Supraventricular tachycardia in children

Supraventricular tachycardia (SVT) affects 1 in 500 children and is characterized by rapid heart rate originating from the atrial tissue above the atrioventricular node and interventricular septum. The purpose of this article is to review the etiology, pathophysiology, types, clinical presentation, diagnosis, and treatment of SVT in children. SVT results from reentry circuits, abnormal automaticity, or triggered activity. Contributing factors include congenital heart defects, electrolyte imbalances, and genetic predisposition. The types of SVT include atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia, atrial tachycardia, and junctional ectopic tachycardia. Infants with SVT may present with poor feeding, vomiting, irritability, increased sleepiness, syncope, or diaphoresis. Toddlers and school-aged children may experience palpitations, chest pain, dizziness, shortness of breath, or syncope. Diagnostic tests include the electrocardiogram, Holter monitor, exercise stress test, and electrophysiologic study. Acute treatment options include vagal maneuvers, pharmacologic cardioversion, and electrical cardioversion. Long-term treatment options include antiarrhythmic drugs, catheter ablation, and surgical treatment. Complications of SVT include hemodynamic instability, thromboembolic events, congestive heart failure, exercise limitation, and decreased quality of life. Special considerations include missed diagnosis in neonates and infants, the association of SVT with congenital heart disease, and transition of care from pediatric to adult cardiology. Future directions and research may include advancements in genetic and molecular biomarkers and ablation methods. It is important to provide education and counseling to patients and their families, including information about the condition, treatment options, potential complications, and psychological support. • Supraventricular tachycardia affects 1 in 500 children. • Causes include reentry circuits, abnormal automaticity, or triggered activity. • Patients may have palpitations, heart failure, syncope, chest pain, or dyspnea. • Acute treatment may include vagal maneuvers or cardioversion. • Severe hemodynamic instability may occur in patients with congenital heart disease.