Supraventricular tachycardia is another type of “short-circuit” arrhythmia. It may result either from atrio-ventricular nodal re-entrant tachycardia (AVNRT) or from an accessory pathway, which may occur as part of the Wolff-Parkinson-White (WPW) syndrome.
In AVNRT, a small extra pathway exists in or near the AV node. If an electrical impulse enters this pathway, it may start traveling in a circular pattern that causes the heart to abruptly start beating fast and regular.
PSVT may occur at any age and commonly occurs in patients who have no other types of heart disease. Patients with PSVT typically describe a rapid, or racing, regular heartbeat (between 130 and 230 beats per minute) that starts and stops abruptly. It is commonly misdiagnosed as a panic attack.
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With the exception of some patients with the
Wolff-Parkinson-White syndrome, PSVT generally is not a dangerous arrhythmia.
However, it can result in debilitating symptoms.
Treatment options include a variety of drugs or catheter ablation, which cures the problem in most patients. The severity of symptoms in patients with PSVT depends on any underlying structural heart disease, the frequency of PSVT episodes, and the patient's hemodynamic reserve.
Usually, patients with
PSVT present with symptoms of dizziness, syncope, nausea, shortness of breath,
intermittent palpitations, pain or discomfort in the neck, pain or discomfort
in the chest, anxiety, fatigue, diaphoresis, and polyuria secondary atrial natriuretic
factor secreted mainly by the heart's atria in response to atrial stretch. The
most common symptoms are dizziness and palpitations.
Paroxysmal supraventricular tachycardia (PSVT) accounts for
intermittent episodes of supraventricular tachycardia with sudden onset and
termination. PSVT is part of the narrow QRS complex tachycardias with a regular
ventricular response in contrast to multifocal atrial tachycardia, atrial
fibrillation, and atrial flutter. SVTs are classified based on the origin of
the rhythm and whether the rhythm is regular or irregular.
PSVT is often due to different reentry circuits in the heart, where less frequent causes include enhanced or abnormal automaticity and triggered activity. Re-entry circuits include a pathway within and around the sinus node, within the atrial myocardium, within the atrioventricular node or an accessory pathway involving the atrioventricular node.
Different types of
PSVT result depending on the existing circuits, and examples are:
·
Sinus node: Sinoatrial node re-entrant
tachycardia
·
Atrial myocardium: Atrial flutter, atrial
fibrillation, and multifocal atrial tachycardia
·
Atrioventricular node: Atrioventricular nodal
re-entrant tachycardia, atrioventricular re-entrant tachycardia
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