Home > Blogs > Understanding Paroxysmal Supraventricular Tachycardia (PSVT)

Understanding Paroxysmal Supraventricular Tachycardia (PSVT)

Author:- Mr. Ritesh Sharma

You all must be familiar with the fact that there are four chambers of the human heart that form the core of the circulatory system. Now, in the upper chambers of the heart, sometimes, a short circuit rhythm begins to develop. When this happens, the person faces a condition called Paroxysmal Supraventricular Tachycardia. As is clear from the name, Paroxysmal Supraventricular Tachycardia, or PSVT is a type of cardiac arrhythmia. In this arrhythmia, the heart beats faster than the normal range, exceeding the parameter of 100 beats per minute.

This occurs due to the formation of a short circuit rhythm in the upper chambers of the heart, i.e. atria. Now, the study of paroxysmal supraventricular tachycardia or PSVT is extremely intricate and laced with enough elements to raise curiosity among healthcare professionals and general people alike. Let’s delve into all the specifics of Paroxysmal Supraventricular Tachycardia or PSVT and dig out some interesting and informative details.

What is Paroxysmal Supraventricular Tachycardia (PSVT)?

PSVT refers to a group of cardiac arrhythmias that cause the heart to beat faster than normal due to abnormal electrical impulses originating above the ventricles. The term “paroxysmal” indicates that the episodes come and go, with periods of normal rhythm in between. These episodes can last from a few seconds to several hours and may occur sporadically or frequently.

Causes and Risk Factors

PSVT can result from various underlying causes or conditions. Some common types include:

Atrioventricular Nodal Reentry Tachycardia (AVNRT): This is the most common type of PSVT, where a reentrant circuit forms within the AV node, leading to rapid heartbeats.
Atrioventricular Reentry Tachycardia (AVRT): This type involves a reentrant circuit that includes the AV node and an extra pathway between the atria and ventricles, known as an accessory pathway. The extra pathway can be congenital and is often seen in conditions like Wolff-Parkinson-White (WPW) syndrome.
Atrial Tachycardia (AT): This type arises from ectopic foci within the atria, causing abnormal electrical activity and rapid heart rate.

Several factors can increase the likelihood of experiencing PSVT, including:

Structural Heart Disease: Abnormalities or damage to the heart’s structure can predispose individuals to PSVT.
Congenital Heart Conditions: Some people are born with structural abnormalities that make them more prone to PSVT.
Stimulants: Excessive caffeine, alcohol, or stimulant use can trigger episodes.
Stress and Anxiety: Emotional stress and anxiety can contribute to the onset of PSVT.
Electrolyte Imbalances: Abnormal levels of potassium, sodium, or calcium in the blood can affect heart rhythm.

Symptoms of PSVT

The symptoms of PSVT can vary in intensity and may include:

Rapid Heartbeat: A noticeable and often alarming rapid heart rate, sometimes exceeding 150-200 beats per minute.
Heart Palpitations: A feeling of the heart racing or pounding in the chest.
Dizziness or Lightheadedness: The rapid heartbeat can lead to decreased blood flow, causing dizziness or a sensation of lightheadedness.
Shortness of Breath: Difficulty breathing or feeling short of breath during an episode.
Chest Pain or Discomfort: Some individuals may experience chest pain or discomfort, though this is less common.

It’s important to note that not everyone with PSVT experiences symptoms. Some individuals may have the condition without ever realizing it, particularly if the episodes are brief and self-limiting.

Diagnosing PSVT

Diagnosing PSVT typically involves a combination of clinical evaluation and diagnostic tests. The following steps are commonly used:

Medical History and Physical Examination: The healthcare provider will review the patient’s medical history, including any episodes of rapid heartbeat, and perform a physical examination.
Electrocardiogram (ECG): An ECG records the electrical activity of the heart and can help identify abnormal rhythms and patterns indicative of PSVT.
Holter Monitor: This portable ECG device is worn for 24-48 hours to capture any episodes of PSVT that might not occur during a standard ECG.
Event Monitor: Similar to a Holter monitor but worn for a longer period, an event monitor allows patients to record their heart rhythm when they experience symptoms.
Electrophysiological Study (EPS): This invasive test involves threading catheters through the blood vessels to the heart to map electrical activity and identify the source of abnormal impulses.

Treatment Options

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

Vagal Maneuvers: Simple techniques, such as holding one’s breath and bearing down (Valsalva maneuver), can sometimes help stop an episode of PSVT by stimulating the vagus nerve and slowing the heart rate.
Medications: Antiarrhythmic medications may be prescribed to control or prevent episodes of PSVT. These medications can include beta-blockers, calcium channel blockers, or other drugs specifically targeting the arrhythmia.
Cardioversion: For persistent or severe episodes, electrical cardioversion may be performed. This procedure involves delivering a controlled electric shock to the heart to restore normal rhythm.
Catheter Ablation: In cases where medication and other treatments are ineffective, catheter ablation may be recommended. This procedure involves using radiofrequency energy to destroy the abnormal electrical pathways causing the arrhythmia.
Lifestyle Modifications: Reducing the intake of stimulants, managing stress, and maintaining a healthy lifestyle can help minimize the frequency and severity of PSVT episodes.

Living with PSVT

For many individuals, PSVT is a manageable condition with appropriate treatment and lifestyle adjustments. Regular follow-up with a healthcare provider is essential to monitor the condition and adjust treatment as needed. Patients should also be educated about recognizing symptoms and when to seek medical attention.

Paroxysmal Supraventricular Tachycardia (PSVT) is a common arrhythmia that can significantly impact an individual’s quality of life if not properly managed. Understanding the nature of PSVT, its causes, symptoms, and treatment options is crucial for effective management and improved outcomes. With advances in medical technology and treatment options, individuals with PSVT can lead normal, active lives while effectively managing their condition. Regular medical evaluations and a proactive approach to treatment and lifestyle modifications are key to managing PSVT successfully.