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Paroxysmal supraventricular tachycardia (PSVT)Definition Paroxysmal supraventricular tachycardia (PSVT) is a rapid heart rate, which occurs from time to time (paroxysmal). PSVT starts with events taking place above the ventricles. Causes, incidence, and risk factors Normally, the chambers of the heart (atria and ventricles) contract in a coordinated manner. The contractions are caused by an electrical signal that begins in the sinoatrial node (also called the sinus node or SA node). The signal is conducted through the atria (the upper heart chambers) and stimulates the atria to contract. The electrical signal then passes through the atrioventricular node (AV node), and travels through the ventricles (the larger, lower chambers), stimulating them to contract. Paroxysmal supraventricular tachycardia (PSVT) can be initiated in the SA node; in the atria or the atrial conduction pathways; or in the AV node. It occurs most often in young people and infants. Risks include excessive smoking, caffeine, and alcohol use. PSVT can occur with digitalis toxicity. It can be a form of a re-entry tachycardia (an electrical current is caught in a reentrant loop, excessively stimulating the heart), as in the case of Wolff-Parkinson-White syndrome. Symptoms
Note: Symptoms may start and stop suddenly, and can last for a few minutes or several hours. A PSVT lasting more than 50% of the day is considered an incessant PSVT. Signs and tests An examination during a PSVT epsiode detects a regular, rapid heart rate. The heart rate may be 150 to 250 beats per minute (bpm) (in children the heart rate tends to be very high). There may be signs of poor perfusion (blood circulation) such as light-headedness. Between episodes of PSVT, the heart rate is normal (60 to 100 bpm).
Treatment PSVT can occur with few or no symptoms, and may not require treatment. If symptoms occur or there are underlying cardiac disorders, treatment may be necessary. People having an episode of PSVT can try to interrupt the episode with a Valsalva maneuver. This consists of holding the breath and straining (pushing with the abdomen as if to provoke a bowel movement) or coughing while sitting with the upper body bent forward. Splashing ice water on the face has been reported by some people as helpful. Persons having an episode of PSVT may be offered therapy to interrupt the arrhythmia and convert it to a normal sinus rhythm. In the emergency room, a health care provider may massage the carotid arteries in the neck in an attempt to interrupt the arrhythmia. Caution -- do not try this at home! This technique can cause severe slowing of the heart rate. Electrical cardioversion (shock) is successful in conversion of PSVT to a normal sinus rhythm in many cases. Another way to rapidly convert a PSVT is to administer intravenous medications, including adenosine and verapamil. Other medications may be used, such as esmolol, procainamide, beta-blockers, and propafenone. Aside from treating isolated episodes of PSVT, some patients may require a long-term or definitive treatment of the PVST which is directed toward the prevention or complete eradication of further episodes or arrhythmia. Such long-term treatment includes:
Expectations (prognosis) PSVT is generally not life-threatening, unless other cardiac disorders are present. Complications
Calling your health care provider Call your health care provider if:
Prevention Avoid excessive smoking, caffeine, and alcohol use. Medications used to treat the disorder may be given as a preventive (prophylactic) treatment in people at a high risk or who have had previous episodes of PSVT. Page Content: PSVT; Supraventricular tachycardia ; supraventricular tachycardia; paroxysmal supraventricular tachycardia; supraventricular tachycardia svt; supraventricular tachycardia treatment; cause of supraventricular tachycardia; psvt |
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