Treatments for paroxysmal supraventricular tachycardia: A review of current practice

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Background: Paroxysmal supraventricular tachycardia (PSVT) is a mostly benign heart condition characterised by unpredictable episodes of rapid pulse. Despite this, PSVT attacks impart great concern in patients and often lead to hospital admissions. Etripamil (formerly MSP-2017) is a novel drug undergoing clinical trials as an intranasally administered treatment for PSVT. This narrative review compares etripamil to contemporary practices against PSVT, including employment of Valsalva manoeuvres (VM), ice water immersion, and anti-arrhythmic drugs with side-effects involving drug-induced QT prolongation. Objective: This review will aid in determining whether etripamil is a feasible alternative to such existing therapies for PSVT. Methods: The literature search was conducted in PubMed and Google Scholar with a time limit from 2013-2018. Results: Etripamil showed higher reversion to sinus rhythm than the VM-the currently most employed therapy for PSVT that patients can perform at home. Etripamil has not been shown to prolong QT intervals, as opposed to anti-arrhythmic drugs such as flecainide and amiodarone. Comparing etripamil to ice water immersion methods was uninformative, as the previous trials were inconclusive. Conclusion: Etripamil offers a relatively safe self-treatment for PSVT, which could replace anti-arrhythmic drugs presenting with acquired long QT and other side-effects. Hospital visits are avoided, since patients can easily administer the nasal spray at home. However, the safety and efficacy of usage is yet to be determined by the Phase III trial. The VM can be performed in patients experiencing PSVT as a preliminary therapy or employed in cases where etripamil fails to restore sinus rhythm.

Original languageEnglish
JournalWorld Heart Journal
Volume12
Issue number3
Pages (from-to)257-268
ISSN1556-4002
Publication statusPublished - 2020

Bibliographical note

Publisher Copyright:
© Nova Science Publishers, Inc.

    Research areas

  • Anti-arrhythmic, Etripamil, Ice water immersion, Paroxysmal supraventricular tachycardia, Valsalva manoeuvre

ID: 290258891