Prevalence and incidence of patients with paroxysmal supraventricular tachycardia in the United States

Rehorn, Michael; Sacks, Naomi; Emden, Maia R.; Healey, Bridget; Preib, Madison T; Cyr, Philip L.; Pokorney, Sean D.

doi:10.1111/jce.15109

Cited by 25 publications

(20 citation statements)

References 14 publications

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“…PSVT is a clinical syndrome characterized by the presence of a regular and rapid heart rhythm with abrupt onset and termination [ 2 ]. By virtue of its episodic nature, confirming a diagnosis of PSVT can be challenging [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Patients may be initially misdiagnosed with anxiety or other rhythm disorders. Consequently, PSVT can go undiagnosed for years, and patients may be diagnosed with other cardiac conditions or arrhythmias before obtaining a formal diagnosis of PSVT [ 2 ]. Furthermore, some patients need invasive electrophysiological study to confirm PSVT.…”

Section: Discussionmentioning

confidence: 99%

“…Paroxysmal supraventricular tachycardia (PSVT) is one of the common types of arrhythmia, a clinical syndrome characterized by the presence of regular and rapid tachycardia with abrupt onset and termination and an incidence of 35 per 100,000 patient-years [ 1 , 2 ]. The most frequent symptoms of PSVT are rapid heart rate, palpitations, lightheadedness, shortness of breath, chest pain, anxiety, and potentially syncope [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Deep-Learning-Based Detection of Paroxysmal Supraventricular Tachycardia Using Sinus-Rhythm Electrocardiograms

Wang

Dang

Chen

et al. 2022

JCM

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Background: Paroxysmal supraventricular tachycardia (PSVT) is a common arrhythmia associated with palpitation and a decline in quality of life. However, it is undetectable with sinus-rhythmic ECGs when patients are not in the symptomatic onset stage. Methods: In the current study, a convolution neural network (CNN) was trained with normal-sinus-rhythm standard 12-lead electrocardiographs (ECGs) of negative control patients and PSVT patients to identify patients with unrecognized PSVT. PSVT refers to atrioventricular nodal reentry tachycardia or atrioventricular reentry tachycardia based on a concealed accessory pathway as confirmed by electrophysiological procedure. Negative control group data were obtained from 5107 patients with at least one normal sinus-rhythmic ECG without any palpitation symptoms. All ECGs were randomly allocated to the training, validation and testing datasets in a 7:1:2 ratio. Model performance was evaluated on the testing dataset through F1 score, overall accuracy, area under the curve, sensitivity, specificity and precision. Results: We retrospectively enrolled 407 sinus-rhythm ECGs of PSVT procedural patients and 1794 ECGs of control patients. A total of 2201 ECGs were randomly divided into training (n = 1541), validation (n = 220) and testing (n = 440) datasets. In the testing dataset, the CNN algorithm showed an overall accuracy of 95.5%, sensitivity of 90.2%, specificity of 96.6% and precision of 86.0%. Conclusion: Our study reveals that a well-trained CNN algorithm may be a rapid, effective, inexpensive and reliable method to contribute to the detection of PSVT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Deep-Learning-Based Detection of Paroxysmal Supraventricular Tachycardia Using Sinus-Rhythm Electrocardiograms

Wang

Dang

Chen

et al. 2022

JCM

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“…Paroxysmal supraventricular tachycardia (SVT) is a cardiac arrhythmia commonly observed in patients in emergency departments (ED). Paroxysmal SVT affects approximately 1 in 300 people, with a higher incidence rate in older patients and women [1]. It is characterized by sudden onset and termination and is accompanied by palpitations, chest pain, and shortness of breath [2].…”

Section: Introductionmentioning

confidence: 99%

Adenosine response and failure to convert paroxysmal supraventricular tachycardia in the emergency department

