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Supraventricular Tachycardia


Please see the separate atrial fibrillation protocol for that diagnosis



Inclusion Criteria

  • Conversion to sinus rhythm in the ED, but requires a period of observation
  • Stable BP, HR under 110 consistently for one hour
  • No chest pain with rate controlled
  • No clinical suspicion of MI, CHF, PE, CVA
  • Primary MD or cardiology consulted and in agreement

Exclusion Criteria

  • Ongoing SVT
  • Abnormal vitals - BP or HR not controlled in ED, Fever (T>100.4)
  • Ongoing ischemic chest pain
  • Acute comorbidities – ACS, CHF, PE, Sepsis, CVA, etc.
  • Primary or on-call MD chooses inpatient admission

Potential Interventions

  • Continuous cardiac and ST segment monitoring
  • Monitor vital signs
  • Rate control: - PO Verapamil, PO beta blockers
  • Potential tests: Serial cardiac biomarkers, TSH, cardiac echo, stress test

Discharge Criteria

Home

    • Patient converts and remains in NSR for over two hours
    • Negative biomarkers
    • Suitable clinical condition for discharge
    • Discuss home meds with MD who will manage F/U care

Admit

    • Failure to keep HR under 100
    • Positive workup for other conditions (e.g. ACS, PE)
    • Unstable clinical condition

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