SVT Therapy - Yesterday, Today and Tomorrow?

This essay is a brief review of advances in treatment of patients with supraventricular tachycardia (SVT) over the past 55 years. We review the knowledge base available in terms of arrhythmia diagnosis and the limited availability of drug therapy. Significant advances resulted in the introduction of direct-current defibrillators as well as introduction of ambulatory ECG recordings. We also witnessed a tremendous increase in an understanding of the mechanisms of SVT which in turn led to the development of first surgical and subsequently catheter based techniques for localization and ablation of foci or pathways responsible for arrhythmias. More recently, surgical and catheter techniques have been introduced in an attempt to cure atrial fibrillation. These techniques have proven especially effective for those with paroxysmal atrial fibrillation and less effective for those with long standing persistent fibrillation. The future brings hope for more extensive use of non-invasive techniques both to diagnose arrhythmia mechanisms together with techniques to ablate cardiac foci without patient instrumentation and finally in the use of gene therapy for patients with cardiac arrhythmia.