates of tachycardia are often between 140 and 250 bpm 1
- Heart rates above 160 bpm are more likely to be correctly identified as PSVT and respond to adenosine treatment 4
Atrial Flutter
- Typical atrial flutter has an atrial rate of approximately 300 bpm 1
- This rate can be slower in the presence of antiarrhythmic drugs or scarring 1
- Ventricular response depends on AV nodal conduction (often 2:1 or variable)
Clinical Implications of Heart Rate in SVT
Heart rate can predict treatment success:
For unstable patients with SVT:
- With ventricular rates <150 bpm in the absence of ventricular dysfunction, the tachycardia is more likely secondary to an underlying condition rather than the primary cause of instability 1
- Rates exceeding this threshold are more likely to cause hemodynamic compromise requiring immediate intervention 1
Important Considerations
- SVT with rates <160 bpm may be more difficult to correctly identify in emergency settings 4
- Syncope is extremely rare in SVT as rates rarely exceed 180 bpm 1
- The upper rate of physiologic sinus tachycardia is age-related (approximately 220 bpm minus the patient's age in years) 1
- Heart rate alone should not be the only criterion for diagnosis; ECG characteristics and clinical presentation are essential for proper identification 1
Remember that while these ranges are typical, individual patients may present with variations based on age, comorbidities, and specific SVT mechanisms.