La Dra. Begoña Benito Villabriga apunta las principales novedades incluidas en la actualización del documento, publicada en ESC Congress 2019.

1. Begoña Benito Villabriga2019 ESC Guidelines on Supraventricular
Tachycardias Begoña Benito Villabriga2019 ESC Guidelines on Supraventricular
Tachycardias
2019 ESC Guidelines on Supraventricular
Tachycardias

2. Begoña Benito Villabriga2019 ESC Guidelines on Supraventricular
Tachycardias
2019 ESC Guidelines on Supraventricular
Tachycardias
Contents
• Definitions and classification
• Electrophysiological mechanisms
• Cardiac anatomy
• Epidemiology
• Clinical presentation
• Initial evaluation
• Differential diagnosis
• Acute management in the absence of an established diagnosis
• Specific types of SVT: acute management
chronic management
• SVT in special populations: CHD, pregnancy

3. Begoña Benito Villabriga2019 ESC Guidelines on Supraventricular
Tachycardias
2019 ESC Guidelines on Supraventricular
Tachycardias
Contents
• Definitions and classification
• Electrophysiological mechanisms
• Cardiac anatomy
• Epidemiology
• Clinical presentation
• Initial evaluation
• Differential diagnosis
• Acute management in the absence of an established diagnosis
• Specific types of SVT: acute management
chronic management
• SVT in special populations: CHD, pregnancy

4. Begoña Benito Villabriga2019 ESC Guidelines on Supraventricular
Tachycardias
Classification
Clinical presentation:
Narrow-QRS complex (≤120ms)
Wide QRS complex (>120ms) if:
- Antidromic tachycardia
- By-stander AP
- Pre-excited AF
- Aberration
- Electrolyte disturbance/antiarrhythmic
drugs

5. Begoña Benito Villabriga2019 ESC Guidelines on Supraventricular
Tachycardias
Acute management of SVT: NON-ESTABLISHED DIAGNOSIS

6. Begoña Benito Villabriga2019 ESC Guidelines on Supraventricular
Tachycardias
Acute management of SVT

7. Begoña Benito Villabriga2019 ESC Guidelines on Supraventricular
Tachycardias
Acute management of SVT
Antidromic
i.v. adenosine is not recommended

8. Begoña Benito Villabriga2019 ESC Guidelines on Supraventricular
Tachycardias
Chronic management of SVT / Prevention
CATHETER
ABLATION
Antiarrhythmic
drugs2019 SVT guidelines
Antidromic

9. Begoña Benito Villabriga2019 ESC Guidelines on Supraventricular
Tachycardias
Chronic management
of asymptomatic
preexcitation

10. Begoña Benito Villabriga2019 ESC Guidelines on Supraventricular
Tachycardias
Conclusions
• Acute management of SVT:
• 12-lead ECG during tachycardia (class I)
• Vagal maneuvers (class I)
• Electrical CV if hemodynamic instability (class I)
• Low threshold for CV in AT and flutter/MRAT
• Pharmacological management as second option (class IIa)
• Chronic management of SVT:
• Recurrent episodes or patient preference: catheter ablation (class I)
• Pharmacological treatment (class IIa)
• Asymptomatic pre-excitation: invasive statification; ablation if high risk (class I)
fup (class IIa) or ablation (class IIb) if low risk
In the absence of an
established diagnosis