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An Evidence-Based Approach To Supraventricular Tachydysrhythmias

April 2008


Patients who present with a supraventricular tachycardia (SVT) may have potentially life-threatening disease, and their outcome is often directly related to the care they receive in the emergency department (ED). In a matter of minutes, the emergency physician must quickly and confidently assess and support the “ABC’s” and determine the need for interventions. The search for an underlying condition must be initiated while immediately addressing the patient’s stability. Synchronized cardioversion is often indicated for unstable patients, while a more sophisticated approach is needed to decipher and manage the stable patient. Although SVTs are a frequent cause of ED1 and primary care office2 visits, they are infrequently the primary reason for hospital admission.1-3 This issue of Emergency Medicine Practice will provide a review of SVTs with a focus on the ECG analysis and the evidence behind the most recent ACLS guidelines.4 The topics of atrial flutter and atrial fibrillation will not be reviewed in detail in this issue as they were the focus of a previous Emergency Medicine Practice issue.5

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