Supraventricular tachycardia AHA recommendations for Management of Symptomatic Patients With Manifest Accessory Pathways

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Management of Symptomatic Patients With Manifest Accessory Pathways
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

Overview

In symptomatic patients with pre-excitation, the findings of abrupt loss of conduction over the pathway during exercise testing in sinus rhythm or intermittent loss of pre-excitation during ECG or ambulatory monitoring are useful for identifying patients at low risk of developing rapid conduction over the pathway. An EP study is useful in symptomatic patients with pre-excitation to risk-stratify for life threatening arrhythmic events.[1]

Management of Symptomatic Patients With Manifest Accessory Pathways

2015 AHA recommendations for the management of symptomatic patients with manifest accessory pathways are described below:[1]

Class I
"1. In symptomatic patients with pre-excitation, the findings of abrupt loss of conduction over the pathway during exercise testing in sinus rhythm (Level of Evidence:B-R ) " or intermittent loss of pre-excitation during ECG or ambulatory monitoring (Level of Evidence:C-LD ) " are useful for identifying patients at low risk of developing rapid conduction over the pathway."
"2. An EP study is useful in symptomatic patients with preexcitation to risk-stratify for life threatening arrhythmic events"(Level of Evidence:B-NR ) "

References

  1. 1.0 1.1 Page RL, Joglar JA, Caldwell MA, Calkins H, Conti JB, Deal BJ; et al. (2016). "2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society". J Am Coll Cardiol. 67 (13): e27–e115. doi:10.1016/j.jacc.2015.08.856. PMID 26409259.