In The Line of Treatment: A Systematic Review of Paroxysmal Supraventricular Tachycardia

Ahmad, Farrukh; Sneineh, Majdi Abu; Patel, R. J.; Reddy, Sai Rohit; Llukmani, Adiona; Hashim, Ayat; Haddad, Dana; Gordon, Domonick K

doi:10.7759/cureus.15502

Cited by 8 publications

(11 citation statements)

References 31 publications

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“… 2 , 3 Previous studies had reported aberrations in ion channel activity within cardiomyocytes, alterations in cellular communication, and dysregulated calcium handling can be intricately linked with SVT pathophysiology. 4 , 5 Despite the relief offered by current therapeutic interventions like drug treatments and catheter ablation, 6 , 7 some cases persistently resist treatment or are prone to recurrence. This accentuates an urgent need for innovative diagnostic tools, treatments and prognostic markers at the myocardial cellular level to optimize the management of SVT and enhance patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

FLRT3 and TGF‐β/SMAD4 signalling: Impacts on apoptosis, autophagy and ion channels in supraventricular tachycardia

Pang,

Xu,

Chen

et al. 2024

J Cellular Molecular Medi

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To explore the underlying molecular mechanisms of supraventricular tachycardia (SVT), this study aimed to analyse the complex relationship between FLRT3 and TGF‐β/SMAD4 signalling pathway, which affects Na+ and K+ channels in cardiomyocytes. Bioinformatics analysis was performed on 85 SVT samples and 15 healthy controls to screen overlapping genes from the key module and differentially expressed genes (DEGs). Expression profiling of overlapping genes, coupled with Receiver Operating Characteristic (ROC) curve analyses, identified FLRT3 as a hub gene. In vitro studies utilizing Ang II‐stimulated H9C2 cardiomyocytes were undertaken to elucidate the consequences of FLRT3 silencing on cardiomyocyte apoptosis and autophagic processes. Utilizing a combination of techniques such as quantitative reverse‐transcription polymerase chain reaction (qRT‐PCR), western blotting (WB), flow cytometry, dual‐luciferase reporter assays and chromatin immunoprecipitation polymerase chain reaction (ChIP‐PCR) assays were conducted to decipher the intricate interactions between FLRT3, the TGF‐β/SMAD4 signalling cascade and ion channel gene expression. Six genes (AADAC, DSC3, FLRT3, SYT4, PRR9 and SERTM1) demonstrated reduced expression in SVT samples, each possessing significant clinical diagnostic potential. In H9C2 cardiomyocytes, FLRT3 silencing mitigated Ang II‐induced apoptosis and modulated autophagy. With increasing TGF‐β concentration, there was a dose‐responsive decline in FLRT3 and SCN5A expression, while both KCNIP2 and KCND2 expressions were augmented. Moreover, a direct interaction between FLRT3 and SMAD4 was observed, and inhibition of SMAD4 expression resulted in increased FLRT3 expression. Our results demonstrated that the TGF‐β/SMAD4 signalling pathway plays a critical role by regulating FLRT3 expression, with potential implications for ion channel function in SVT.

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Section: Introductionmentioning

confidence: 99%

FLRT3 and TGF‐β/SMAD4 signalling: Impacts on apoptosis, autophagy and ion channels in supraventricular tachycardia

Pang,

Xu,

Chen

et al. 2024

J Cellular Molecular Medi

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“…Hemodynamic compromise and cerebral hypoperfusion may occur. 1 Treatment options include drug therapy or ablation, the choice of which depends on the severity of SVT. 2 Catheter ablation is first‐line therapy for symptomatic, recurrent SVT (Class I), especially among higher‐risk individuals, such as those with preexcited atrial fibrillation or high‐risk occupations.…”

Section: Introductionmentioning

confidence: 99%

“…Supraventricular tachycardia (SVT) refers to rapid arrhythmias (>100/min), originating in tissue within or above the His bundle. Hemodynamic compromise and cerebral hypoperfusion may occur 1 . Treatment options include drug therapy or ablation, the choice of which depends on the severity of SVT 2 .…”

Section: Introductionmentioning

confidence: 99%

Cost‐utility analysis of radiofrequency ablation versus optimal medical therapy in managing supraventricular tachycardia among Filipinos

