What is supraventricular tachycardia. How is SVT diagnosed. What are the common types of SVT. What causes supraventricular tachycardia. How is SVT treated. Can SVT be prevented. When should you seek medical attention for SVT.

What is Supraventricular Tachycardia (SVT)?

Supraventricular tachycardia (SVT) is a group of heart rhythm disorders characterized by an abnormally fast heartbeat, typically ranging from 151 to 250 beats per minute (BPM). The term “supraventricular” indicates that the issue originates above the heart’s ventricles, in the atria or the atrioventricular (AV) node.

SVT affects approximately 2 out of every 1,000 people, including both children and adults. This condition can lead to various serious health complications if left untreated.

How does SVT differ from normal heart rhythm?

In a healthy heart, the electrical signal that initiates each heartbeat originates in the sinoatrial (SA) node, located in the upper right atrium. This signal then travels through the heart’s electrical system, coordinating the contraction of the atria and ventricles. However, in SVT, the electrical signal comes from an abnormal location, disrupting the heart’s normal rhythm and causing it to beat much faster than usual.

Common Types of Supraventricular Tachycardia

There are several types of SVT, each involving different parts of the heart or having a unique origin. Understanding these types is crucial for proper diagnosis and treatment.

• Atrial Fibrillation (AFib): The most common form of heart arrhythmia, affecting 2.7 million adults in the United States alone. In AFib, the atria beat more quickly and irregularly than the ventricles.
• Atrial Flutter: This occurs when the atria beat faster than the ventricles, sometimes reaching up to 300 BPM, resulting in a pulse rate of around 150 BPM.
• Paroxysmal SVT (PSVT): Characterized by occasional episodes of SVT that come and go.
• Atrioventricular Node Reentrant Tachycardia (AVNRT): The most common type of SVT, caused by an additional pathway near the AV node that leads to premature heartbeats.
• Atrioventricular Reciprocating Tachycardia (AVRT): The second most common type of SVT, occurring when a second connection develops between the upper and lower chambers of the heart.
• Atrial Tachycardia: Causes the atria to beat at an accelerated rate, with the electrical signal originating from a location other than the SA node.
• Multifocal Atrial Tachycardia: More common in older adults with respiratory problems, characterized by electrical signals coming from different areas of the atria.

Symptoms and Warning Signs of SVT

Recognizing the symptoms of SVT is crucial for early detection and treatment. The most common symptom is a sudden feeling that your heart is racing or pounding out of your chest. However, SVT can manifest in various ways, and it’s essential to be aware of the following signs:

• Lightheadedness or dizziness
• Sweating
• Exercise intolerance
• Anxiety or panic attacks
• Fatigue
• Chest discomfort or pressure
• Shortness of breath
• Fainting (in severe cases)

It’s important to note that SVT episodes can develop suddenly and end just as quickly, making it challenging to record the abnormal heart rate and associated symptoms.

When should you seek immediate medical attention for SVT?

While many SVT episodes resolve on their own, certain symptoms warrant immediate medical attention. Go to an emergency room if your SVT episode occurs with:

• Chest pain
• Difficulty breathing
• Fainting or loss of consciousness

Causes and Risk Factors for Supraventricular Tachycardia

SVT is primarily caused by the improper functioning of the heart’s electrical system. While the exact cause may not always be apparent, several factors can contribute to the development of SVT:

• Congenital heart defects: Some people are born with an extra electrical pathway in their heart, leading to abnormal electrical activity.
• Strenuous exercise
• Periods of stress
• Stimulant use
• Electrolyte imbalances
• Thyroid dysfunction

Additionally, certain underlying health conditions and lifestyle factors can increase the risk of developing SVT:

• Heart disease
• Heart failure
• Chronic obstructive pulmonary disease (COPD)
• Excessive caffeine or alcohol consumption
• Smoking
• Drug use, especially stimulants and methamphetamine
• Certain medications, including antihistamines, decongestants, and asthma medications

Diagnosing Supraventricular Tachycardia

Diagnosing SVT can be challenging due to its intermittent nature. However, several methods and tools are used to identify and confirm the presence of this condition:

Cardiac Monitoring

A cardiac monitor is the primary tool used to record the heart’s electrical activity and identify abnormal rhythms. This may involve:

• Electrocardiogram (ECG or EKG): A standard 12-lead ECG can capture the heart’s electrical activity during an SVT episode.
• Holter Monitor: A portable device worn for 24-48 hours to record the heart’s rhythm continuously.
• Event Recorder: A wearable device that can be activated by the patient when symptoms occur, allowing for longer-term monitoring.

