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Supraventricular tachycardia (SVT) means that from time to time your
heart beats very fast for a reason other than exercise, high fever, or stress.
For most people who have SVT, the heart still works normally to pump blood through the body.
Types of SVT include:
During an episode of SVT, the heart's electrical system
doesn't work right, causing the heart to beat very fast. The heart beats at
least 100 beats a minute and may reach 300 beats a minute. After treatment
or on its own, the heart usually returns to a normal rate of 60 to 100 beats a
SVT may start and end quickly, and you may not have
symptoms. SVT becomes a problem when it happens often, lasts a long time, or
SVT also is called paroxysmal supraventricular
tachycardia (PSVT) or paroxysmal atrial tachycardia (PAT).
Most episodes of SVT are caused by
faulty electrical connections in the heart.
SVT also can be
caused by certain medicines. Examples include very high levels of the heart medicine digoxin or the lung medicine theophylline.
Some types of SVT may run in families, such as
Wolff-Parkinson-White syndrome. Other types of SVT may be caused by certain health problems, medicines, or surgery.
Some people with SVT have no
symptoms. Others may have:
Other symptoms include near-fainting or fainting (syncope), shortness of breath, chest pain, throat
tightness, and sweating.
Your doctor will diagnose
SVT by asking you questions about your health and symptoms, doing a physical
exam, and perhaps giving you tests. Your doctor:
If you do not have an episode of SVT while you're at the
doctor's office, your doctor probably will ask you to wear a portable electrocardiogram (EKG), also called an ambulatory electrocardiogram. When
you have an episode, the device will record it.
Your doctor also
may do tests to find the cause of the SVT. These may include blood tests, a
X-ray, and an
echocardiogram, which shows the heart in motion.
Some SVTs don't cause
symptoms, and you may not need treatment. If you do have symptoms, your doctor
probably will recommend treatment.
To treat sudden episodes of
SVT, your doctor may:
If these treatments don't work, you may have to go to your
doctor's office or the emergency room. You may get a fast-acting medicine such
as adenosine or verapamil. If the SVT is serious, you may have
electrical cardioversion, which uses an electrical
current to reset the heart rhythm.
If you often have episodes of
SVT, you may need to:
You can try some things at home to help prevent SVT by avoiding the things that trigger it.
To find your triggers, keep a diary of your heart rate and
your symptoms. You might find, for example, that smoking or caffeine causes
your SVT episodes.
Health Tools help you make wise health decisions or take action to improve your health.
Learning about tachycardia:
Living with tachycardia:
Two common types of
supraventricular tachycardia—atrioventricular reciprocating tachycardia (AVRT) and
atrioventricular nodal reentrant tachycardia (AVNRT)—are caused by an abnormal
electrical pathway in the heart and often occur in
people who do not have any other type of heart disease. What causes this
abnormal pathway might not be clear.
Some experts believe that
Wolff-Parkinson-White syndrome—may in some cases be
For more information about how SVT happens, see the topic Types of Supraventricular Tachycardia.
Other types of supraventricular tachycardia may be
supraventricular tachycardia include:
Some lifestyle factors can
raise your risk of having an episode of
supraventricular tachycardia, such as overuse of
caffeine, nicotine, or alcohol or use of illegal drugs, such as stimulants like
cocaine or methamphetamine.
Decongestants that contain stimulants
should also be avoided, including oxymetazoline (such as Afrin and other
brands) and pseudoephedrine (such as Sudafed and other brands). Doctors also
warn against using nonprescription diet pills or "pep" pills, because many
contain caffeine, ephedra, ephedrine, the herb ma huang, or other
Conditions that affect the lungs, such as
chronic obstructive pulmonary disease (COPD),
heart failure, and
pulmonary embolism, can raise your risk for multifocal
atrial tachycardia (MAT), a type of supraventricular tachycardia.
Many experts believe that
Wolff-Parkinson-White syndrome may in some cases be
inherited. If you have a first-degree relative, which is a parent, brother, or
sister, with this disorder and he or she has symptoms, talk with your doctor
about your risk for this abnormal heart rhythm.
Call 911 or seek emergency services immediately if you have a fast heart rate and
Call your doctor if you are having fluttering in your chest
(palpitations) that persists and does not go away quickly or if you have
Call your doctor right away if you have symptoms that could mean your device is not working properly, such as:
Health professionals who can evaluate symptoms of a fast or irregular
Most people who have
supraventricular tachycardia need to see a
cardiologist or electrophysiologist for follow-up care.
