Paroxysmal supraventricular tachycardias: modern principles of diagnostics and treatment
Abstract
The article is devoted to one of the most actual problems in modern arrhythmology - treatment of paroxysmal supraventricular tachycardias. Modern views on diagnostics and treatment of atrio-ventricular (AV) nodal reciprocating tachycardia and AV reciprocating tachycardia with extra nodal accessory pathways’ involvement are presented. Vagal maneuvers for paroxysm termination are described in detail. Algorithms for differential diagnostics and antiarrhythmic therapy selection, according to arrhythmic mechanisms, are presented.
About the Authors
A. V. Vetluzhsky
I.M. Sechenov Moscow Medical Academy, City Clinical Hospital No. 61, Moscow
Russian Federation
Russian Federation
I. G. Fomina
I.M. Sechenov Moscow Medical Academy, City Clinical Hospital No. 61, Moscow
Russian Federation
Russian Federation
References
1. Ардашев В.Н., Ардашев В.А., Стеклов В.И. Лечение нарушений сердечного ритма. Москва «Медпрактика-М» 2005.
2. Бокерия Л.А., Ревишвили А.Ш. Катетерная аблация аритмий у пациентов детского и юношеского возраста. Москва «Изд НЦССХ им. А.Н. Бакулева РАМН» 1999; 20-7.
3. Сулимов В.А., Маколкин В.И. Чреспищеводная электрическая стимуляция сердца. Москва «Медицина» 2001; 120-30.
4. Голицын С.П. Электрофизиологические механизмы пароксизмальных тахиаритмий у больных с синдромом ВольфаПаркинсона-Уайта и воздействие на них некоторых антиаритмических препаратов. Автореф дисс докт мед наук. Москва 1981.
5. Сулимов В.А. Пароксизмальные тахикардии. Автореф дисс докт мед наук. Москва 1990.
6. Татарский А.Б. Протекторный эффект пропафенона при пароксизмальных реципрокных атриовентрикулярных тахикардиях. РКЖ 2004; 1: 45-53.
7. Фомина И.Г. Клинико-генетические аспекты синдрома преждевременного возбуждения желудочков. Дисс докт мед наук. Москва 1991.
8. Antiarrhythmic therapy: a pathophysiologic approach. By members of the Sicilian Gambit. Futura publishing Co, Armonk, NY 1994; 149-59.
9. Blomström-Lundqvist C, Scheinman MM, Aliot EM, et al. ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Supraventricular Arrhythmias). Eur Heart J 2003; Suppl. 24/20.
10. Buxton AE, Marchlinski FE, Doherty JU, et al. Hazards of intravenous verapamil for sustained ventricular tachycardia. Am J Cardiol 1987; 59: 1107-10.
11. Calkins H, Yong P, Miller JM, et al. Catheter ablation of accessory pathways, atrioventricular nodal reentrant tachycardia, and the atrioventricular junction. Final results of a prospective, multicenter clinical trial. Circulation 1999; 99: 262-70.
12. Chung EK, Walsh TJ, Massie E. Wolff-Parkinson-White syndrome. Am Heart J 1965; 69: 116-25.
13. Gambhir DS, Bhargava M, Nair M, et al. Comparison of electrophysiologic effects and efficacy of singledose intravenous and long-term oral amiodarone therapy in patients with AV nodal reentrant tachycardia. Indian Heart J 1996; 48: 133-7.
14. Gorgels AP, van den DA, Hofs A, et al. Comparison of procainamide and lidocaine in terminating sustained monomorphic ventricular tachycardia. Am J Cardiol 1996; 78: 43-6.
15. Goyal R, Zivin A, Souza J, et al. Comparison of the ages of tachycardia onset in patients with atrioventricular nodal reentrant tachycardia and accessory pathway-mediated tachycardia. Am Heart J 1996; 132: 765-7.
16. Jackman WM, Wang ZX, Friday KJ, et al. Catheter ablation of accessory atrioventricular pathways (Wolff-Parkinson-White syndrome) by radiofrequency current. N Engl J Med 1991; 324: 1605-11.
