BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuParoxysmal supraventricular tachycardia (PSVT)PSVT; Supraventricular tachycardia; Abnormal heart rhythm - PSVT; Arrhythmia - PSVT; Rapid heart rate - PSVT; Fast heart rate - PSVTParoxysmal supraventricular tachycardia (PSVT) is episodes of a rapid heart rate that start in a part of the heart above the ventricles. "Paroxysmal" means from time to time. Rapid heart rateA bounding pulse is a strong throbbing felt over one of the arteries in the body. It is due to a forceful heartbeat.ImageRead Article Now Book Mark Article Causes Related video goes here for no-HTML5 browsersNormally, the chambers of the heart (atria and ventricles) contract in a coordinated manner. The contractions are caused by an electrical signal that begins in an area of the heart called the sinoatrial node (also called the sinus node or SA node). The signal moves through the upper heart chambers (the atria) and tells the atria to contract. After this, the signal moves down in the heart and tells the lower chambers (the ventricles) to contract. Previous imagePlay SlideshowStop SlideshowNext image / The rapid heart rate from PSVT may start with events that occur in areas of the heart above the lower chambers (ventricles). There are a number of specific causes of PSVT. It can develop when doses of the heart medicine, digitalis, are too high. It can also occur with a condition known as Wolff-Parkinson-White syndrome, which often causes symptoms in young people and infants.Wolff-Parkinson-White syndromeWolff-Parkinson-White (WPW) syndrome is a condition in which there is an extra electrical pathway in the heart that leads to periods of rapid heart r...ImageRead Article Now Book Mark Article The following increase your risk for PSVT:Alcohol use Alcohol useAlcohol use involves drinking beer, wine, or hard liquor.Read Article Now Book Mark Article Caffeine use CaffeineCaffeine is a substance that is found in certain plants. It can also be man-made and added to foods. It is a central nervous system stimulant and a...Read Article Now Book Mark Article Illicit stimulant 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 AnxietyStress is a feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stres...ImageRead Article Now Book Mark Article Chest tightness Palpitations (a sensation of feeling the heartbeat), often with an irregular or fast rate (racing) PalpitationsPalpitations are feelings or sensations that your heart is pounding or racing. They can be felt in your chest, throat, or neck. You may:Have an unpl...ImageRead Article Now Book Mark Article Rapid pulse Rapid pulseA bounding pulse is a strong throbbing felt over one of the arteries in the body. It is due to a forceful heartbeat.ImageRead Article Now Book Mark Article Shortness of breathShortness of breathBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article Other symptoms that can occur with this condition include:Dizziness DizzinessDizziness is a term that is often used to describe 2 different symptoms: lightheadedness and vertigo. Lightheadedness is a feeling that you might fai...ImageRead Article Now Book Mark Article FaintingFaintingFainting is a brief loss of consciousness due to a drop in blood flow to the brain. The episode most often lasts less than a couple of minutes and y...Read Article Now Book Mark Article Exams and Tests A physical exam during a PSVT episode will show a rapid heart rate. It may also show forceful pulses in the neck.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).Heart rateThe pulse is the number of heartbeats per minute.ImageRead Article Now Book Mark Article An electrocardiogram (ECG) during symptoms shows PSVT. An electrophysiology study (EPS) may be needed for an accurate diagnosis and to find the best treatment.ElectrocardiogramAn electrocardiogram (ECG) is a test that records the electrical activity of the heart.ImageRead Article Now Book Mark Article Electrophysiology studyIntracardiac electrophysiology study (EPS) is a test to look at how well the heart's electrical signals are working. It is used to evaluate abnormal...ImageRead Article Now Book Mark Article Because PSVT comes and goes, to diagnose it people may need to wear a 24-hour Holter monitor. For longer periods of time, another type of the rhythm recording device may be used.Holter monitorA Holter monitor is a machine that continuously records the heart's rhythms. The monitor is worn for 24 to 48 hours during normal activity.ImageRead Article Now Book Mark Article Previous imagePlay SlideshowStop SlideshowNext image / Treatment PSVT that occurs only once in a while may not need treatment if you don't have symptoms or other heart problems.