Diagnosis and conventional treatment of supraventricular tachycardia in children
DOI:
https://doi.org/10.13112/pc.1085Keywords:
TACHYCARDIA, SUPRAVENTRICULAR; ARRHYTHMIAS, CARDIAC; ANTI-ARRHYTHMIA AGENTS; CHILDAbstract
Supraventricular tachycardia (SVT) is an inappropriately rapid heart rhythm generated above the atrioventricular node. It is one of the most common tachycardias in children. There are several types of SVT, but it most commonly refers to a group of reentrant arrhythmias, such as atrioventricular reentrant tachycardia (AVRT) and atrioventricular nodal reentrant tachycardia (AVNRT). Supraventricular tachycardia typically presents as paroxysms, meaning it starts and stops suddenly, with symptoms such as palpitations, chest pain, and pallor. In younger children, symptoms like pallor, restlessness, excessive crying, irritability, and refusal to eat may predominate, often going unnoticed, which can lead to the development of heart failure. The diagnosis is made based on an electrocardiogram (ECG). Treatment of SVT involves acute management and prevention of arrhythmia. Nowadays, SVT in children is successfully treated and has a very low mortality rate.
References
1. Kafali HC, Ergul Y. Common Supraventricular and Ventricular Arrhythmias in Children. Turk Arch Pediatr. 2022 Sep 2;57(5):476-88. doi: 10.5152/turkarchpediatr.2022.22216
2. Dubin AM. Clinical features and diagnosis of supraventricular tachycardia (SVT) in children [Internet]. 2023. Available from: www.uptodate.com
3. Josephson ME, Wellens HJ. Differential diagnosis of supraventricular tachycardia. Cardiol Clin. 1990 Aug;8(3):411-42.
4. Tripathi A, Black GB, Park YMM, Jerrell JM. Factors Associated With the Occurrence and Treatment of Supraventricular Tachycardia in a Pediatric Congenital Heart Disease Cohort. Pediatr Cardiol. 2014 Feb;35(2):368-73.
5. Bibas L, Levi M, Essebag V. Diagnosis and management of supraventricular tachycardias. Can Med Assoc J. 2016 Dec 6;188(17-18):E466-73. doi: 10.1503/cmaj.150818
6. Ko JK, Deal BJ, Strasburger JF, Benson DW. Supraventricular tachycardia mechanisms and their age distribution in pediatric patients. Am J Cardiol. 1992 Apr;69(12):1028-32.
7. Weindling SN, Saul JP, Walsh EP. Efficacy and risks of medical therapy for supraventricular tachycardia in neonates and infants. Am Heart J. 1996 Jan;131(1):66-72.
8. Di Biase L, Walsh EP. Wolff-Parkinson-White syndrome: Anatomy, epidemiology, clinical manifestations, and diagnosis [Internet]. 2024. Available from: www.uptodate.com
9. Miller JM. Therapy of Wolff‐Parkinson‐White Syndrome and Concealed Bypass Tracts: Part I. J Cardiovasc Electrophysiol. 1996 Jan;7(1):85-93. doi: 10.1111/j.1540-8167.1996.tb00423.x
10. Cohen MI, Triedman JK, Cannon BC, et al. PACES/HRS Expert Consensus Statement on the Management of the Asymptomatic Young Patient with a Wolff-Parkinson-White (WPW, Ventricular Preexcitation) Electrocardiographic Pattern. Heart Rhythm. 2012 Jun;9(6):1006-24. doi: 10.1016/j.hrthm.2012.03.002
11. Santinelli V, Radinovic A, Manguso F, et al. The Natural History of Asymptomatic Ventricular Pre-Excitation. J Am Coll Cardiol. 2009 Jan;53(3):275-80. doi: 10.1016/j.jacc.2008.08.037
12. Silka MJ, Kron J, Halperin BD, McANULTY JH. Mechanisms of AV Node Reentrant Tachycardia in Young Patients With and Without Dual AV Node Physiology. Pacing Clin Electrophysiol. 1994 Nov;17(11):2129-33.
