Supraventricular tachycardia
A group of arrhythmias with heart rate above 100 bpm originating above the bundle of His. Typically presents as paroxysms. Beta-blockers and verapamil are the mainstays of treatment and prevention.
ICD-10 I47.13 drugs
Also known as: SVT, AVNRT, AVRT
Drugs used for this condition
- AMetoprololFirst line · Selective β1-adrenoceptor blockersMetoprolol is one of the first-choice agents for heart rate control and prevention of supraventricular tachycardia paroxysms. In acute SVT, metoprolol is given intravenously 5 mg over 2 minutes, repeatable up to 3 times at 5-minute intervals. Oral form is used for long-term prevention.
- BDigoxinCase-by-case decision · Cardiac glycosides (digitalis)In adults with paroxysmal SVT, digoxin is rarely used for prophylaxis – international guidelines (ESC 2019 on SVT, ACC/AHA/HRS 2015) prefer beta-blockers and non-dihydropyridine calcium antagonists, and propafenone or flecainide in WPW. In infants, digoxin remains acceptable for long-term prophylaxis of AV nodal reciprocating tachycardia. IV adenosine is the agent of choice for acute conversion.
- BFlecainideSecond line · Class Ic antiarrhythmicTreats supraventricular tachycardias including AV nodal reentrant and accessory-pathway-mediated forms. SEC requires exclusion of structural heart disease before starting.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit