What Is Paroxysmal Supraventricular Tachycardia and How Is It Treated?

Written by Medicover Team and Medically Reviewed by Dr Jagadeesh Chandra Bose Y , Cardiologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Paroxysmal Supraventricular Tachycardia (PSVT) is a heart rhythm disorder that causes sudden episodes of rapid heart rate originating above the heart's ventricles. These episodes can begin and end abruptly and may cause palpitations, dizziness, chest discomfort, or shortness of breath. Understanding the symptoms, causes, diagnosis, and treatment options can help with appropriate management.

What are the Types of Paroxysmal Supraventricular Tachycardia?

PSVT generally refers to sudden-onset and sudden-offset episodes of supraventricular tachycardia. The most common mechanisms include abnormal electrical circuits involving the atrioventricular node or an accessory pathway.

Atrioventricular Nodal Reentrant Tachycardia (AVNRT): The most common form of PSVT, caused by a re-entry circuit involving or near the atrioventricular node.
Atrioventricular Reentrant Tachycardia (AVRT): Caused by an additional electrical pathway between the atria and ventricles. It can occur in people with conditions such as Wolff-Parkinson-White syndrome.
Atrial Tachycardia: A rapid rhythm that originates from an abnormal focus in the atria and can sometimes present as a paroxysmal supraventricular tachycardia.

Atrial fibrillation and atrial flutter are also supraventricular arrhythmias, but they are generally not classified as PSVT because their mechanisms and rhythm patterns differ.

What are the Symptoms of Paroxysmal Supraventricular Tachycardia?

Paroxysmal Supraventricular Tachycardia (PSVT) typically causes sudden episodes of rapid heart rate that may last from a few minutes to several hours. Some people may have mild symptoms, while others may experience significant discomfort.

Rapid heartbeat
Palpitations or a pounding or fluttering sensation in the chest
Chest discomfort or pain
Dizziness or lightheadedness
Shortness of breath
Fainting or near-fainting episodes
Fatigue or weakness

What are the Causes of Paroxysmal Supraventricular Tachycardia?

PSVT usually occurs because of abnormal electrical signaling in the heart. In many cases, an extra electrical pathway or a re-entry circuit causes the heart to suddenly beat very quickly. Certain factors can trigger or increase the likelihood of an episode.

Abnormal electrical pathways in the heart
Stress or anxiety
Caffeine or nicotine consumption
Overactive thyroid gland
Alcohol consumption
Certain medications or stimulants
Electrolyte imbalances
Underlying heart conditions or structural heart abnormalities

When to See a Doctor?

Consult a cardiologist if you experience sudden or recurring episodes of rapid heartbeat. Early evaluation can help determine the cause and reduce the risk of complications.

Frequent or recurring episodes of rapid heartbeat or palpitations
Dizziness, lightheadedness, or shortness of breath
Chest discomfort or unusual fatigue during episodes

Get medical help immediately if:

Fainting or near-fainting occurs
Severe chest pain or difficulty breathing develops
A rapid heartbeat persists and does not stop
Severe dizziness, weakness, or other concerning symptoms occur

These symptoms may indicate a serious heart rhythm problem or another medical emergency and require urgent evaluation.

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How Is Paroxysmal Supraventricular Tachycardia Diagnosed?

PSVT is diagnosed using the patient's symptoms, medical history, physical examination, and tests that record the heart's electrical activity. Because episodes can stop before a person reaches a healthcare facility, longer-term monitoring may sometimes be necessary.

Electrocardiogram (ECG): Records the heart's electrical activity and can identify PSVT when an episode occurs during the test.
Holter monitor: Continuously records the heart rhythm, usually for 24 to 48 hours, to detect intermittent episodes.
Event monitor: Records the heart rhythm over a longer period and can be activated when symptoms occur.
Electrophysiology study: A specialized test that evaluates the heart's electrical pathways and can identify the mechanism causing PSVT.
Blood tests: May be performed to identify contributing factors such as thyroid disorders or electrolyte abnormalities.
Echocardiogram: Uses ultrasound to assess the heart's structure and function and identify underlying heart disease.

What are the Treatment Options for Paroxysmal Supraventricular Tachycardia?

Treatment for PSVT depends on the frequency and severity of episodes, underlying heart conditions, and the specific type of arrhythmia. Some episodes may stop without treatment, while recurrent or prolonged episodes may require medication or a procedure.

Vagal Maneuvers

Vagal maneuvers, such as the Valsalva maneuver, can sometimes interrupt certain types of PSVT by affecting the electrical conduction through the atrioventricular node. These techniques should be performed according to medical advice.

Medications

Adenosine: An intravenous medicine commonly used in a medical setting to rapidly interrupt certain types of PSVT.
Beta-blockers: Medicines such as metoprolol may help prevent or reduce recurrent episodes in appropriate patients.
Calcium channel blockers: Medicines such as verapamil or diltiazem may be used in selected patients to control episodes.

Cardioversion

Electrical cardioversion may be required when PSVT causes significant symptoms, is prolonged, or does not respond to appropriate initial treatment.

Catheter Ablation

Catheter ablation is a minimally invasive procedure that identifies and destroys the abnormal electrical pathway or tissue responsible for PSVT. It can provide a long-term solution for many people with recurrent PSVT.

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What are the Risk Factors of Paroxysmal Supraventricular Tachycardia?

PSVT can occur in people without underlying heart disease, but certain medical conditions and lifestyle factors may increase the likelihood of episodes or trigger an attack.

High blood pressure
Heart disease
Thyroid disorders
Excessive alcohol consumption
Stimulant use
Stress or anxiety
Smoking
Family or personal history of certain heart rhythm disorders

Frequently Asked Questions

1. What is Paroxysmal Supraventricular Tachycardia (PSVT)?

PSVT is a type of rapid heart rhythm disorder that originates above the heart's ventricles.

2. What are the symptoms of PSVT?

Symptoms may include palpitations, dizziness, chest discomfort, shortness of breath, and fatigue.

3. How is PSVT diagnosed?

Diagnosis is usually made through an electrocardiogram (ECG) during an episode or through a Holter monitor for continuous monitoring.

4. What triggers can worsen PSVT episodes?

Common triggers include stress, caffeine, alcohol, tobacco, certain medications, and stimulants.

5. What treatment options are available for PSVT?

Treatment may involve vagal maneuvers, medications to control heart rate or rhythm, catheter ablation, or in severe cases, implantation of a pacemaker.