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Clinical features
Published in Gregory YH Lip, Atrial Fibrillation in Practice, 2020
A patient initially presenting with atrial fibrillation may do so acutely or as a more chronic rhythm disorder, which can be symptomatic or asymptomatic. Most patients (90%) in AF who are referred to outpatients have symptoms. Asymptomatic AF is usually discovered incidentally during pulse-taking, cardiac auscultation or 12-lead ECG recording or 24-hour Holter recording undertaken for unrelated reasons. In one comparison of patients with paroxysmal supraventricular tachycardia (PSVT) and
Recognition of common arrhythmias
Published in John Edward Boland, David W. M. Muller, Interventional Cardiology and Cardiac Catheterisation, 2019
Nicholas P. Kerr, Rajesh N. Subbiah
Paroxysmal supraventricular tachycardia (SVT) refers to episodic supraventricular tachyarrhythmias other than atrial flutter and AF that have a re-entrant or focal mechanism. The most common types are atrioventricular nodal re-entrant tachycardia, atrioventricular re-entrant tachycardia and (focal) atrial tachycardia (Figure 20.2b). They generally manifest as regular narrow complex tachycardia (NCT) with a 1:1 AV relationship, but may also present as a regular wide complex tachycardia (WCT) due to rate-related aberrancy or pre-excitation.
Supraventricular tachyarrhythmias in the elderly
Published in Wilbert S. Aronow, Jerome L. Fleg, Michael W. Rich, Tresch and Aronow’s Cardiovascular Disease in the Elderly, 2019
Jason T. Jacobson, Sei Iwai, Ali Ahmed, Wilbert S. Aronow
Paroxysmal supraventricular tachycardia (PSVT) is a regular narrow complex tachycardia with a rate usually between 140 and 220 beats per minute. A wide QRS complex occurs in the presence of bundle branch block or aberrant ventricular conduction. If aberrant ventricular conduction is present, the QRS complex is usually <140 ms, and a right bundle branch block pattern is present 85% of the time.
Hospitalization rate of paroxysmal supraventricular tachycardia in Sweden
Published in Annals of Medicine, 2018
Per Rosengren, Xinjun Li, Jan Sundquist, Kristina Sundquist, Bengt Zöller
Paroxysmal supraventricular tachycardia (PSVT) is a relatively common arrhythmia that is frequently encountered in the emergency room setting [1]. PSVTs are rapid and are usually regular rhythms. The most common types are atrial tachycardias, atrioventricular nodal reentrant tachycardias and tachycardias mediated by an accessory pathway [2]. Its occurrence is sporadic and unpredictable [3,4]. Symptoms vary, the most common being dyspnea, tachycardia, nausea, hypotension, hyperhidrosis, syncope and aborted sudden death [3–9]. Nevertheless, PSVT has generally been considered to be a benign illness. Previous studies have, however, shown a link between PSVT and higher incidence of atrial fibrillation, and an increased risk of thromboembolic events in patients with PSVT [10–13]. An association between sustained supraventricular tachycardias and cardiomyopathic changes has been previously observed [14,15]. In spite of this, there is a paucity of large nationwide population-based data describing the incidence of PSVT. A small hospital-based study (33 cases) that examined the incidence and descriptive epidemiology of PSVT was published in 1998 [16]. There are some studies published regarding the prevalence, incidence and epidemiology of PSVT in infancy and adolescence [17–22]. However, the epidemiology of PSVT in the general population is unknown, which calls for population-based studies to assess the clinical burden of PSVT and to describe its demographics.
Etripamil nasal spray: an investigational agent for the rapid termination of paroxysmal supraventricular tachycardia (SVT)
Published in Expert Opinion on Investigational Drugs, 2020
Anthony H. Kashou, Peter A. Noseworthy
Paroxysmal supraventricular tachycardia (SVT) represents an array of regular, often narrow complex, rapid rhythms with sudden onset and termination. The most common forms of SVT are atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentry tachycardia (AVRT) which both include the AV node as an essential limb of the reentrant circuit. Less commonly, atrial tachycardia (AT) can arise for a focal atrial site, but this arrhythmia is not an AV nodal-dependant reentrant rhythm. The prevalence of SVT in the general population is 2–3 per 1,000 people, with an estimated age- and sex-adjusted incidence of 35 per 100,000 people per year in the United States [1]. There are approximately 570,000 people with SVT and about 89,000 new cases each year [1].
Scoping review of complications associated with epinephrine use in arthroscopy fluid
Published in The Physician and Sportsmedicine, 2021
Taher Abdelrahman, Scott Tulloch, Kate Lebedeva, Ryan M. Degen
Cho et al [3] described ventricular tachycardia in association with epinephrine in two cases undergoing arthroscopic shoulder surgery (19 and 49 years old) (Table 2). Both developed paroxysmal supraventricular tachycardia (PSVT) complicated with ventricular tachycardia 5 minutes after starting the epinephrine infusion (35 min after general anesthetic). In both cases the procedure had to be stopped for patient resuscitation. The first patient required cardiopulmonary resuscitation to restore cardiac rhythm, developed pulmonary edema and was transferred to the Intensive Treatment Unit (ITU) for low blood pressure (BP) management with dopamine. The second patient required cardioversion to restore sinus rhythm, transferred to ITU to control the BP with dopamine. Both patients 1 and 2 were discharged from ITU on days 8 and 5, respectively, with no further follow-up. The author concluded that epinephrine was responsible for the reported complications. They hypothesized that improper mixing of epinephrine can result in rapid infusion of highly concentrated epinephrine into the joint over a short period of time. The hypothesis was tested by injecting 0.3 mL of epinephrine and 1 mL of gentacin violet into a 1-l saline bag. This showed if the saline bag was not shaken well after injection, the violet reagent would become concentrated around the bags’ outflow region. This can result in an initial high concentration of epinephrine pumped into the joint over a short time. In the second case, a 900 ml residual of a 1-l irrigation fluid bag was sent for lab examination and showed no epinephrine was left, proving their hypothesis.