Evaluation of treatment options in patients diagnosed with supraventricular tachycardia in the emergency department

Objective: This study aims to examine the treatment options for patients presenting to the emergency department with palpitation and diagnosed with supraventricular tachycardia (SVT). Method: The study includes individuals aged 18 years and over who presented to the emergency department with the complaint of palpitation and were diagnosed with SVT. Patients who underwent carotid sinüs massage, the Valsalva maneuver, and electrical and medical cardioversion were included, while those under 18 years of age and pregnant women were excluded. Data were collected from the hospital information management system and the hospital pharmacy's records of antiarrhythmic drug use between January 2015 and December 2023. Frequency analyses conducted using the SPSS software were utilized for statistical analysis. Results: The mean age of the patients included in the study is 58 years, with a nearly equal gender distribution (49.4% female, 50.6% male). The majority of the patients (98.1%) were categorized under the triage category 2, and most visits occurred during the morning and afternoon hours. The most common treatments administered were adenosine (96.1%), carotid sinüs massage (90.7%), and the Valsalva maneuver (90.8%). Other treatments included calcium channel blockers (12.6%), beta blockers (4.7%), and amiodarone (1.4%). A frequent combination observed was adenosine and calcium channel blockers. The recorded average systolic and diastolic blood pressures at the time of presentation were 120 and 80 mm Hg respectively, with a pulse rate of 183.50 beats per minute. The average oxygen saturation was measured at 99%, and the rate of return to normal sinus rhythm was high (96.3%). Comorbidities included arrhythmia (45.5%), coronary artery disease (23.8%), hypertension (20.5%), and diabetes mellitus (6.7%). Cardiopulmonary resuscitation was required for a very small fraction of patients (0.8%). After treatment, a significant majority of the patients (86.3%) were discharged, while 11.8% continued to receive treatment as inpatients, and 1.9% were referred to another healthcare facility. Conclusion: Adenosine, carotid sinus massage, and the Valsalva maneuver are the most common and most effective treatment methods in SVT. Among the treatment options, adenosine and calcium channel blockers stood out for their rapid and effective results, with the majority of patients quickly reverting to normal sinus rhythm. Additionally, the presence of comorbidities such as arrhythmia, coronary artery disease, hypertension, and diabetes mellitus highlights the need for individualization in SVT treatment strategies.