13. Brugada J, Blom N, Sarquella-Brugada G,et al. Pharmacological and non-pharmacological therapy for arrhythmias in the pediatric population: EHRA and AEPC-Arrhythmia Working Group joint consensus statement. EP Eur. 2013 Sep;15(9):1337-82. doi: 10.1093/europace/eut204
14. Moore JA, Stephens SB, Kertesz NJ, et al. Clinical Predictors of Recurrent Supraventricular Tachycardia in Infancy. J Am Coll Cardiol. 2022 Sep;80(12):1159-72. doi: 10.1016/j.jacc.2022.06.040
15. Kanter RJ. Care of the Infant With Supraventricular Tachycardia. J Am Coll Cardiol. 2022 Sep;80(12):1173-6. doi: 10.1016/j.jacc.2022.06.041
16. Dubin AM. Management of supraventricular tachycardia (SVT) in children [Internet]. 2023. Available from: www.uptodate.com
17. Bolourchi M, Batra AS. Diagnostic Yield of Patch Ambulatory Electrocardiogram Monitoring in Children (from a National Registry). Am J Cardiol. 2015 Mar;115(5):630-4. doi: 10.1016/j.amjcard.2014.11.040
18. Ferdman DJ, Liberman L, Silver ES. A Smartphone Application to Diagnose the Mechanism of Pediatric Supraventricular Tachycardia. Pediatr Cardiol. 2015 Oct;36(7):1452-7. doi: 10.1007/s00246-015-1155-6
19. Nguyen HH, Van Hare GF, Rudokas M, Bowman T, Silva JNA. SPEAR Trial: Smartphone Pediatric ElectrocARdiogram Trial. Hund T, editor. PLOS ONE. 2015 Aug 21;10(8):e0136256. doi: 10.1371/journal.pone.0136256
20. Gaita F, Giustetto C, Riccardi R, Mangiardi L, Brusca A. Stress and pharmacologic tests as methods to identify patients with Wolff-Parkinson-White syndrome at risk of sudden death. Am J Cardiol. 1989 Sep;64(8):487-90.
21. Brugada J, Katritsis DG, Arbelo E, et al. 2019 ESC Guidelines for the management of patients with supraventricular tachycardia: The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J. 2020 Feb 1;41(5):655-720. doi: 10.1093/eurheartj/ehz486
22. Yammine ML, Tamborrino PP, Flore F, et al. Intermittent ventricular preexcitation in children: not always a low-risk condition. Europace. 2024 Oct 3;26(10):euae250. doi: 10.1093/europace/euaa250
23. Manickavasagam A, Patloori SCS, Perla HT, Chase D, Roshan J. Impact of transesophageal electrophysiological study on midterm management of pediatric tachyarrhythmias. Ann Pediatr Cardiol. 2022 Sep;15(5 & 6):453-8.
24. Abbasi E, Vijayashankar SS, Goldman RD. Management of acute supraventricular tachycardia in children. Can Fam Physician. 2023 Dec;69(12):839-41.
25. Lu Z, Zhu J, Gao M, et al. Efficacy and safety of modified Valsalva maneuver for treatment of paroxysmal supraventricular tachycardia: a meta-analysis. J Int Med Res. 2024 Jan;52(1):3000605231220871. doi: 10.1177/03057310231220871
26. Mullen JC, Waskiewich K, Bhargava R, Bentley MJ. Bilateral partial anomalous pulmonary venous return. Can J Cardiol. 1997 Jun;13(6):567-9.
27. Sherwood M, Lau K, Sholler G. Adenosine in the management of supraventricular tachycardia in children. J Paediatr Child Health. 1998 Feb;34(1):53-6.
28. Srinivasan C, Balaji S. Neonatal supraventricular tachycardia. Indian Pacing Electrophysiol J. 2019 Nov;19(6):222-31.
29. Kugler JD, Danford DA. Management of infants, children, and adolescents with paroxysmal supraventricular tachycardia. J Pediatr. 1996 Sep;129(3):324-38.
30. Basza M, Maciejewski C, Bojanowicz W,et al. Flecainide in clinical practice. Cardiol J. 2023;30(3):473-82. doi: 10.5603/CJ.a2022.0159
31. Oeffl N, Schober L, Faudon P, et al. Antiarrhythmic Drug Dosing in Children-Review of the Literature. Child Basel Switz. 2023 May 8;10(5):847. doi: 10.3390/children10050847
32. Wei N, Lamba A, Franciosi S, et al. Medical Management of Infants With Supraventricular Tachycardia: Results From a Registry and Review of the Literature. CJC Pediatr Congenit Heart Dis. 2022 Feb;1(1):11-22. doi: 10.1016/j.cjped.2022.01.003
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Davor Petrović

This work is licensed under a Creative Commons Attribution 4.0 International License.
By publishing in Paediatria Croatica, authors retain the copyright to their work and grant others the right to use, reproduce, and share their research articles in accordance with the Creative Commons Attribution License (CC BY 4.0), which allows others to distribute and build upon the work as long as they credit the author for the original creation.