Paroxysmal Supraventricular Tachycardia (SVT, PSVT)

Paroxysmal supraventricular tachycardia is an abnormally fast (around 160 to 220 bpm – beats per minute) but regular heart rhythm, that suddenly appears and disappears, and has an abnormal origin in an area other than that in the ventricles.

  • Shortness of breath, chest pain (angina) and awareness of heartbeat (palpitations) are the usual symptoms.
  • Stimulation of the vagus nerve which has the effect of slowing down the heart rate, help reverse the tachycardia.
  • Drugs may be used to stop it.
  • Incidence of paroxysmal supraventricular tachycardia, most frequent in the younger age group, is not often as dangerous as it is unpleasant. Strenuous activity and exercise may precipitate it.

Paroxysmal supraventricular tachycardia is the result of the heart getting activated into a rapid heart rhythm, initiated by repeated premature heartbeats of an abnormal nature. Certain abnormalities such as atrioventricular reciprocating supraventricular tachycardia resulting from the presence of an abnormal electrical conduction between the atria and the ventricles or atrioventricular nodal reentrant supraventricular tachycardia resulting from the existence of two different pathways in the atrioventricular node, usually trigger this condition. Occasionally, another abnormality called true paroxysmal atrial tachycardia, due to the generation of abnormally fast or circling impulses in the atria also may precipitate paroxysmal supraventricular tachycardia.

Symptoms and Diagnosis

Uncomfortable palpitations, felt suddenly and then disappearing as suddenly after only a few minutes or even many hours, is the most commonly occurring symptom. Giddiness, shortness of breath, fatigue and chest pain are some of the other common symptoms. Often, no other heart problem is found. Electrocardiogram (ECG) can confirm the diagnosis made from symptoms and physical examination.

Treatment of

The vagus nerve, which has the action of decreasing the heart rate, if stimulated, it can stop paroxysmal supraventricular tachycardia. Taking advantage of this, there are some easy, non-invasive procedures usually performed by qualified medical practitioner or under the supervision of a doctor to reverse this arrhythmia. However, those who have frequent episodes often learn to do them, themselves. Stimulating the carotid sinus on the carotid artery by rubbing or pressing at a point on the neck right below the joint of the jaw, suddenly dipping the face into ice-cold water or straining and applying pressure as if in a hard bowel movement are some such procedures. Initiated soon after the onset of the arrhythmia, these simple procedures are extremely effective.

If the symptoms are very severe and the manual procedures fail to stop the arrhythmia even after 20 minutes, doctors my give an intravenous injection of verapamil or adenosine which can immediately stop it.

In rare cases, applying electric shock to the heart (cardioversion) may be the only option, if drugs are not effective. Treating the condition is easier than prevention, since most antiarrhythmic drugs are effective. Beta-blockers and drugs such as verapamil, diltiazem and digoxin are commonly used. So are flecainide and propafenone.

A minimally invasive procedure called radiofrequency ablation has become very popular in the treatment of arrhythmia. In this procedure, the area from which paroxysmal supraventricular tachycardia is originating, is selectively destroyed by applying high frequency energy, through a catheter fitted with electrodes, that is introduced into the heart through via a vein.

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Yasser Elnahas

MD, PHD, Professor Of CardioVascular Surgery
Dr. Yasser Elnahas, Is an associate Professor of Cardiovascular Surgery. Dr. Elnahas was trained as a fellow At Texas Heart Institute And Mayo Clinic Foundation.Dr. Elnahas is dedicated to educating the general public about different disease conditions and simplifying the medical knowledge in an easy to understand terminology.

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