What is Paroxysmal Supraventricular Tachycardia (PSVT)?

Paroxysmal Supraventricular Tachycardia (PSVT) is a type of arrhythmia, or abnormal heartbeat, characterized by sudden and rapid heartbeats originating from the upper chambers of the heart (atria). These episodes can start and stop abruptly, often without warning, and may last from a few seconds to several hours. PSVT typically results from abnormal electrical pathways or circuits within the heart, leading to a rapid heart rate that can range from 150 to 220 beats per minute or higher.

What Causes PSVT?

PSVT can develop due to various underlying conditions and factors, including:

• Atrioventricular Nodal Re-entrant Tachycardia (AVNRT): The most common type of PSVT, occurring when an extra pathway exists in or near the AV node, causing rapid heartbeats.
• Wolff-Parkinson-White Syndrome (WPW): A congenital condition where an additional electrical pathway between the atria and ventricles leads to episodes of rapid heart rate.
• Atrial Tachycardia: Occurs when an abnormal electrical focus in the atria causes rapid heartbeats.
• Other Contributing Factors:
  • Excessive alcohol consumption
  • Caffeine intake
  • Smoking
  • Stress or anxiety
  • Fatigue
  • Electrolyte imbalances
  • Use of certain medications
  • Underlying heart conditions

What Are the Symptoms of PSVT?

Symptoms of PSVT can vary in intensity and may include:

• Sudden onset of a rapid, regular heartbeat
• Palpitations (feeling of fluttering or pounding in the chest)
• Dizziness or lightheadedness
• Shortness of breath
• Chest discomfort or tightness
• Fatigue
• Fainting (syncope)

How is PSVT Diagnosed?

To diagnose PSVT, healthcare providers may employ several methods:

• Electrocardiogram (ECG or EKG): Records the electrical activity of the heart to identify abnormal rhythms.
• Holter Monitor: A portable ECG device worn for 24 to 48 hours to detect intermittent arrhythmias.
• Event Monitor: Similar to a Holter monitor but used for longer periods, activated by the patient during symptoms.
• Electrophysiological Study: A procedure where catheters are inserted into the heart to map electrical pathways and identify the source of arrhythmias.

What Are the Treatment Options for PSVT?

Treatment for PSVT depends on the frequency and severity of episodes, as well as the underlying cause:

• Vagal Maneuvers: Techniques such as coughing, bearing down, or splashing cold water on the face can stimulate the vagus nerve and may help slow the heart rate.
• Medications:
  • Adenosine: Administered intravenously to rapidly slow the heart rate.
  • Beta-blockers or calcium channel blockers: Used to prevent episodes.
  • Antiarrhythmic drugs: Prescribed for frequent or persistent episodes.
• Catheter Ablation: A minimally invasive procedure where abnormal electrical pathways are destroyed using radiofrequency energy.

What Are the Potential Complications of Untreated PSVT?

If left untreated, PSVT can lead to:

• Pulmonary Hypertension: High blood pressure in the lungs.
• Heart Failure: Due to overworking of the heart.
• Endocarditis: Infection of the heart’s inner lining.

What is the Prognosis for Individuals with PSVT?

With appropriate treatment, most individuals with PSVT can lead normal, active lives. The condition is generally not life-threatening, but it can cause significant discomfort and anxiety. Lifestyle modifications, such as managing stress, avoiding known triggers, and adhering to prescribed treatments, can help manage the condition effectively.