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.Emergency treatment to slow the heartbeat back to normal may include:Electrical cardioversion, the use of electric shock CardioversionCardioversion is a method to bring an abnormal heart rhythm back to normal.ImageRead Article Now Book Mark Article Medicines through a vein Long-term treatment for people who have repeat episodes of PSVT, or who also have heart disease, may include:Cardiac ablation, a procedure used to destroy small areas in your heart that may be causing the rapid heartbeat (currently the treatment of choice for most PSVTs) Cardiac ablationCardiac ablation is a procedure that is used to scar small areas in your heart that may be involved in your heart rhythm problems. This can prevent ...Read Article Now Book Mark Article Daily medicines to prevent repeat episodes Pacemakers to override the fast heartbeat (on occasion may be used in children with PSVT who have not responded to any other treatment) PacemakersA pacemaker is a small, battery-operated device. This device senses when your heart is beating too slowly. It sends a signal to your heart that mak...ImageRead Article Now Book Mark Article Surgery to change the pathways in the heart that send electrical signals (this may be recommended in some cases for people who need heart surgery for other reasons) Outlook (Prognosis) PSVT is generally not life threatening. If other heart disorders are present, it can lead to congestive heart failure or angina.Congestive heart failureHeart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...ImageRead Article Now Book Mark Article When to Contact a Medical Professional Contact your health care provider if: You have a sensation that your heart is beating quickly and the symptoms do not end on their own in a few minutes. You have a history of PSVT and an episode does not go away with the Valsalva maneuver or by coughing. You have other symptoms with the rapid heart rate. Symptoms return often. New symptoms develop.It is especially important to contact your provider if you also have other heart problems. Open ReferencesReferencesDalal AS, Van Hare GF. Disturbances of rate and rhythm of the heart. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 462.Kalman JM, Sanders P. Supraventricular tachycardias. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 65.Page RL, Joglar JA, Caldwell MA, et al. 2015 ACC/AHA/ HRS guideline for the management of adult patients with supraventricular tachycardia: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2016;133(14);e471-e505. PMID: 26399662 pubmed.ncbi.nlm.nih.gov/26399662/.Zimetbaum P, Goldman L. Supraventricular ectopy and tachyarrhythmias. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 52.AllVideoImagesTogWhat makes your heart beat?Animation Related video goes here for no-HTML5 browsersWhat makes your heart beat? - Animation Let’s take a closer look inside the heart. The yellow objects are not nerves. They’re actually specialized cardiac muscle cells in the walls of the heart. Their job is to send signals to the rest of the heart muscle and cause a contraction. Together, this group of cells is called the Cardiac conduction system. The main components of the Cardiac conduction system are the SA node, AV node, Bundle of His, Bundle branches, and Purkinje fibers. Let’s follow a signal through the contraction process. The SA node starts the sequence by causing the atrial muscles to contract. That’s why doctors sometimes call it the anatomical pacemaker. From there, the signal travels to the AV node, through the Bundle of His, down the Bundle branches, and through the Purkinje fibers, causing the ventricles to contract. This signal creates an electrical current that can be seen on a graph called an Electrocardiogram, or EKG. Doctors us an EKG as a way of seeing how well the Cardiac conduction system works. Any changes to the EKG can mean serious problems.Conduction system of the heart - illustration The intrinsic conduction system sets the basic rhythm of the beating heart by generating impulses which stimulate the heart to contract.Conduction system of the heartillustrationHolter heart monitor - illustration During a heart Holter monitor study, the patient wears a monitor that records electrical activity of their heart (similarly to the recording of an electrocardiogram). This usually occurs for 24 hours, while at the same time the patient also records a diary of their activity. Health care providers then analyze the recording, tabulate a report of the heart's activity, and correlate irregular heart activity with the entries of the patient's diary.Holter heart monitorillustrationWhat makes your heart beat?Animation Related video goes here for no-HTML5 browsersWhat makes your heart beat? - Animation Let’s take a closer look inside the heart. The yellow objects are not nerves. They’re actually specialized cardiac muscle cells in the walls of the heart. Their job is to send signals to the rest of the heart muscle and cause a contraction. Together, this group of cells is called the Cardiac conduction system. The main components of the