Alghadeer,

Almohammed,

Alshaya

et al. 2023

European Journal of Emergency Medicine

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Background and importanceAlthough adenosine is the recommended first-line therapy for patients with paroxysmal supraventricular tachycardia (SVT), it may fail to restore normal sinus rhythm. The factors associated with this failure remain unclear.Objective To assess the response rate to adenosine and identify the factors causing adenosine failure in the management of paroxysmal SVT. Design, setting, and participantsThis retrospective study was conducted on adult patients diagnosed with paroxysmal SVT and treated with adenosine in the emergency departments of two large tertiary hospitals between June 2015 and June 2021. Outcome measure and analysisThe primary outcome of the study was the patient response to adenosine, defined as the restoration of sinus rhythm documented in the patients' files. Backward-stepwise multivariate logistic regression was used to examine the predictors of adenosine failure based on the overall response to adenosine therapy. Main resultsA total of 404 patients, with a mean age of 49 (SD 15) years and a BMI of 32 (SD 8) kg/m 2 , and treated with adenosine for paroxysmal SVT, were included. Sixty-nine percent of patients were women. The overall response rate to any adenosine dose was 86% (n = 347).The baseline heart rate did not significantly differ between adenosine responders and non-responders (179.6 ± 23.1 vs. 183.2 ± 23.4). An association was observed between the history of paroxysmal SVT and successful response to adenosine (odds ratio = 2.08; 95% confidence interval 1. 05-4.11). ConclusionThe findings of this retrospective study suggested that the use of adenosine restored normal sinus rhythm in 86% of patients with paroxysmal SVT. Furthermore, a history of paroxysmal SVT and older age were associated with an increased chance of adenosine success.

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“…Rarer forms of SVT including junctional ectopic tachycardia, nodoventricular tachycardia, and nodofascicular tachycardia are also not covered in this Review.The prevalence of PSVT in the US is estimated to be 168 to 332 per 100 000 individuals based on retrospective analyses using large clinical databases. 3,4 Major associated comorbidities included chronic pulmonary disease (15.7%), diabetes (12.5%), heart failure (8.4%), cerebrovascular disease (7.8%), and peripheral vascular disease (7.6%). While pharmacologic therapies have largely remained unchanged over the past 2 decades, advances in monitoring techniques and ablation therapies have led to accurate diagnostic tools and curative treatment options for patients with PSVT.…”

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confidence: 99%

Diagnosis and Management of Paroxysmal Supraventricular Tachycardia

Peng,

Zei

2024

JAMA

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ImportanceParoxysmal supraventricular tachycardia (PSVT), defined as tachyarrhythmias that originate from or conduct through the atria or atrioventricular node with abrupt onset, affects 168 to 332 per 100 000 individuals. Untreated PSVT is associated with adverse outcomes including high symptom burden and tachycardia-mediated cardiomyopathy.ObservationsApproximately 50% of patients with PSVT are aged 45 to 64 years and 67.5% are female. Most common symptoms include palpitations (86%), chest discomfort (47%), and dyspnea (38%). Patients may rarely develop tachycardia-mediated cardiomyopathy (1%) due to PSVT. Diagnosis is made on electrocardiogram during an arrhythmic event or using ambulatory monitoring. First-line acute therapy for hemodynamically stable patients includes vagal maneuvers such as the modified Valsalva maneuver (43% effective) and intravenous adenosine (91% effective). Emergent cardioversion is recommended for patients who are hemodynamically unstable. Catheter ablation is safe, highly effective, and recommended as first-line therapy to prevent recurrence of PSVT. Meta-analysis of observational studies shows single catheter ablation procedure success rates of 94.3% to 98.5%. Evidence is limited for the effectiveness of long-term pharmacotherapy to prevent PSVT. Nonetheless, guidelines recommend therapies including calcium channel blockers, β-blockers, and antiarrhythmic agents as management options.Conclusion and RelevanceParoxysmal SVT affects both adult and pediatric populations and is generally a benign condition. Catheter ablation is the most effective therapy to prevent recurrent PSVT. Pharmacotherapy is an important component of acute and long-term management of PSVT.

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Prevalence and incidence of patients with paroxysmal supraventricular tachycardia in the United States

Cited by 25 publications

References 14 publications

Deep-Learning-Based Detection of Paroxysmal Supraventricular Tachycardia Using Sinus-Rhythm Electrocardiograms

Deep-Learning-Based Detection of Paroxysmal Supraventricular Tachycardia Using Sinus-Rhythm Electrocardiograms

Adenosine response and failure to convert paroxysmal supraventricular tachycardia in the emergency department

Diagnosis and Management of Paroxysmal Supraventricular Tachycardia

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