Profile and Outcomes of Patients Presenting with Supraventricular Tachycardia to the Accident and Emergency Department of a Large Tertiary Hospital in Jamaica

Abstract

Objective: To describe the profile and outcomes of patients presenting to the Accident and Emergency (A&E) department of a large tertiary hospital in Jamaica with Supraventricular Tachycardia (SVT) over a 28- month period. Methods: A cross-sectional study was done involving 130 patients presenting to the A&E department with an electrocardiogram (ECG) - confirmed diagnosis of SVT requiring medical therapy, over a 28- month period. Data relating to sociodemographic characteristics, presenting complaint, comorbidity and patient outcomes were obtained. Logistic and linear regressions were used to identify independent predictors of cardioversion in A&E, death on the ward, and length of hospital stay. Results: Most (69.2%) patients were female. Number of chronic illnesses ranged from zero to three (median =1). The most common presenting complaint was palpitation (82.3%), and the majority (73.6%) of patients were treated with Adenosine. Approximately 89% of patients cardioverted in the A&E. Almost all patients were admitted to the ward; Length of hospital stay ranged from 1-20 days (median = 3 days). ‘Palpitation’ was the only variable that independently predicted length of hospital stay (B= - 3.351, p=<0.001); those presenting with palpitation, spending less days in hospital. Compared to those who presented to the emergency room unresponsive, patients who presented to the emergency room responsive were almost 98% less likely to die on the ward (OR=0.022, 95% CI: 0.001-0.661, p= 0.028). Conclusion: Established protocols, a multidisciplinary approach, advanced training and adequate resources are key in the management of SVT patients in order to improve outcome.

Keywords

• supraventricular tachycardia
• cardioverted
• emergency room
• jamaica