Additional Diagnostic Tests

To rule out other underlying conditions and assess the heart’s structure and function, your healthcare provider may recommend:

• Echocardiogram: An ultrasound of the heart to evaluate its structure and function.
• Stress Test: Monitors the heart’s activity during exercise to detect any abnormalities.
• Electrophysiology Study: An invasive procedure that can pinpoint the exact location of the abnormal electrical pathway.

Treatment Options for Supraventricular Tachycardia

The treatment approach for SVT depends on the frequency and severity of episodes, as well as the underlying cause. Options range from simple at-home techniques to more advanced medical procedures:

Acute Management of SVT Episodes

For immediate relief during an SVT episode, the following techniques may be effective:

• Vagal Maneuvers: Actions like bearing down, coughing, or placing an ice pack on the face can stimulate the vagus nerve and slow the heart rate.
• Medications: Intravenous adenosine or other antiarrhythmic drugs may be administered in a medical setting to terminate the episode.

Long-Term Management Strategies

For patients with recurrent SVT episodes, long-term management options include:

• Lifestyle Modifications: Reducing caffeine intake, managing stress, and avoiding known triggers.
• Medications: Beta-blockers, calcium channel blockers, or antiarrhythmic drugs may be prescribed to prevent or reduce the frequency of episodes.
• Catheter Ablation: A minimally invasive procedure that uses radiofrequency energy or cryotherapy to destroy the abnormal electrical pathway causing SVT.
• Pacemaker Implantation: In rare cases, a pacemaker may be necessary to regulate the heart’s rhythm.

Living with Supraventricular Tachycardia: Coping Strategies and Lifestyle Adjustments

Living with SVT can be challenging, but there are several strategies to manage the condition and improve quality of life:

Emotional Well-being

According to research published in 2013, anxiety and panic attacks are common among people with SVT. The unpredictability of episodes can lead to feelings of nervousness about having plans or events interrupted by symptoms. To address this:

• Seek support from family, friends, or support groups
• Consider cognitive-behavioral therapy to manage anxiety
• Practice relaxation techniques such as meditation or deep breathing exercises

Lifestyle Modifications

Making certain lifestyle changes can help reduce the frequency and severity of SVT episodes:

• Maintain a healthy diet and exercise regimen
• Limit or avoid caffeine, alcohol, and tobacco
• Manage stress through relaxation techniques or counseling
• Get adequate sleep and maintain a consistent sleep schedule
• Stay hydrated and maintain proper electrolyte balance

Monitoring and Self-Care

Taking an active role in managing your condition can improve outcomes:

• Keep a symptom diary to track episodes and potential triggers
• Learn and practice vagal maneuvers for acute management of episodes
• Adhere to prescribed medication regimens
• Attend regular follow-up appointments with your healthcare provider

Preventing Supraventricular Tachycardia: Risk Reduction and Early Intervention

While not all cases of SVT can be prevented, there are steps you can take to reduce your risk and catch potential issues early:

Addressing Modifiable Risk Factors

Focus on lifestyle changes that can improve overall heart health:

• Maintain a healthy weight
• Exercise regularly, following your doctor’s recommendations
• Manage underlying conditions such as high blood pressure, diabetes, or thyroid disorders
• Avoid smoking and limit alcohol consumption
• Reduce caffeine intake, especially if you’re sensitive to its effects

Regular Health Check-ups

Routine medical evaluations can help detect potential heart rhythm issues before they become more serious:

• Schedule annual physical exams
• Discuss any unusual symptoms with your healthcare provider
• Follow through with recommended screenings, especially if you have a family history of heart problems

Medication Management

If you’re taking medications that may increase your risk of SVT:

• Review your medication list with your doctor or pharmacist
• Discuss potential alternatives if you’re taking medications known to trigger SVT
• Never stop or change medications without consulting your healthcare provider

Future Directions in SVT Research and Treatment

As medical science advances, new approaches to diagnosing and treating SVT are emerging:

Improved Diagnostic Tools

Researchers are developing more sophisticated monitoring devices that can provide longer-term, more accurate data on heart rhythms. These may include:

• Implantable loop recorders with enhanced detection algorithms
• Wearable technology that can continuously monitor heart rhythms and alert patients to potential SVT episodes
• Artificial intelligence-powered ECG analysis for more precise diagnosis

Advanced Treatment Modalities

Emerging treatments aim to provide more targeted, less invasive options for managing SVT:

• Gene therapy to correct underlying genetic causes of SVT
• Novel catheter ablation techniques with improved precision and reduced risk of complications
• Development of new antiarrhythmic drugs with fewer side effects

Personalized Medicine Approaches

The future of SVT treatment may involve more individualized care based on genetic profiles and specific mechanisms of arrhythmia:

• Genetic testing to identify individuals at higher risk for SVT
• Tailored treatment plans based on the specific type and cause of SVT in each patient
• Integration of lifestyle factors and personal preferences into treatment decision-making

As research in the field of cardiac electrophysiology continues to evolve, patients with SVT can look forward to more effective, personalized treatment options that may significantly improve their quality of life and long-term outcomes.