An exact diagnosis is important
because the treatment you receive depends on the type of tachycardia you have.
Supraventricular tachycardia can sometimes be
diagnosed simply on the basis of a
medical history and physical exam and a few
simple tests. Tests that may be done to
monitor your heart and diagnose the type of fast heart rate that you have
After finding tachycardia, your doctor may need to search
for its cause. The specific tests needed depend on the particular tachycardia.
These tests may include:
Supraventricular tachycardia is usually treated if:
supraventricular tachycardia (SVT) start suddenly and
cause symptoms, you can try
vagal maneuvers—such as gagging, holding your breath and bearing down (Valsalva maneuver), immersing your face in ice-cold
water (diving reflex), or coughing. These
simple maneuvers stimulate the vagus nerve, which can slow conduction of
electrical impulses that control your heart rate. Your doctor will teach you
how to do vagal maneuvers safely.
Your doctor may also
prescribe a short-acting medicine that you can take by mouth if vagal maneuvers
don't work. This allows some people to manage their SVT without having to visit
the emergency room repeatedly.
If your heart rate cannot be slowed
using vagal maneuvers, you may have to go to your doctor's office or the
emergency room, where a fast-acting medicine such as adenosine can
be given. If the arrhythmia does not stop and symptoms are severe,
electrical cardioversion, which uses an electrical
current to reset the heart rhythm, may be needed.
If you have recurring episodes of
supraventricular tachycardia, you may need to take
medicines, either on an as-needed basis or daily. Medicine treatment typically
calcium channel blockers, other
antiarrhythmic medicines, or
digoxin. In people who have frequent episodes, treatment
with medicines can decrease recurrences. But these medicines may have side
Many people with supraventricular tachycardia have a
catheter ablation. This procedure can stop the rhythm problem in most people. Ablation is considered safe, but it has some rare, serious risks.
In the case of
atrioventricular nodal reentrant tachycardia (AVNRT),
medicines can be taken—either daily or only when the fast heartbeat arises—or
catheter ablation may be done.
If you have infrequent episodes of
AVNRT that last hours but do not cause severe symptoms, your doctor may
recommend that you take medicines only when you have an episode. These
calcium channel blockers, and
Your doctors may recommend
daily doses of calcium channel blockers, beta-blockers, and/or digoxin if you
have frequent episodes of AVNRT. If these medicines are not effective in
supraventricular tachycardia from recurring, your
doctor may recommend that you take an antiarrhythmic medicine.
you take daily medicine for AVNRT or you have significant symptoms, you may
want to consider having
In the case of
atrioventricular reciprocating tachycardia (AVRT), including Wolff-Parkinson-White (WPW) syndrome, you
can take medicines for recurrent episodes either on an as-needed or daily
basis, depending on how frequently they occur. These medicines—which include
calcium channel blockers—are often effective in stopping or preventing
episodes of AVRT. Treatment of WPW
antiarrhythmic medicines that slow electrical conduction over the
Catheter ablation is often recommended
for people who have WPW, especially those who have severe symptoms or also have
atrial fibrillation or flutter.
If supraventricular tachycardia occurs in someone
who has significant
coronary artery disease, the heart may not receive
enough blood to keep up with the demands of the increased heart rate. If this
occurs, the heart may not get enough oxygen, potentially causing chest pain
(angina) or a
Mild supraventricular tachycardia,
with short episodes that don't happen often, doesn't typically weaken the heart or lead to heart failure. But some people have a higher risk of getting heart failure, such as those who have a heart valve disease. If tachycardia is left untreated,
repeated and long episodes of tachycardia can lead to
heart failure (known
as a tachycardia-mediated cardiomyopathy). But this heart failure might be stopped, or reversed, if the supraventricular tachycardia is stopped with treatment.
You can reduce your risk of having
supraventricular tachycardia by avoiding certain
stimulants or stressors, such as caffeine, nicotine, some medicines (for
example, decongestants), illegal drugs (stimulants, like methamphetamines and
cocaine), and excess alcohol.
heart rates continue, long-term medicines may be used to
help prevent a recurrence of the fast heart rate.
Home care includes
supraventricular tachycardia and trying to slow your
heart when a fast heart rate occurs. To monitor your condition, you may find it
helpful to keep a
diary of your heart rate and your symptoms.
Check your pulse when you have symptoms, and record the
information in your diary. Be aware that if your heart is beating rapidly, it
may be hard to feel your pulse and get an accurate count of your actual
By keeping a diary of your heart rate and symptoms,
you may be able to identify stressors—such as drinking alcohol or smoking—that trigger episodes.
Also, it's usually important
to avoid overuse of caffeine, nicotine, or alcohol and the use of illegal
drugs, such as stimulants like cocaine, ecstasy, or methamphetamine. For people
who are especially sensitive, even decaffeinated teas or coffee can cause
supraventricular tachycardia episodes.
Decongestants that contain
stimulants should also be avoided, including oxymetazoline (such as Afrin and
other brands) and pseudoephedrine (such as Sudafed and other brands). Doctors
also warn against using diet pills or "pep" pills (because many contain
caffeine), ephedrine, ephedra, the herb ma huang, or other stimulants.
Your doctor may suggest that you try
vagal maneuvers—such as gagging, holding your breath and bearing down, or
immersing your face in cold water—to slow your heart rate. Your doctor will
help you learn these procedures so you can try them at home when your fast
heart rate occurs.
If you have symptoms, medicines may be
used to treat
For severe symptoms, such as
chest pain, shortness of breath, or feeling faint, you may be given fast-acting
antiarrhythmic medicines by health professionals in
the hospital emergency department, where your heart can be monitored.
Fast-acting antiarrhythmic medicines commonly used to slow the heart rate
during an episode include:
Long-term use of an antiarrhythmic medicine may also be
needed to reduce the chance of having more episodes of supraventricular
tachycardia or to reduce the heart rate during these episodes. Common medicines
used for this purpose include:
Open-heart surgery is rarely done for
supraventricular tachycardia. Surgery might be done if you cannot have catheter ablation or if you are having surgery for another heart condition.
An electric shock to the heart
(electrical cardioversion) may be needed if you are having severe symptoms
supraventricular tachycardia and your heart rate does
not return to normal using
vagal maneuvers or fast-acting medicines.
If you continue to have
episodes that cause serious symptoms, a procedure called catheter ablation may
be done during an
electrophysiology (EP) study. During an EP study, the
extra electrical pathway or cells in the heart that are causing the fast heart
rate can often be identified and destroyed using catheter ablation.
Visit the American Heart Association (AHA) website for information on
physical activity, diet, and various heart-related conditions. You can search for information on heart disease and stroke, share information with friends and family, and use tools to help you make heart-healthy goals and plans. Contact the AHA to find your
nearest local or state AHA group. The AHA provides brochures and information
about support groups and community programs, including Mended Hearts, a
nationwide organization whose members visit people with heart problems and
provide information and support.
The U.S. National Heart, Lung, and Blood Institute
(NHLBI) information center offers information and publications about preventing
Other Works Consulted
Blomström-Lunqvist C, et al. (2003). ACC/AHA/ESC
guidelines for the management of patients with supraventricular
arrhythmias—Executive summary: A report of the ACC/AHA/ESC Committee for
Practice Guidelines. Circulation, 108(15):
Calkins H (2011). Supraventricular tachycardia: Atrioventricular nodal reentry and Wolf-Parkinson-White syndrome. In V Fuster et al., eds., Hurst's the Heart, 13th ed., vol. 1, pp. 987–1005. New York: McGraw-Hill.
Epstein AE, et al. (2008). ACC/AHA/HRS 2008 Guidelines
for Device-Based Therapy of Cardiac Rhythm Abnormalities: A Report of the
American College of Cardiology/American Heart Association Task Force on
Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002
Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia
Devices): Developed in Collaboration With the American Association for Thoracic
Surgery and Society of Thoracic Surgeons. Circulation,
117(21): e350–e408. [Correction in Circulation, 120(5): e34–e35.]
Miller JM, Zipes DP (2012). Therapy for cardiac arrhythmias. In RO Bonow et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 1, pp. 710–744. Philadelphia: Saunders.
Olgin JE, Zipes DP (2012). Specific arrhythmias: Diagnosis and treatment. In RO Bonow et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 1, pp. 771–824. Philadelphia: Saunders.
August 9, 2012
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology & John M. Miller, MD, FACC - Cardiology, Electrophysiology
How this information was developed to help you make better health decisions.
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