17. Kunze KP, Schluter M, Kuck KH. Sotalol in patients with WolffParkinson-White syndrome. Circulation 1987; 75: 1050-7.
18. Lai WT, Voon WC, Yen HW, et al. Comparsion of the electrophysiologic effects of oral sustained-release and intravenouse verapamil in patients with paroxysmal supraventricular tachycardia. Am J Cardiol 1993; 71: 405-8.
19. Levine JH, Massumi A, Scheinman MM, et al. Intravenous amiodarone for recurrent sustained hypotensive ventricular tachyarrhythmias. Intravenous Amiodarone Multicenter Trial Group. JACC 1996; 27: 67-75.
20. Manolis AS, Katsaros C, Cokkinos DV. Electrophysiological and electropharmacological studies in pre- excitation syndromes: results with propafenone therapy and isoproterenol infusion testing. Eur Heart J 1992; 13: 1489-95.
21. Mathew J, Hunsberger S, Fleg J, et al. Incidence, predictive factors, and prognostic significance of supraventricular tachyarrhythmias in congestive heart failure. Chest 2000; 118: 914-22.
22. Mehta D, Wafa S, Ward DE, Camm AJ. Relative efficacy of various physical manoeuvres in the termination of junctional tachycardia. Lancet 1988; 1: 1181-5.
23. Morillo CA. Supraventricular tachycardia. In book: Cardiology, Ed.Crawford 2004.
24. Munger TM, Packer DL, Hammill SC, et al. A population study of the natural history of Wolff-Parkinson-White syndrome in Olmsted County, Minnesota, 1953-1989. Circulation 1993; 87: 866-73.
25. Neuss H, Schlepper M. Long-term efficacy and safety of flecainide for supraventricular tachycardia. Am J Cardiol 1988; 62: 56D-61.
26. Orejarena LA, Vidaillet H Jr, DeStefano F, et al. Paroxysmal supraventricular tachycardia in the general population. JACC 1998; 31: 150-7.
27. Pritchett EL, McCarthy EA, Wilkinson WE. Propafenone treatment of symptomatic paroxysmal supraventricular arrhythmias: a randomized, placebo-controlled, crossover trial in patients tolerating oral therapy. Ann Intern Med 1991; 114: 539-44.
28. Scheinman MM. NASPE Survey on Catheter Ablation. Pacing Clin Electrophysiol 1995; 18: 1474-8.
29. Sorbo MD, Buja GF, Miorelli M, et al. The prevalence of the Wolff-Parkinson-White syndrome in a population of 116542 young males. G Ital Cardiol 1995; 25: 681-7.
30. Stewart RB, Bardy GH, Greene HL. Wide complex tachycardia: misdiagnosis and outcome after emergent therapy. Ann Intern Med 1986; 104: 766-71.
31. Sung RJ, Waxman HL, Saksena S, Juma Z. Sequence of retrograde atrial activation in patients with dual atrioventricular nodal pathways. Circulation 1981; 64: 1059-67.
32. Vidaillet HJ Jr, Pressley JC, Henke E, et al. Familial occurrence of accessory atrioventricular pathways (preexcitation syndrome). N Engl J Med 1987; 317: 65-9.
33. Wellens HJ, Lie KI, Bar FW, et al. Effect of amiodarone in the Wolff-Parkinson-White syndrome. Am J Cardiol 1976; 38: 189-94.
34. Winniford MD, Fulton KL, Hillis LD. Long-term therapy of paroxysmal supraventricular tachycardia: a randomized, doubleblind comparison of digoxin, propranolol and verapamil. Am J Cardiol 1984; 54: 1138-9.
Review
For citations:
Vetluzhsky A.V., Fomina I.G. Paroxysmal supraventricular tachycardias: modern principles of diagnostics and treatment. Cardiovascular Therapy and Prevention. 2005;4(4):70-78. (In Russ.)
Views:
669
Email this article 
