Supraventricular tachycardia. Mechanisms and therapy.

The insights into the mechanisms of supraventricular tachycardia provided by the techniques of intracardiac recording and programmed cardiac stimulation have had a major impact on our therapeutic approach to this common problem. These techniques have led to a more systematic analysis and precise interpretation of the standard surface electrocardiogram. An accurate diagnosis of the mechanism of supraventricular tachycardia can be made in the majority of patients using the electrocardiogram aided by special leads (eg, Lewis leads) and bedside maneuvers. Identification of the likely electrophysiologic mechanism allows for a more rational and effective approach to both acute and chronic therapy.