Supraventricular Arrhythmias: An Electrophysiology Primer

Carol Chen-Scarabelli, MSN, APRN, BC, CCRN


Prog Cardiovasc Nurs. 2005;20(1):24-31. 

In This Article

Abstract and Introduction

Supraventricular arrhythmias are the most widespread group of arrhythmias and affect all age groups. Atrial fibrillation is the most common arrhythmic disorder and is even more prevalent among the elderly. Due to their prevalence, it is imperative for the clinician to be informed about these arrhythmias and treatment considerations. This paper presents a basic review of the incidence, pathophysiology, diagnosis, and treatment of supraventricular arrhythmias, along with gender differences, and discusses important implications for the health care provider. A summary of common electrocardiogram findings in supraventricular arrhythmias is presented along with a brief overview of pharmacologic agents.

Although ventricular arrhythmias and implantable cardioverter-defibrillators have garnered the spotlight in the field of cardiovascular electrophysiology, supraventricular tachycardias (SVTs) continue to be the most prevalent arrhythmias, with atrial fibrillation (AF) remaining the most common cardiac arrhythmia,[1,2,3] affecting 2% of the general population.[4] As the population ages, the incidence of AF continues to increase,[2,3] affecting 8%-11% of people over 65 years of age.[4] Eighty-four percent of patients with AF are over 65 years (median age, 75 years),[5] and the prevalence of AF is expected to double over the next 50 years.[6,7,8]

As the incidence of ischemic heart disease grows worldwide, the risk of myocardial infarction (MI) also increases. AF, along with other SVTs, is common in the pre-[9] and postinfarction period, after cardiac surgery,[10] and in critically ill patients.[11,12] Independent predictors of tachyarrhythmias have been identified in patients in the intensive care unit after cardiac surgery: age, presence or history of congestive heart failure, sepsis, postoperative systemic inflammatory response, severity of multiple organ dysfunction, and severity of cardiovascular dysfunction.[10] AF and atrial flutter (AFL) were the most frequently observed arrhythmias (76% incidence), followed by paroxysmal supraventricular tachycardia (PSVT) (15%), and ventricular tachycardia/ventricular fibrillation (11%).[10]

This paper reviews the incidence, pathophysiology, diagnosis, and treatment of SVT, along with gender differences, and discusses important implications for the health care provider.