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Supraventricular Tachycardia

Supraventricular Tachycardia is a topic covered in the 5-Minute Emergency Consult.

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  • Rhythm that originates ectopically above the His bundle
  • Heart rate of 100 bpm or greater
  • Irregular narrow complex supraventricular tachycardia (SVT):
    • Atrial fibrillation (AF):
      • Most common form of pathologic SVT seen in the ED
      • 10% of people >75 yr of age have AF.
    • Atrial flutter with variable block
    • Multifocal atrial tachycardia
  • Regular narrow complex SVT:
    • Atrial flutter
    • Atrioventricular nodal re-entry tachycardia (AVNRT):
      • 60% of SVT in adults, 70% are female
      • Typically present age 30–40 yr
    • Atrioventricular reciprocating tachycardia (AVRT) involving an accessory pathway
  • Wide complex SVT:
    • Conduction is outside of the normal His-Purkinje system.
    • Accessory pathway or a bundle branch block is present.
    • More common in younger patients without structural disease
    • Always suspect a ventricular rhythm with a wide complex rhythm
    • Treat as ventricular tachycardia (VT) unless absolutely certain of SVT


  • Atrial tachycardia:
    • Precipitated by a premature atrial or ventricular contraction
    • Electrolyte disturbances
    • Drug toxicity (i.e., theophylline)
    • Hypoxia
    • Increased atrial pressure
  • Junctional tachycardia:
    • AV nodal re-entry
    • Myocardial ischemia
    • Structural heart disease
    • Pre-excitation syndromes
  • Wolff–Parkinson–White (WPW) syndrome:
    • Intrinsic accessory pathway
    • Drug and alcohol toxicity
  • AF:
    • HTN
    • Coronary artery disease
    • Hypo-/hyperthyroidism
    • Heavy alcohol intake
    • Mitral valve disease
    • Chronic pulmonary disease
    • Pulmonary embolus
    • WPW syndrome
    • Hypoxia
    • Digoxin toxicity
    • Chronic pericarditis
    • Sepsis
  • Atrial flutter:
    • Ischemic heart disease
    • Valvular heart diseases
    • CHF
    • Myocarditis
    • Cardiomyopathies
    • Pulmonary embolus
    • Other pulmonary disease

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Rosen, Peter, et al., editors. "Supraventricular Tachycardia." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307244/all/Supraventricular_Tachycardia.
Supraventricular Tachycardia. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307244/all/Supraventricular_Tachycardia. Accessed April 24, 2019.
Supraventricular Tachycardia. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307244/all/Supraventricular_Tachycardia
Supraventricular Tachycardia [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 24]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307244/all/Supraventricular_Tachycardia.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Supraventricular Tachycardia ID - 307244 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307244/all/Supraventricular_Tachycardia PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -