SUE COPPINGER WARREN, M.D.
To the editor: The review "Supraventricular Tachycardia: Mechanisms and Management" by Josephson and Kastor (Ann Intern Med 87:346-358, 1977) emphasizes that sustained re-entry is the mechanism that accounts for most cases of paroxysmal supraventricular tachycardia and these arrhythmias are initiated by premature beats.
In the discussion of prophylactic treatment, however, no mention is made of identification of possible precipitating stimuli such as alcohol, tobacco, and coffee. These substances may precipitate ectopic beats in normal persons (1,2). Restricted use of them, therefore, seems logical for patients with paroxysmal supraventricular tachycardia.
WARREN SC. Stimuli to Supraventricular Tachycardia. Ann Intern Med. ;88:431. doi: 10.7326/0003-4819-88-3-431_1
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Published: Ann Intern Med. 1978;88(3):431.
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