Supraventricular tachyarrhythmias occur more frequently in patients with Arrhythmogenic Cardiomyopathy and Brugada SyndromeHeart conditions like Brugada syndrome increase risk of rapid heartbeats

Frontiers in Medicine Published July 30, 2026 DOI ↗ Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease

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Key Takeaway

Recognize higher SVT prevalence in ACM and BrS patients and the potential underestimation of thromboembolic risk by CHA2DS2-VASc.

This systematic review analyzed 30 studies to evaluate the prevalence and clinical impact of supraventricular tachyarrhythmias (SVT), including atrial fibrillation (AF), atrial flutter (AFL), atrioventricular nodal re-entrant tachycardia (AVNRT), and atrioventricular re-entrant tachycardia (AVRT), in patients with Arrhythmogenic Cardiomyopathy (ACM) and Brugada Syndrome (BrS). The review found that SVT occurs more frequently in both ACM and BrS populations than in age-matched general populations. Atrial fibrillation was identified as the most common arrhythmia, often manifesting at a young age in structurally normal atria.

The authors synthesize evidence linking SVT to several clinical complications, including inappropriate ICD shocks, heart failure progression, recurrence of ventricular arrhythmias, and increased thromboembolic risk. Notably, the review suggests that the CHA2DS2-VASc score frequently underestimates thromboembolic risk in these specific patient populations.

Limitations noted by the authors include a need for prospective studies to refine risk-stratification tools and clarify the mechanistic overlap between conditions. These findings suggest that SVT has significant implications for arrhythmic monitoring, ICD programming, and thromboembolic risk assessment in patients with ACM and BrS.

Living with heart conditions like Arrhythmogenic cardiomyopathy (ACM) and Brugada syndrome (BrS) brings unique challenges. A review of 30 studies shows that people with these conditions experience supraventricular tachyarrhythmias (SVT) much more often than the general population. SVT is a broad term for fast heartbeats starting in the upper chambers of the heart, such as atrial fibrillation or atrial flutter.

These rapid heartbeats are not just a nuisance. The research links them to serious clinical issues, including the progression of heart failure and an increased risk of blood clots. They can also cause inappropriate shocks from an internal defibrillator (ICD) and lead to more dangerous heart rhythms returning.

One important finding is that current tools used by doctors to predict blood clot risks may underestimate the danger for these specific patients. While the data shows a clear link between these fast heartbeats and worse outcomes, researchers note that more studies are needed to perfectly refine how we manage these risks.

What this means for you:

Patients with ACM and BrS have higher rates of fast heartbeats, which can lead to heart failure or blood clots.

Common questions

What are supraventricular tachyarrhythmias (SVT)?

SVT is a general term for fast heartbeats that start in the upper chambers of the heart. This includes conditions like atrial fibrillation and atrial flutter. In patients with Arrhythmogenic cardiomyopathy or Brugada syndrome, these rapid heartbeats occur much more frequently than in the general population.

How do these fast heartbeats affect people with heart conditions?

These rapid heartbeats are linked to several serious issues. They can lead to the progression of heart failure, an increased risk of blood clots, and a higher chance of receiving inappropriate shocks from an internal defibrillator (ICD). They may also cause dangerous ventricular arrhythmias to return.

Is the risk of blood clots accurately measured for these patients?

Current tools like the CHA2DS2-VASc score often underestimate the risk of blood clots for people with Arrhythmogenic cardiomyopathy and Brugada syndrome. Because these fast heartbeats are common in these groups, doctors must carefully consider how to manage thromboembolic risks.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedJul 2026

View Original Abstract ↓

BackgroundArrhythmogenic cardiomyopathy (ACM) and Brugada syndrome (BrS) are inherited arrhythmogenic disorders historically defined by their predisposition to ventricular arrhythmias and sudden cardiac death (SCD). Accumulating evidence indicates that both conditions also involve the atrial myocardium and are associated with a high prevalence of supraventricular tachyarrhythmias (SVT). A clearer understanding of their mechanisms and clinical impact is essential to optimize risk stratification and management.MethodsA systematic review was conducted in accordance with the PRISMA 2020 statement. PubMed and the Cochrane Library were searched up to December 2025 for studies reporting atrial fibrillation (AF), atrial flutter (AFL), atrioventricular nodal re-entrant tachycardia (AVNRT), or atrioventricular re-entrant tachycardia (AVRT) in patients with ACM or BrS. Of 487 records identified, 486 were screened after removal of one duplicate, and 30 studies met the inclusion criteria. Data on atrial substrate, SVT prevalence, mechanisms, and clinical outcomes were extracted.ResultsSVT were consistently more frequent in both ACM and BrS than in age-matched general populations. AF was the most common arrhythmia, often arising at a young age and in structurally normal atria. Across studies, SVT were linked to inappropriate implantable cardioverter-defibrillator (ICD) shocks, heart failure progression, recurrence of ventricular arrhythmias, and an elevated thromboembolic risk that was frequently underestimated by the CHA₂DS₂-VASc score.ConclusionsSVT represent a clinically relevant manifestation of ACM and BrS and carry prognostic implications for arrhythmic monitoring, ICD programming, and thromboembolic risk assessment. Prospective studies are needed to refine risk-stratification tools and to clarify the mechanistic overlap between these inherited arrhythmogenic syndromes.

Supraventricular tachyarrhythmias occur more frequently in patients with Arrhythmogenic Cardiomyopathy and Brugada SyndromeHeart conditions like Brugada syndrome increase risk of rapid heartbeats

Common questions

Study Details

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Supraventricular tachyarrhythmias occur more frequently in patients with Arrhythmogenic Cardiomyopathy and Brugada SyndromeHeart conditions like Brugada syndrome increase risk of rapid heartbeats

Common questions

Study Details

Dual antiplatelet therapy reduces all-cause death but not MACE or myocardial infarction in MINOCA

Dual antiplatelet therapy shows survival benefits for MINOCA patients

Clinical research that matters. Delivered to your inbox.

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