What criteria should I use to decide whether to refer a patient with SVT for specialist evaluation?

Patients with supraventricular tachycardia (SVT) should be referred for specialist evaluation if they present with any of the following criteria: red flag features on ECG such as conduction abnormalities, evidence of long or short QT interval, or other significant arrhythmias; syncope or transient loss of consciousness (TLoC) associated with exertion; a family history of sudden cardiac death or inherited cardiac conditions; new or unexplained breathlessness; or a heart murmur suggesting underlying structural heart disease. Additionally, urgent referral is warranted if the patient has an abnormal ECG or symptoms suggestive of significant cardiac pathology requiring specialist cardiovascular assessment within 24 hours ¹.

Referral should also be considered if the SVT is associated with signs or symptoms of heart failure or if there is suspicion of underlying valve disease or other structural heart disease, as these conditions may require echocardiography and specialist input ¹,².