Supraventricular tachyarrhythmias

Abstract

Supraventricular tachyarrhythmias (SVTs) include atrial tachycardia (AT), atrioventricular nodal re-entrant tachycardia (AVNRT), atrioventricular re-entrant tachycardia (AVRT), atrial flutter (AFL), and atrial fibrillation (AF).

The prevalence of SVT does not differ between athletes and the general population. An exception is AF, with a two- to eightfold higher prevalence in athletes, probably due to exercise-induced atrial remodelling. Symptoms of SVTs include palpitations, dizziness, weakness, and rarely syncope, and may impair athletic performance. Except for AF in the presence of an accessory pathway, SVTs are rarely life-threatening. For treatment of AT, AVNRT, AVRT, and AFL catheter ablation is generally preferred over lifelong anti-arrhythmic drug (AAD) therapy because of high rates of resolution. Reduction of training volume and AAD therapy should be attempted in athletes with AF. However, catheter ablation of AF may be the first-line therapy in athletes with severe symptoms. Most athletes with SVT can continue leisure-time activities and competitive sports.