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European Heart Journal 2003 24(20):1857-1897; doi:10.1016/j.ehj.2003.08.002
Copyright © 2003 by the European Society of Cardiology.
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ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias—executive summary

A Report of the American College of Cardiology/American HeartAssociation Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines(Writing Committee to Develop Guidelines for the Management of Patients With Supraventricular Arrhythmias)Developed in collaboration with NASPE–Heart Rhythm Society

Committee Members, Carina Blomström-Lundqvist, (Co-chair)a,c, Melvin M Scheinman, (Co-chair)a, Etienne M Aliota,c, Joseph S Alperta,b,c, Hugh Calkinsa,b, A.John Camma,b,c, W.Barton Campbella,b, David E Hainesa, Karl H Kucka,c, Bruce B Lermana, D.Douglas Millera, Charlie Willard Shaeffer, Jra, William G Stevensona and Gordon F Tomasellia,b

Task Force Members, Elliott M Antman, (Chair)a,b, Sidney C Smith, Jr, (Vice-Chair)a,b,c, Joseph S Alperta,b,c, David P Faxona,b, Valentin Fustera,b,c, Raymond J Gibbonsa,b,{dagger}{ddagger}, Gabriel Gregoratosa,b, Loren F Hiratzkaa,b, Sharon Ann Hunta,b, Alice K Jacobsa,b and Richard O Russell, Jra,b,{dagger}

ESC Committee for Practice Guidelines Members, Silvia G Priori, Chair, Jean-Jacques Blanc, Andzrej Budaj, Enrique Fernandez Burgos, Martin Cowie, Jaap Willem Deckers, Maria Angeles Alonso Garcia, Werner W Klein{ddagger}, John Lekakis, Bertil Lindahl, Gianfranco Mazzotta, João Carlos Araujo Morais, Ali Oto, Otto Smiseth and Hans-Joachim Trappe

The first 150 words of the full text of this article appear below.

Preamble
Introduction
    Organization of committee and evidence review
    Contents of these guidelines—scope
Public health considerations and epidemiology
General mechanisms of SVA
    Specialized atrial tissue
    General mechanisms
    Clinical presentation, general evaluation, and management of patients with SVA
    General evaluation of patients without documentedarrhythmia
        Clinical history and physical examination
        Diagnostic investigations
        Management
    General evaluation of patients with documentedarrhythmia
        Diagnostic evaluation
            Differential diagnosis for narrow QRS-complex tachycardia
            Differential diagnosis for wide QRS-complextachycardia
        Management
            Acute management of narrow QRS-complextachycardia
            Acute management of wide QRS-complextachycardia
            Further management
Specific arrhythmias
    Sinus tachyarrhythmias
        Physiological sinus tachycardia
            Definition
            Mechanism
            Diagnosis
            Treatment
        Inappropriate sinus tachycardia
            Definition
            Mechanism
            Presentation
            Diagnosis
            Treatment
        Postural orthostatic tachycardia syndrome
        Sinus node re-entry tachycardia
            Definition
            Mechanism
            Presentation
            Diagnosis
            Treatment
    Atrioventricular nodal reciprocating tachycardia
        Definitions and clinical features
        Acute treatment
        Long-term pharmacologic therapy
            Prophylactic pharmacologic therapy
            Single-dose oral therapy (pill-in-the-pocket)
        Catheter ablation
    Focal and nonparoxysmal junctional tachycardia
        Focal junctional tachycardia
            Definition
            Diagnoses
            Clinical features
            Management
        Nonparoxysmal . . . [Full Text of this Article]


   1. Preamble
 

   2. Introduction
 
2.1. Organization of committee and evidence review
2.2. Contents of these guidelines—scope

   3. Public health considerations and epidemiology
 

   4. General mechanisms of SVA
 
4.1. Specialized atrial tissue
4.2. General mechanisms

   5. Clinical presentation, general evaluation, and management of patients with SVA
 
5.1. General evaluation of patients without documented arrhythmia
5.1.1. Clinical history and physical examination
5.1.2. Diagnostic investigations
5.1.3. Management
5.2. General evaluation of patients with documented arrhythmia
5.2.1. Diagnostic evaluation
5.2.1.1. Differential diagnosis for narrow QRS-complextachycardia
5.2.1.2. Differential diagnosis for wide QRS-complex tachycardia
5.2.2. Management
5.2.2.1. Acute management of narrow QRS-complex tachycardia
5.2.2.2. Acute management of wide QRS-complex tachycardia
5.2.2.3. Further management

