Paroxysmal supraventricular tachycardia (PSVT) is characterized by episodes of faster-than-normal heart rate. PSVT is a fairly common type of irregular heartbeat. It can occur at any age and even in people who don’t have any other heart conditions.
In PSVT, the heart’s sinus node, which sends electrical signals to tell the heart muscle when to contract short circuits. This causes the heart to beat more frequently than normal. Episodes of rapid heart rate can last only a few minutes to several hours. A person with PSVT can have a heart rate as high as 250 beats per minute (bpm). A normal rate is between 60 and 80 bpm.
PSVT can cause uncomfortable symptoms, but it’s usually not life-threatening. Most people don’t require treatment for PSVT. There are medications and procedures that can relieve symptoms or cure the disorder in cases where PVST interferes with normal heart function.
PSVT is more common in children and younger adults than in older adults. Wolff-Parkinson-White syndrome is the most common cause of PSVT in children and infants. People with this disorder have an extra electrical pathway, or circuit, in their heart.
In a normal heart, the sinus node directs electrical signals through one specific pathway. This regulates the frequency of your heartbeats. An extra pathway, as is present in people with Wolff-Parkinson-White syndrome, can cause the fast heartbeat of PSVT.
There are also certain medications that can cause PSVT. For example, when taken in large doses, the heart medication digitalis can lead to episodes of PSVT. Also, the following can increase your risk of having an episode of PSVT:
- ingesting caffeine
- ingesting alcohol
- taking illegal drugs
The symptoms of PSVT are not life-threatening. They are similar to symptoms of an anxiety attack and can include:
- heart palpitations
- a rapid pulse
- a feeling of tightness or pain in the chest
- shortness of breath
In more serious cases, PSVT can cause dizziness and even fainting.
Sometimes, a person experiencing symptoms of PSVT may confuse the condition with a heart attack, especially if this is their first PSVT episode. If your chest pain is severe, and you’re not sure whether or not you’re having a heart attack, you should go to the emergency room for testing.
If you have an episode of fast heartbeats during an examination, your doctor will be able to measure your heart rate. If it’s very high, your doctor may suspect you have PSVT.
To diagnose PSVT, your doctor may order an intracardiac electrophysiology study (EPS). This will involve threading wires through a vein in your groin and up into your heart. This will allow the doctor to place electrodes that will monitor your heart’s rhythm. An EPS allows your doctor to evaluate the electrical pathways of your heart over the course of one or two hours.
Your doctor may also choose to monitor your heart rate over a longer period of time. In this case, you may be asked to wear a Holter monitor for 24 hours. During that time, you’ll have sensors attached to your chest and will wear the monitor around your waist. The monitor will record your heart rate. Your doctor will assess the recordings to determine if you have PSVT.
You might not need treatment if your symptoms are minimal or if you only have episodes of rapid heart rate occasionally. Treatment may be necessary if you have an underlying condition causing the PSVT or more severe symptoms.
If you frequently have a rapid heart rate but your symptoms are not severe, your doctor can show you a technique for restoring your heart rate to normal, called the Valsalva maneuver. It involves closing your mouth and pinching your nose while trying to exhale and straining as if you were trying to have a bowel movement. All of this should be done while sitting with your body bent forward. You can perform this maneuver at home. You can also try coughing while sitting and bending forward. Splashing ice water on your face is another technique to lower your heart rate.
Treatments for PSVT may include medications, such as propafenone, to help regulate your heartbeat. A procedure called radiofrequency catheter ablation is a common way to correct PSVT permanently. It’s performed in the same way as an EPS. It allows your doctor to use electrodes to destroy tissue in your heart muscle that’s causing the short circuit of PSVT.
If your PSVT doesn’t respond to other treatments, your doctor can surgically implant a pacemaker into your chest to regulate your heart rate.
PSVT is usually not life-threatening. If you have an underlying heart condition, PSVT could increase your risk of congestive heart failure or angina. Remember that your outlook depends on what treatment options are available to you, as well as what your specific needs are.