Paroxysmal atrial tachycardia

It is a disorder characterized by a dysrhythmia with a heart rate greater than 100 beats per minute that originates above the ventricles.

Atrial tachycardia

Other names

Supraventricular tachycardia or SVT.

Paroxysmal

The term paroxysmal refers to the episodic nature of these events.

Causes

SVT can develop when doses medications such as digitalis is too high in a condition called digitoxicity Other conditions include Wolff-Parkinson-White syndrome, which is most often seen in young people and infants.

The recording shows the initiation of supraventricular tachycardia.

Risk factors

• Alcohol use
• Caffeine use
• Illicit drug use
• Smoking

Symptoms

Symptoms most often start and stop suddenly. They can last for a few minutes or several hours.

Symptoms may include:

• Anxiety
• Chest tightness
• Palpitations
• Rapid pulse
• Shortness of breath

Other symptoms

• Dizziness
• Fainting

The first EKG shows an atrial tachycardia at about 240/min.

Diagnosis

The heart rate may be over 100, and even more than 250 beats per minute (bpm). In children, the heart rate tends to be very high. There may be signs of poor blood circulation such as lightheadedness. Between episodes of PSVT, the heart rate is normal (60 to 100 bpm).

• An ECG during symptoms shows PSVT.
• An electrophysiology study (EPS) may be needed
• Because PSVT comes and goes, to diagnose it people may need to wear a 24-hour Holter monitor.

Treatment

PSVT that occurs only once in a while may not need treatment.

You can try the following techniques to interrupt a fast heartbeat during an episode of PSVT:

Valsalva maneuver. To do this, you hold your breath and strain, as if you were trying to have a bowel movement. Coughing while sitting with your upper body bent forward. Splashing ice water on your face You should avoid smoking, caffeine, alcohol, and illicit drugs.

Treatment options include: Electrical cardioversion

Long-term treatments include:

• Cardiac ablation
• Cardiac medications such as beta blockers, calcium channel blockers, antiarrhythmic medications of which there are many different classes such as class IA, IC, or class III antiarrhythmics
• Pacemakers to override the fast heartbeat
• Rarely, CT surgery

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