Supraventricular Tachycardia (SVT)
A re-entry circuit running through the atrioventricular (AV) node, either within it or looping via an accessory pathway, fires at a fixed rate and gives abrupt regular narrow-complex tachycardia.
Definition
Supraventricular tachycardia is any tachycardia arising above the ventricles. In practice the SVT pathway means a regular narrow-complex paroxysmal tachycardia, most often AVNRT or orthodromic AVRT. Atrial fibrillation, atrial flutter, focal atrial tachycardia and sinus tachycardia are separated out because their treatment differs.
First principles
SVT names where the rhythm starts, not how it works
Any rhythm arising above the ventricles is supraventricular, but atrial fibrillation, atrial flutter, focal atrial tachycardia and sinus tachycardia behave nothing like the re-entry circuits this chapter covers. In practice the SVT pathway means a regular narrow-complex tachycardia, usually AV nodal re-entrant tachycardia (AVNRT) or orthodromic AV re-entrant tachycardia (AVRT). Flutter with fixed block is the mimic that catches people out.
This page is exam revision material, not medical advice, and must not be used for patient care. Always check drug doses against the BNF and current guidance. Full disclaimer.

