Supraventricular Tachycardia in Young Adults

Supraventricular tachycardia (SVT) refers to paroxysmal tachyarrhythmias, which require atrial or atrioventricular(AV) nodal tissue or both for their initiation and maintenance. Our objective was to study incidence of SVT in young adults. The study also includes the response of SVT to different modalities of treatment such as antiarrhythmic drugs, electrical therapy such as radio frequency ablation and to study safety and complications of different modalities of treatment.

We studied 35 young adults presenting with SVT; the symptoms, ECG and 2 Decho findings, other causes of tachyarrhythmias were analyzed. They were classified on the basis of Electrophysiological studies (EPS). Different modalities of treatment such as antiarrhythmic drugs and electrical therapy such as radiofrequency ablation, their safety and complications were analyzed.

Out of the 35 patients, 19 were males and 16 were females.; 22 (62.86%) patients had accessory pathways (AP) and 13 (37.14%) had atrioventricular re-entrant tachycardia(AVNRT). Of the 22 with AP, 16 had concealed retrograde AP (11 lateral and 5 posteroseptal). Pre excitation (Wolff-Parkinson-White syndrome - WPW syndrome) was seen in 6. Out of the 35 patients, 28 (80%) underwent radiofrequency ablation (RFA) and 7 (20%) were put only on antiarrhythmic drug therapy. Out of the 7 patients on drugs alone 6 (17.14%) had recurrence. Of the 28 who underwent RFA, only 1 patient, who had multiple accessory pathways had recurrence (3.57%); overall success rate was 96.43%. There were no intra or post-procedure complications.

Electrophysiological studies are mandatory for SVT; to understand the underlying mechanisms and classify them accurately. Successful ablation of bypass tracts and modification of AV node by radiofrequency energy are extremely successful and cost effective, with few complications. So this option should be considered early in the course of treatment of symptomatic patients.