Supraventricular tachycardias (SVT) are common, with an estimated prevalence of 2.25/1,000 persons and an incidence of 35/100,000 person-years.1 Atrioventricular nodal reentrant tachycardia (AVNRT), in particular, represents the most common regular arrhythmia in the human, and its proportion increases with age.2 However, the European Society of Cardiology has not published management guidelines for SVT since its original 2003 document,3 while our colleagues in the US did so in 2015.4 In this respect, the recent initiative of the European Heart Rhythm Association (EHRA) to produce a consensus document guiding the management of patients with SVT is most welcome. This will be presented in the forthcoming CARDIOSTIMEHRA EUROPACE congress in June, and is to be followed by formal ESC guidelines scheduled for 2019.
The Task Force convened for this purpose by EHRA worked together with representatives from the Heart Rhythm Society (HRS), the Asia Pacific Heart Rhythm Society (APHRS) and the Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLAECE). Thus, a global, rather than strictly European perspective, was ensured. The final document is aimed at summarising current developments in the field, with focus on new advances since the last ESC guidelines, and providing general recommendations for the management of these common clinical entities, based on the principles of evidence-based medicine. In addition, it presents a new concept of recommended diagnostic and therapeutic practices. Current systems of ranking levels of evidence are becoming complicated in such a way that their practical utility might be compromised.5 EHRA, APHRS and SOLAECE therefore, have opted for an easier system of ranking that classifies recommendations simply as recommended, may be recommended or not recommended. It is hoped that this user-friendly and straightforward approach will allow physicians to easily assess the current status of evidence and consequent guidance.
Editor-in-Chief, Arrhythmia & Electrophysiology Review
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, US