A five-year retrospective analysis of patients with supraventricular tachycardia evaluated in the emergency department

A Five-Year Retrospective Analysis of Patients with Supraventricular Tachycardia Evaluated in the Emergency Department Introduction: The aim of this study is to retrospectively examine the clinical and demographic characteristics of patients diagnosed with supraventricular tachycardia (SVT) in the emergency department, evaluate the success rates of pharmacological and non-pharmacological treatments, and improve the SVT management algorithm. Materials and Methods: This study retrospectively evaluate the demographic, clinical, laboratory, treatment data, and outcomes of adult patients diagnosed with supraventricular tachycardia (SVT) at the Çukurova University Faculty of Medicine, Department of Emergency Medicine, between January 1, 2019, and June 30, 2024. Results: The study included 108 adult patients diagnosed with supraventricular tachycardia (SVT) in the emergency department between January 1, 2019, and June 30, 2024. Of the patients, 52.8% were male, and 47.2% were female, with a mean age of 58.4 ± 17.4 years. The most common presenting complaint was palpitations (67.6%), followed by chest pain and shortness of breath (25%). Among comorbidities, SVT (35.2%), hypertension (30.8%), and coronary artery disease/heart failure (25%) were prominent. The most frequently used medications were beta-blockers (23.1%), aspirin (13.9%), and calcium channel blockers (9.3%). On physical examination, rales (20.4%) and pretibial edema (9.3%) were the most commonly observed findings. Cardiac ultrasound revealed that 80.8% of patients had a normal ejection fraction. For treatment, 95.4% of patients received a first dose of adenosine, 40.7% received a second dose, and 16.7% received a third dose. Beta-blockers (20.4%), calcium channel blockers (13.9%), and electrical cardioversion (4.6%) were other treatments administered. Of the patients, 78.7% were discharged from the emergency department, while 19.4% were admitted to the intensive care unit. No significant differences were found between genders in terms of age, vital signs, or presenting complaints; however, the prevalence of malignancy was higher in males (38.6% vs. 3.9%, p<0.001), while serum glucose, creatinine, and ferritin levels differed in females (p<0.05). When comparing patients treated with adenosine alone (Group 1) and those receiving additional treatments (Group 2), Group 2 had a higher incidence of shortness of breath (35.1% vs. 17.4%, p=0.04), as well as higher rates of coronary artery disease/heart failure, diabetes mellitus, and elevated troponin, CK-MB, and lactate levels (p<0.05). In Group 2, the use of second and third doses of adenosine and the rate of discharge prescriptions were also higher (p<0.05). Post-treatment ECG showed that 94.2% of patients returned to sinus rhythm. Conclusion: In this retrospective study, adenosine therapy demonstrated a notably high success rate among patients diagnosed with supraventricular tachycardia (SVT) in the emergency department. However, in patients requiring additional treatment (Group 2), the more frequent presence of comorbidities such as coronary artery disease, heart failure, and diabetes, along with abnormalities in troponin, CK-MB, and lactate levels, suggests the need for closer clinical monitoring in this subgroup.In the management of SVT in the emergency department, adopting a treatment algorithm based on the patient's hemodynamic stability—combined with the prioritized use of vagal maneuvers and adenosine—may increase discharge rates and reduce the need for intensive care. Future studies should focus on integrating long-term therapeutic options, such as catheter ablation, into emergency department management protocols. Keywords: Emergency Department, Supraventricular Tachycardia, Palpitations, Adenosine, Electrocardiography