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June 24, 1983

Supraventricular Tachycardias

JAMA. 1983;249(24):3357-3360. doi:10.1001/jama.1983.03330480063034

SUPRAVENTRICULAR tachycardia is a common clinical arrhythmia, occurring in patients with and without heart disease. The attacks of tachycardia are characterized as paroxysmal, being of sudden onset and abrupt termination, and occurring without a period of gradual acceleration in rate. The rate of tachycardia is usually around 150 to 220 beats per minute. The episode is usually initiated by premature atrial and/or ventricular beats. During tachycardia the QRS complex manifests a regular RR interval and is of normal duration unless bundle-branch block is present. When visible, the morphology of the P wave is different from that of the sinus P wave and may occur before, simultaneously with, or after the QRS complex. Vagal maneuvers frequently terminate the tachycardia. Reentry is the mechanism of tachycardia in most patients, while in some patients the mechanism may be due to enhanced automaticity. The classification, diagnosis, and management of supraventricular tachycardia are discussed in