November 1986

Incidence of Symptomatic Tachycardia in Untreated Patients With Paroxysmal Supraventricular Tachycardia

Author Affiliations

From the Department of Medicine, Division of Cardiology (Drs Sintetos, Roark, McCarthy, and Pritchett), and from the Department of Community and Family Medicine, Division of Biometry (Dr Lee), Duke University Medical Center, Durham, NC. Dr Smith is now with the Medical College of Georgia, Augusta.

Arch Intern Med. 1986;146(11):2205-2209. doi:10.1001/archinte.1986.00360230139020

• The purpose of this article is to investigate the occurrence of symptomatic paroxysmal supraventricular tachycardia (PSVT) in untreated patients and to assess factors that influenced its occurrence. We studied 34 patients with this arrhythmia during an observation period in which they received no antiarrhythmic drug therapy for up to 90 days. Recurrence of PSVT was documented by telephone transmission of the electrocardiogram. Each patient was allowed to have exactly one episode of tachycardia before being removed from the study. We measured how long patients remained free of their tachycardia (the tachycardia-free period) and heart rate during tachycardia. Twenty-nine of the 34 patients had an attack of symptomatic tachycardia within the 90-day observation period. The proportion of patients who had not had any symptomatic PSVT by each day of follow-up was calculated using the Kaplan-Meier method as follows: 75% by day 3, 50% by day 19, 25% by day 36, and 17% by day 90. Patients with any other heart or lung disease had significantly shorter tachycardia-free periods. The mean heart rate during spontaneous tachycardia was 203.5 ± 34.9 beats per minute (range, 142 to 288 beats per minute). Patients with longer tachycardiafree periods had significantly faster heart rates during tachycardia.

(Arch Intern Med 1986;146:2205-2209)