supraventriculaire

Supraventricular refers to arrhythmias that originate above the ventricular level of the heart. In clinical use, this term covers disturbances arising in the atria or the atrioventricular (AV) node and its pathways, as opposed to ventricular arrhythmias that arise from the heart's ventricles. Supraventricular rhythms may be intermittent or persistent and vary in clinical significance.

The most commonly encountered supraventricular tachycardias (SVTs) include reentrant tachycardias such as AV nodal reentrant tachycardia (AVNRT) and AV reentrant tachycardia (AVRT) related to accessory pathways as seen in Wolff-Parkinson-White syndrome, as well as focal atrial tachycardias. Atrial fibrillation and atrial flutter are atrial arrhythmias that can also be considered supraventricular, depending on origin.

Symptoms range from palpitations and dizziness to shortness of breath and chest discomfort. Some episodes terminate spontaneously, while others require medical treatment. In people with structural heart disease, there is a higher risk of hemodynamic compromise during tachyarrhythmias.

Diagnosis is primarily by electrocardiography (ECG) during the episode. Additional monitoring with ambulatory ECG, event recorders, or electrophysiology studies may be used to define the mechanism and plan therapy.

Treatment aims to terminate the arrhythmia, prevent recurrence, and manage associated risks. Acute management may include vagal maneuvers or drug therapy (for example, adenosine, beta-blockers, or calcium-channel blockers). Long-term options include catheter ablation for many SVTs and antiarrhythmic medications. Anticoagulation is considered in atrial fibrillation to reduce stroke risk.

Prognosis depends on the specific rhythm and heart health. Supraventricular tachycardias are often benign in individuals without structural heart disease, whereas atrial fibrillation carries longer-term stroke risk requiring risk stratification and management.