Whinnett et al listed patients with supraventricular tachycardia who should be referred to an electrophysiologist for evaluation. These patients may benefit from ablation of aberrant conduction pathways. The authors are from St. Mary's Hospital and Imperial College Healthcare NHS Trust London.


Patient selection: supraventricular tachycardia (SVT)


Situations requiring urgent referral to an electrophysiologist:

(1) The patient has severe symptoms.

(2) The patient has structural heart disease.

(3) Delta waves (indicative of pre-excitation) are seen on the 12-lead ECG.

(4) Exertion is associated with syncope and palpitations.

(5) The patient has broad complex tachycardia (QRS duration > 120 ms, heart rate > 100 beats per minute).


Situations where routine referral to an electrophysiologist may be indicated:

(1) There is uncertainty about the diagnosis.

(2) The patient would prefer not to take medication.

(3) The patient has not responded to optimal medical management.

(4) The patient has had significant adverse reactions to medications.


To read more or access our algorithms and calculators, please log in or register.