Paroxysmal Supraventricular Tachycardia: Pathophysiology, Diagnosis, and Management

Crit Care Nurs Clin North Am. 2016 Sep;28(3):309-16. doi: 10.1016/j.cnc.2016.04.005. Epub 2016 Jun 7.

Abstract

Paroxysmal supraventricular tachycardia (PSVT) is a well-known and thoroughly studied clinical syndrome, characterized by regular tachycardia rhythm with sudden onset and abrupt termination. Most patients present with palpitations and dizziness, and their electrocardiogram demonstrates a narrow QRS complex and regular tachycardia with hidden or inverted P waves. PSVT is caused by re-entry due to the presence of inhomogeneous, accessory, or concealed conducting pathways. Hemodynamically stable patients are treated by vagal maneuvers, intravenous adenosine, diltiazem, or verapamil, hemodynamically unstable patients are treated by cardioversion. Patients with symptomatic and recurrent PSVT can be treated with long-term drug treatment or catheter ablation.

Keywords: Accessory pathways; Paroxysmal supraventricular tachycardia; Supraventricular arrhythmia; Wolff-Parkinson-White syndrome.

Publication types

  • Review

MeSH terms

  • Cardiovascular Agents / therapeutic use
  • Disease Management*
  • Electrocardiography
  • Humans
  • Tachycardia, Paroxysmal / diagnosis*
  • Tachycardia, Paroxysmal / physiopathology
  • Tachycardia, Paroxysmal / therapy
  • Tachycardia, Supraventricular / diagnosis*
  • Tachycardia, Supraventricular / physiopathology
  • Tachycardia, Supraventricular / therapy

Substances

  • Cardiovascular Agents