Summary

Supraventricular arrhythmias in the emergency department: experience of a Latin American cardiovascular hospital

David Jacobo Sánchez-Amaya¹, Daniel Eduardo Sandoval-Colin², Rodrigo Gopar-Nieto^1,3, Jorge Daniel Sierra Lara-Martínez³

Affiliation of the authors

¹Cardiología Clínica, Instituto Nacional de Cardiología Ignacio Chávez. ²Oficina para la Asistencia Sistemática en Investigación, Instituto Nacional de Cardiología Ignacio Chávez. ³Unidad de Cuidados Coronarios, Instituto Nacional de Cardiología Ignacio Chávez; Ciudad de México, México.

DOI

Download Article

Quote

Sánchez-Amaya DJ, Sandoval-Colin DE, Gopar-Nieto R, Sierra Lara-Martínez JD. Supraventricular arrhythmias in the emergency department: experience of a Latin American cardiovascular hospital. Rev Esp Urg Emerg. 2024;3:77–83

Summary

BACKGROUND AND OBJECTIVE. Tachyarrhythmias are a common reason for emergency department (ED) visits. This study aimed to describe the clinical profile of patients with tachyarrhythmias and their association with recurrences of supraventricular tachycardia (SVT), as well as their condition and destination on discharge.
MATERIALS AND METHODS. Observational cross-sectional study of 392 patients treated for SVT in a tertiary-care hospital ED over a period of 22 months. We used bivariate analysis to explore statistically significant differences (P < .05).
RESULTS. The median patient age was 60 years and over half (55%) were women. A majority of patients (n = 258, 66%) had no history of cardiovascular disease; these patients had a lower risk of recurrence (odds ratio [OR], 0.34; 95% CI, 0.20-0.59, P < .001). Sixty-seven patients (17.1%) experienced a recurrence of SVT, and 28% had a history of atrial fibrillation, which was the most common SVT (n = 192, 49%). High-sensitivity troponin levels were higher in patients with recurrences (29 ng/mL vs 26 in patients with no recurrences (P = .02). Adenosine (n = 69, 18%) and amiodarone (n = 81, 21%) were the most common initial treatments. Treatment with amiodarone on discharge was associated with risk of recurrence (OR, 2.52; 95% CI, 1.28-4.81, P = .006). Not having a prior diagnosis of cardiovascular disease was protective against death (OR, 0.08; 95% CI, 0.02-0.35; P < .001).
CONCLUSIONS. Atrial fibrillation was the most common tachyarrhythmia treated in our ED. A prior history of cardiovascular disease was associated with higher risk of recurrence in this study of the incidence and recurrence of SVT in an ED specializing in the treatment of cardiovascular disease.