Supraventricular Tachycardia: Types, Symptoms, and Treatment

Supraventricular tachycardia (SVT) is a very rapid heartbeat (usually between 151 and 250 beats per minute, or BPM) and can cause a number of serious health issues. It’s seen in just over 2 out of every 1,000 people, affecting children and adults alike.

There are several types of SVT, with each involving a different part of the heart or having a unique origin. Signs of SVT include a racing heart rate and other symptoms that can cause discomfort, pain, or feeling faint.

A cardiac monitor is used to record the heart to identify an abnormal rhythm. Treatment for SVT ranges from tips you can apply at home to procedures that can get rid of or bypass the source of this condition.

Supraventricular tachycardia is actually a group of arrhythmias — or abnormal heart rhythms — characterized by an unusually fast heartbeat.

The phrase “supraventricular” means that the issue happens above the heart’s two lower chambers (ventricles). The two upper chambers are the atria. Tachycardia refers to any type of rapid heartbeat.

Normally, the electrical signal that starts every heartbeat originates in the sinoatrial (SA) node in the upper right atrium. Then, it travels through the heart’s circuitry to the atrioventricular (AV) node in the lower right atrium and down into the ventricles to help them pump blood out of the heart.

Along the way, the electrical impulse travels through the rest of the heart muscle, causing it to contract. This usually happens in a very coordinated and synchronized manner.

When your heart is in SVT, the electrical signal comes from somewhere else instead of the SA node — sometimes even from the AV node where it’s supposed to travel through. Because the heart beats much faster than normal, the ventricles can’t always fill with enough blood to supply all the organs and tissue in your body.

SVT can develop in several ways. Some of the more common types of SVT include:

• Atrial fibrillation (AFib). The most common form of heart arrhythmia, AFib affects 2.7 million adults in the United States alone. This happens when the atria beat more quickly than the ventricles in an irregular rhythm.
• Atrial flutter. Atrial flutter happens when your atria beat faster than the ventricles, sometimes beating up to 300 bpm and resulting in a pulse rate of around 150 bpm.
• Paroxysmal SVT (PSVT). SVT episodes occur occasionally. They are limited, and they come and go.
• Atrioventricular node reentrant tachycardia (AVNRT). The most common type of SVT. AVNRT results from an additional pathway (reentrant circuit) near the AV node that causes the heart to beat too early.
• Atrioventricular reciprocating tachycardia (AVRT). This second most common type of SVT occurs when a second connection between the upper and lower chambers develops. This allows the electrical impulses to move in a faster circuit than they would without that additional connection.
• Atrial tachycardia. This causes the atria to beat at an accelerated rate. The electrical signal originates from a location other than the SA node.
• Multifocal atrial tachycardia. More common in older adults with respiratory problems, this type is characterized by electrical signals coming from different areas, causing the atria to contract.

SVT is caused by the improper functioning of the heart’s electrical system. Sometimes, an SVT episode develops after strenuous exercise, a period of stress, or after stimulant use.

In some cases, people are born with an extra electrical pathway in their heart that leads to abnormal electrical activity. For some, it can be due to abnormal electrolytes or thyroid function. Sometimes there is no obvious trigger. But many people with SVT have other health problems that affect heart function, including:

• heart disease
• heart failure
• chronic obstructive pulmonary disease (COPD)
• too much caffeine, alcohol consumption, or toxin use
• smoking
• drug use (especially stimulants and methamphetamine)
• thyroid disease
• various medications, including antihistamines, decongestants, and other cold or asthma medications

The most common symptom of SVT is the feeling that your heart is racing. It may feel like it’s pounding out of your chest.

Other symptoms may include:

• lightheadedness
• sweating
• exercise intolerance

According to 2013 research, anxiety and panic attacks are also common among people with SVT. The unpredictability of SVT episodes can make people feel nervous about having plans or events interrupted by a racing heart, lightheadedness, or fatigue.

Seek immediate medical attention

Go to an emergency room if your SVT episode occurs with:

• chest pain
• difficulty breathing
• fainting

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SVT episodes can develop suddenly and end just as quickly and unpredictably. That’s why it can be difficult to record the abnormal heart rate and any changes in heart rhythm caused by the condition.

A 2020 study in Clinical Medicine suggests that the use of 12-lead electrocardiography (ECG) is critical in diagnosing SVT and determining short- and long-term management of the condition.

This is because SVTs have specific heartbeat patterns that can be seen on an ECG readout. For example, atrial fibrillation has its own unique patterns. ECG information helps doctors make accurate diagnoses.

