What Is Paroxysmal Supraventricular Tachycardia?

Tachycardia is when your heart beats faster than normal, even when you’re not doing anything. Paroxysmal supraventricular tachycardia (PSVT) is when your fast heartbeat starts in the upper, or supraventricular, chambers of the heart. It’s also known as supraventricular tachycardia. PSVT is most common in younger people, especially women. It doesn’t seem linked to long-term health issues.

Symptoms

The main symptom is a faster pulse for no clear reason. In adults, that typically means a racing heart between 120 and 230 beats per minute. It starts and stops suddenly. Other symptoms include:

  • Trouble catching your breath
  • General tiredness
  • Chest tightness or pain
  • Dizziness
  • Fainting

Even though PSVT doesn’t seem to lead to serious long-term health issues, you should still talk to your doctor. These symptoms could be signs of another health problem.

Causes

A muscle in the upper chambers of your heart sends out an electrical signal. Sometimes the signal messes up and keeps going around in a circle. This leads to a speeding heartbeat, or PSVT. Doctors don’t always know why PSVT happens. It may be because of genetic issues with your heart tissue or electrical signaling. Certain things can trigger your symptoms, like:

Diagnosis

The doctor will ask you about your health history and symptoms. They’ll do an exam. A racing heart would be an obvious sign. But they’ll need more information to figure out if PSVT is the problem. Something else may be causing your fast pulse, like certain heart and thyroid conditions. Mental health issues like anxiety could also be a reason. Tests that can help your doctor figure out if it’s PSVT include:

  • Blood tests to check for conditions like heart disease
  • An EKG (electrocardiogram) to analyze your heart’s electrical pulses
  • A Holter monitor to track heart activity for 24 hours or more
  • A chest X-ray for pictures of heart and lungs
  • An echocardiogram to check your heart’s size, strength, and ability to pump blood

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Treatment

The doctor may suggest a “wait and see” approach if your symptoms aren’t causing major problems. Try to avoid triggers like nicotine, alcohol, or caffeine. Exercise and eating well can help keep your heart strong.

At-home treatments. The doctor can show you movements that may help lower your pulse during an episode. They include:

  • Dive reflex. This is when you quickly put your face into water, especially cold water.
  • Valsalva maneuver. This is kind of like straining during a bowel movement: You attempt to push air out of your lungs while you block the flow at your throat or nose.
  • Carotid sinus massage. This is gentle pressure on your neck, where the carotid artery splits into two branches.
  • Eyeball massage. You press gently on your eyes while they’re closed.

Medication. Your doctor may prescribe drugs like ivabradine, beta-blockers, or calcium channel blockers to lower your pulse.

Catheter ablation. If your symptoms don’t get better, your doctor might suggest a procedure called catheter ablation. It’s also known as radiofrequency ablation. This is when doctors use small radio waves to destroy a tiny bit of heart tissue in the area that might trigger your PSVT. It takes 2 to 4 hours. You usually go home the same day.

Catheter ablation is typically safe. But it could damage blood vessels or lead to infection.

WebMD Medical Reference Reviewed by James Beckerman, MD, FACC on February 24, 2020

Sources

SOURCES:

American Heart Association: “Tachycardia: Fast Heart Rate,” “Ablation for Arrhythmias.”

Arrhythmia Alliance: “Inappropriate Sinus Tachycardia.”

Cedars Sinai: “Inappropriate Sinus Tachycardia.”

Journal of the American College of Cardiology: “Inappropriate Sinus Tachycardia.”

Johns Hopkins Medicine: “Paroxysmal Supraventricular Tachycardia (PSVT).”

Mayo Clinic: “Supraventricular tachycardia.”

Merck Manual: “Paroxysmal Supraventricular Tachycardia (SVT, PSVT).”

Stanford Health Care: “Medications to Treat SVT.”

UpToDate: “Narrow QRS complex tachycardias: Clinical manifestations, diagnosis, and evaluation.”

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