Gervacio-Domingo

Kimwell

Fadreguilan

et al. 2023

Journal of Arrhythmia

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Background: Radiofrequency ablation (RFA) is the standard of care in the management of supraventricular tachycardia (SVT). Its cost-effectiveness in an emerging Asian country has not been studied. Objectives:A cost-utility analysis of RFA versus optimal medical therapy (OMT) among Filipinos with SVT was conducted using the public healthcare provider's perspective.Methods: A simulation cohort using a lifetime Markov model was constructed using patient interviews, a review of literature, and expert consensus. Three basic health states were defined: stable, SVT recurrence, and death. The incremental cost per quality-adjusted life year (ICER) was determined for both arms. Utilities for the entry states were derived from patient interviews using the EQ5D-5L tool; utilities for other health states were taken from publications. Costs were assessed from the healthcare payer perspective. A sensitivity analysis was done.Results: Base case analysis showed that RFA versus OMT is both highly cost-effective at 5 years and over a lifetime. RFA at 5 years costs about PhP276,913.58 (USD5,446) versus OMT of PhP151,550.95 (USD2,981) per patient. Discounted lifetime costs were PhP280,770.32 (USD5,522) for RFA, versus PhP259,549.74 (USD5,105) for OMT.There was improved quality of life with RFA (8.1 vs. 5.7 QALYs per patient). The 5-year and lifetime incremental cost-effectiveness ratios were PhP148,741.40 (USD2,926) and Php15,000 (USD295), respectively. Sensitivity analysis showed 56.7% of simulations for RFA fell below a GDP-benchmarked willingness-to-pay (WTP) threshold. Conclusion:Despite the initial higher cost, RFA versus OMT for SVT is highly costeffective from the Philippine public health payer's perspective.

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“… 2 A recent systematic review showed that adenosine was not only equally efficacious in treating SVT but was also safer than intravenous calcium channel blockers (CCB). 3 Furthermore, another study found adenosine to be a safe and effective treatment for SVT in pre‐hospital settings. 4 It has a success rate of over 90% for terminating SVT.…”

Section: Introductionmentioning

confidence: 99%

“…The standard guidelines for management of SVT state that adenosine should be the first medication therapy if vagal maneuvers fail to terminate SVT 2 . A recent systematic review showed that adenosine was not only equally efficacious in treating SVT but was also safer than intravenous calcium channel blockers (CCB) 3 . Furthermore, another study found adenosine to be a safe and effective treatment for SVT in pre‐hospital settings 4 .…”

Section: Introductionmentioning

confidence: 99%

Comparison between the double‐syringe and the single‐syringe techniques of adenosine administration for terminating supraventricular tachycardia: A pilot, randomized controlled trial

Kotruchin

Chaiyakhan

Kamonsri³

et al. 2022

Clinical Cardiology

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Background Adenosine has been recommended as a first‐line treatment for stable supraventricular tachycardia (SVT). Standard guidelines recommend 6‐mg of adenosine administered intravenously (IV) with an immediate 20‐ml IV bolus of normal saline solution (NSS; double syringe technique [DST]). However, a newly proposed single‐syringe technique (SST), in which adenosine is diluted with an up to 20 ml IV bolus of NSS, was found to be beneficial. Hypothesis We hypothesized that the SST was noninferior to the DST for terminating stable SVT. Methods A pilot multicenter, single‐blind, randomized controlled study was conducted at nine hospitals in north and northeast Thailand. Thirty patients who were diagnosed with stable SVT were randomized into two groups of 15, with one receiving adenosine via the DST and the other via the SST. We examined SVT termination, the average successful dose, and the complication rate of each group. Analyses were based on the intention‐to‐treat principle. Result The termination rate was 93.3% in the DST and 100% in the SST group ( p = 1.000), and the success rate of the first 6‐mg dose of adenosine was 73.3% and 80%, respectively ( p = 1.000). The total administered dose was 8.6 ± 5.1 mg in the DST group and 7.6 ± 4.5 mg in the SST group ( p = .608). No complications were found in either group. Conclusions The SST was non‐inferior to the DST for termination of SVT. However, a further definitive study with a larger sample size is required.

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In The Line of Treatment: A Systematic Review of Paroxysmal Supraventricular Tachycardia

Cited by 8 publications

References 31 publications

FLRT3 and TGF‐β/SMAD4 signalling: Impacts on apoptosis, autophagy and ion channels in supraventricular tachycardia

FLRT3 and TGF‐β/SMAD4 signalling: Impacts on apoptosis, autophagy and ion channels in supraventricular tachycardia

Cost‐utility analysis of radiofrequency ablation versus optimal medical therapy in managing supraventricular tachycardia among Filipinos

Comparison between the double‐syringe and the single‐syringe techniques of adenosine administration for terminating supraventricular tachycardia: A pilot, randomized controlled trial

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