For the regular supraventricular tachycardias — atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) — catheter ablation is the cornerstone of definitive treatment. Radiofrequency ablation of the slow pathway is highly effective for AVNRT, with success rates around 99% and a low risk of atrioventricular block, because it targets the atrial end of the slow pathway while preserving normal nodal conduction. For AVRT, ablation of the accessory pathway is similarly effective and safe.
For acute termination, vagal maneuvers and adenosine are first-line, with intravenous calcium channel blockers (diltiazem or verapamil) or beta-blockers if those fail. Emerging pharmacological approaches targeting specific ion channels and structural remodeling are in early-phase trials and may offer more individualized options in future, but ablation remains the definitive therapy.
Further reading: radiofrequency ablation of AVNRT (Jackman et al., NEJM 1992); experimental drugs for supraventricular tachycardia (Narasimhan et al., 2023); review of SVT management (Tednes et al., 2024).