   6. Specific arrhythmias
 
6.1. Sinus tachyarrhythmias
6.1.1. Physiological sinus tachycardia
6.1.1.1. Definition
6.1.1.2. Mechanism
6.1.1.3. Diagnosis
6.1.1.4. Treatment
6.1.2. Inappropriate sinus tachycardia
6.1.2.1. Definition
6.1.2.2. Mechanism
6.1.2.3. Presentation
6.1.2.4. Diagnosis
6.1.2.5. Treatment
6.1.3. Postural orthostatic tachycardia syndrome
6.1.4. Sinus node re-entry tachycardia
6.1.4.1. Definition
6.1.4.2. Mechanism
6.1.4.3. Presentation
6.1.4.4. Diagnosis
6.1.4.5. Treatment
6.2. Atrioventricular nodal reciprocating tachycardia
6.2.1. Definitions and clinical features
6.2.2. Acute treatment
6.2.3. Long-term pharmacologic therapy
6.2.3.1. Prophylactic pharmacologic therapy
6.2.3.2. Single-dose oral therapy (pill-in-the-pocket)
6.2.4. Catheter ablation
6.3. Focal and nonparoxysmal junctional tachycardia
6.3.1. Focal junctional tachycardia
6.3.1.1. Definition
6.3.1.2. Diagnoses
6.3.1.3. Clinical features
6.3.1.4. Management
6.3.2. Nonparoxysmal junctional tachycardia
6.3.2.1. Definition and clinical features
6.3.2.2. Management
6.4. Atrioventricular reciprocating tachycardia (extra nodal accessory pathways)
6.4.1. Sudden death in WPW syndrome and risk stratification
6.4.2. Acute treatment
6.4.2.1. Special considerations for patients with wide-complex (pre-excited) tachycardias
6.4.3. Long-term pharmacologic therapy
6.4.3.1. Prophylactic pharmacologic therapy
6.4.3.2. Single-dose oral therapy (pill-in-the-pocket)
6.4.4. Catheter ablation
6.4.5. Management of patients with asymptomatic accessory pathways
6.4.6. Summary of management
6.5. Focal atrial tachycardias
6.5.1. Definition and clinical presentation
6.5.2. Diagnosis
6.5.3. Site of origin and mechanisms
6.5.3.1. Drug-induced atrial tachycardia
6.5.4. Treatment
6.5.4.1. Acute treatment
6.5.4.2. Long-term pharmacologic therapy
6.5.4.3. Catheter ablation
6.5.5. Multifocal atrial tachycardia
6.6. Macro-re-entrant atrial tachycardia
6.6.1. Isthmus-dependent atrial flutter
6.6.1.1. Definitions of cavotricuspid isthmus-dependent flutter circuits
6.6.1.2. Other CTI-dependent flutter circuits
6.6.1.3. Pathophysiology and treatment rationale
6.6.1.4. Clinical presentation
6.6.1.5. Acute treatment
6.6.1.6. Chronic pharmacologic treatment
6.6.1.7. Role of anticoagulant therapy for patients with atrial flutter
6.6.1.8. Catheter ablation of the cavotricuspid isthmus for isthmus-dependent flutter
6.6.1.9. Treatment of atrial flutter in special circumstances
6.6.2. Non-cavotricuspid isthmus-dependent atrial flutter
6.6.2.1. Catheter ablation and mapping of non-cavotricuspid isthmus-dependent flutter

   7. Special circumstances
 
7.1. Pregnancy
7.1.1. Acute conversion of atrioventricular node-dependent tachycardias
7.1.2. Prophylactic antiarrhythmic drug therapy
7.2. Supraventricular tachycardias in adult patients with congenital heart disease
7.2.1. Introduction
7.2.2. Specific disorders
7.2.2.1. Atrial septal defect
7.2.2.2. Transposition of the great vessels
7.2.2.3. Tetralogy of fallot
7.2.2.4. Ebstein's anomaly of the tricuspid valve
7.2.2.5. Fontan repairs
7.3. Quality-of-life and cost considerations

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