Genetic testing clarifies some heart rhythm issues but is not routine for most cases

This narrative review examines the genetic architecture of several types of supraventricular tachycardia. The authors looked at conditions including atrioventricular nodal reentrant tachycardia and Wolff-Parkinson-White syndrome. They found that genetic clustering supports a polygenic or oligogenic basis for some forms. Specific genes like NKX2-5 and TTN were linked to developmental pathways in atrioventricular nodal reentrant tachycardia. For accessory pathway-mediated cases, the connection to conduction biology is clearest, involving genes such as SCN5A and MRC2. However, the genetic basis for focal atrial tachycardia remains underpowered and heterogeneous. The highest current utility lies in identifying syndromic cases where diagnosis alters prognosis and screening. Routine translation into standard care remains limited. The review notes that genetic testing is not indicated for most isolated supraventricular tachycardia. Instead, phenotype-guided evaluation and implementation frameworks may enable targeted personalization. This approach is particularly relevant for early-onset, familial, or cardiomyopathy-overlap presentations. Readers should understand that while genetics explain some mechanisms, it does not change care for every patient.