[Pharmacotherapy of supraventricular arrhythmias. What comes, what remains, what goes?].

Supraventricular tachycardias consist of AV-nodal-reentrant-tachycardias, atrioventricular tachycardias with accessory pathways (WPW-syndrome), atrial tachycardias, atrial fibrillation and atrial flutter. Only specific ECG interpretation with an exact arrhythmia classification offers the way to perform modern differential therapy including drug treatment and also interventional therapy modalities. In atrial fibrillation, drug treatment is still first-line therapy: physicians have to make a decision either to follow the rate or rhythm control concept. In case of rhythm control, drug therapy is tailored to the individual patient taking into account the patients symptomatology, left ventricular ejection fraction and nature and degree of an underlying cardiac disease. Drug refractory symptomatic atrial fibrillation patients should be considered for interventional treatment like pulmonary vein ablation. Recurrent typical right atrial flutter, AV-nodal-reentrant-tachycardia and all forms of atrioventricular tachycardias however are indications for catheter ablation; long-term drug treatment will only be performed in rare cases.