If your heart is not in SVT while undergoing an ECG, your doctor may recommend a wearable heart monitor, such as a Holter monitor or event monitor. You may also be asked for a blood test to check for electrolyte levels and any signs of infection.

Mild cases of SVT may not need any treatment, but they first need to be diagnosed.

You may want to consider a treatment plan if SVT episodes occur frequently, or they disrupt your life in any way. Treatments range from steps you can take at home to heart procedures, usually performed with a catheter (rather than open surgery).

Home remedies

If you feel your heart starting to race with an SVT episode, vagal maneuvers that stimulate the vagus nerve can help control your heart rate and other important functions.

Here are some vagal maneuvers you may want to try:

• Pinch your nose and close your mouth while you try to exhale for 20 seconds. The pressure in your head will lead to changes in blood pressure. This can trigger a return to a normal heart rate.
• Cough a few times.
• Hold your breath and bear down as if you’re having a bowel movement.
• Dunk your face in a bowl of ice-cold water.

Ask a doctor before you perform any of these remedies to make sure they’re safe for you to try.

Management tips

A doctor may also advise you to make some of the following lifestyle changes to better manage your condition:

• Have little or no caffeine.
• Drink little or no alcohol.
• Try to quit smoking if you smoke.
• Exercise regularly, though working out with a partner is safer in case of a major SVT episode.
• Try to get at least 7 to 8 hours of sleep at night, and treat obstructive sleep apnea if applicable.

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Medications

Medications can help slow down a racing heart if your SVT episodes are frequent and last long, or if they’re causing symptoms such as:

• dizziness
• chest pain
• shortness of breath
• reduced blood pressure

A 2016 report in JAMA Cardiology suggests that the anti-arrhythmic drug adenosine (Adenocard) is recommended for most common types of SVT. The report also suggests that the following drugs, often administered intravenously (IV), may be appropriate for certain types of SVT:

• diltiazem
• verapamil
• metoprolol

Ablation

For people with recurrent SVT, including children, ablation is considered generally safe and effective. According to a 2015 study, this is true even if you’re taking SVT medications, or you choose not to take medications in the long term.

Ablation involves the use of radio waves or cold temperatures to destroy the cells causing the abnormal heart rate. It’s also been shown to be safe and effective in treating people born with complex congenital heart disease.

SVT is different from a condition called ventricular tachycardia (VT).

The main difference is that SVT begins above the ventricles, and VT starts in the heart’s lower chambers.

The other key difference is that VT can have more severe and life threatening symptoms because it originates in the heart’s primary pumping chambers.

Sinus tachycardia originates in the SA node and usually presents milder symptoms than SVT and is not considered an arrhythmia.

A heart rate with sinus tachycardia is usually between 100 and 150 BPM. SVT is typically characterized by a rate of between 151 and 250 BPM.

See a doctor if you feel your heart racing faster or longer than it should after strenuous activity, or speeding up for no apparent reason.

While supraventricular tachycardia is rarely life threatening, it’s important to know what is going on with your heart so you can pursue treatment if needed.

Supraventricular tachycardia (SVT) | Health Information

Expand all

• 
  
  

  You should be able to go home on the same day as a catheter (cardiac) ablation and get back to most of your normal activities fairly quickly. But take it easy for a few days. For more information, see our section on treatment of supraventricular tachycardia (SVT).

• 
  
  

  Sinus tachycardia means your heart beats in a normal, regular rhythm, but faster than usual. It may be triggered by lots of things such as exercise, stress or certain medicines. There’s usually nothing wrong with your heart. For more information, see our section on types of supraventricular tachycardia (SVT).

• 
  
  

  WPW syndrome is a type of supraventricular tachycardia (SVT). It’s caused by an extra electrical pathway between your atria and your ventricles (the upper and lower chambers of your heart). For more information, see our section on types of supraventricular tachycardia (SVT).

• 
  
  

  You should be able to travel by aeroplane safely, as long as you have only occasional SVT symptoms that are generally well controlled. If your symptoms aren’t under control, you shouldn’t fly. Your GP or heart specialist can give you the correct advice. For more information, see our section on driving and travelling with supraventricular tachycardia (SVT).

• 
  
  

  SVT isn’t dangerous or life-threatening, but the symptoms can affect your daily life. So, it’s important to keep the condition under control with lifestyle changes, medicines or a procedure called catheter (cardiac) ablation. For more information on treatments, see our section on treatments of supraventricular tachycardia (SVT).

• 
  
  

  SVT doesn’t usually have a specific cause because you’re normally born with it. Some situations may trigger the situations, as well as certain medicines, alcohol or smoking. For more information, see our section on causes of supraventricular tachycardia (SVT).

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