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ClearRounds Health · Cardiology · Quick Reference

SVT and Atrial Tachyarrhythmias

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Arrhythmias & DevicesIntermediateIn progressOne-page PDF

AVNRT/AVRT/atrial tachycardia basics, acute management, vagal maneuvers, adenosine concepts, meds, and EP referral.

Groups AVNRT, AVRT, and atrial tachycardia.

Last reviewed

Pending initial clinical review

Sources / guidelines to verify

  • 2015 ACC/AHA/HRS SVT Guideline
Disclaimer: Educational reference only. Not a substitute for clinician judgment, local protocols, or current guideline review.

One-page reference

Draft content pending the site owner’s clinical review. Verify against the sources above and local protocol before clinical use.

1

What it is / why it matters

  • Regular narrow-complex tachycardias arising above the ventricles.
  • Most common: AVNRT, then AVRT and atrial tachycardia. Usually not life-threatening but very symptomatic.
2

Key diagnostic clues

  • Abrupt onset/offset palpitations, regular, rate 150–250.
  • ECG: narrow QRS; AVNRT may show pseudo-R′/pseudo-S; AVRT seen with WPW; atrial tachycardia has a discrete P-wave.
3

Initial workup

  • 12-lead ECG during the episode is the single most useful test.
  • Echo, TSH; ambulatory monitor to capture paroxysmal episodes.
4

Management framework

Acute — stable

  • Vagal maneuvers (modified Valsalva)
  • Adenosine by rapid IV push
  • IV CCB or beta-blocker if needed

Acute — unstable

  • Synchronized cardioversion

Chronic

  • Beta-blocker or non-dihydropyridine CCB
  • Catheter ablation is curative for recurrent AVNRT/AVRT (Class 1, high success)
5

Red flags / escalate now

  • Hemodynamic instability → cardioversion.
  • Pre-excitation (WPW) with AF → avoid AV-nodal blockers; refer to EP.
  • Wide-complex tachycardia → treat as VT until proven otherwise.
6

Follow-up / monitoring

  • Track symptom frequency; refer recurrent SVT to EP for ablation evaluation.
7

Clinic pearls

  • Get a 12-lead DURING the episode — it guides everything.
  • Modified Valsalva (with passive leg raise) outperforms the standard maneuver.
  • If the rhythm is irregular or wide, rethink the diagnosis.

Related quick references

📄 Atrial Fibrillation / Atrial Flutter📄 WPW / Pre-excitation

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ClearRounds Health · Cardiology — SVT and Atrial Tachyarrhythmias Quick Reference · Last reviewed: Pending initial clinical review · Educational reference only. Not a substitute for clinician judgment, local protocols, or current guideline review.