Cardiac conduction system are the SA node, AV node, Bundle of His, Bundle branches, and Purkinje fibers. Let’s follow a signal through the contraction process. The SA node starts the sequence by causing the atrial muscles to contract. That’s why doctors sometimes call it the anatomical pacemaker. From there, the signal travels to the AV node, through the Bundle of His, down the Bundle branches, and through the Purkinje fibers, causing the ventricles to contract. This signal creates an electrical current that can be seen on a graph called an Electrocardiogram, or EKG. Doctors us an EKG as a way of seeing how well the Cardiac conduction system works. Any changes to the EKG can mean serious problems.Conduction system of the heart - illustration The intrinsic conduction system sets the basic rhythm of the beating heart by generating impulses which stimulate the heart to contract.Conduction system of the heartillustrationHolter heart monitor - illustration During a heart Holter monitor study, the patient wears a monitor that records electrical activity of their heart (similarly to the recording of an electrocardiogram). This usually occurs for 24 hours, while at the same time the patient also records a diary of their activity. Health care providers then analyze the recording, tabulate a report of the heart's activity, and correlate irregular heart activity with the entries of the patient's diary.Holter heart monitorillustration Tests for Paroxysmal supraventricular tachycardia (PSVT) Holter monitor (24h)Related Information Pulse - bounding(Symptoms)Caffeine in the diet(Nutrition)Alcohol use and safe drinking(Special Topic)Digitalis toxicity(Condition)Wolff-Parkinson-White syndrome (WPW)(Condition)Heart failure(Condition)Heart failure - InDepth(In-Depth) Review Date: 2/27/2024 Reviewed By: Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
Paroxysmal supraventricular tachycardia (PSVT)PSVT; Supraventricular tachycardia; Abnormal heart rhythm - PSVT; Arrhythmia - PSVT; Rapid heart rate - PSVT; Fast heart rate - PSVTParoxysmal supraventricular tachycardia (PSVT) is episodes of a rapid heart rate that start in a part of the heart above the ventricles. "Paroxysmal" means from time to time. Rapid heart rateA bounding pulse is a strong throbbing felt over one of the arteries in the body. It is due to a forceful heartbeat.ImageRead Article Now Book Mark Article Causes Related video goes here for no-HTML5 browsersNormally, the chambers of the heart (atria and ventricles) contract in a coordinated manner. The contractions are caused by an electrical signal that begins in an area of the heart called the sinoatrial node (also called the sinus node or SA node). The signal moves through the upper heart chambers (the atria) and tells the atria to contract. After this, the signal moves down in the heart and tells the lower chambers (the ventricles) to contract. Previous imagePlay SlideshowStop SlideshowNext image / The rapid heart rate from PSVT may start with events that occur in areas of the heart above the lower chambers (ventricles). There are a number of specific causes of PSVT. It can develop when doses of the heart medicine, digitalis, are too high. It can also occur with a condition known as Wolff-Parkinson-White syndrome, which often causes symptoms in young people and infants.Wolff-Parkinson-White syndromeWolff-Parkinson-White (WPW) syndrome is a condition in which there is an extra electrical pathway in the heart that leads to periods of rapid heart r...ImageRead Article Now Book Mark Article The following increase your risk for PSVT:Alcohol use Alcohol useAlcohol use involves drinking beer, wine, or hard liquor.Read Article Now Book Mark Article Caffeine use CaffeineCaffeine is a substance that is found in certain plants. It can also be man-made and added to foods. It is a central nervous system stimulant and a...Read Article Now Book Mark Article Illicit stimulant 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 AnxietyStress is a feeling of emotional or physical tension. It can come from any event or thought that makes you feel frustrated, angry, or nervous. Stres...ImageRead Article Now Book Mark Article Chest tightness Palpitations (a sensation of feeling the heartbeat), often with an irregular or fast rate (racing) PalpitationsPalpitations are feelings or sensations that your heart is pounding or racing. They can be felt in your chest, throat, or neck. You may:Have an unpl...ImageRead Article Now Book Mark Article Rapid pulse Rapid pulseA bounding pulse is a strong throbbing felt over one of the arteries in the body. It is due to a forceful heartbeat.ImageRead Article Now Book Mark Article Shortness of breathShortness of breathBreathing difficulty may involve:Difficult breathing Uncomfortable breathingFeeling like you are not getting enough airImageRead Article Now Book Mark Article Other symptoms that can occur with this condition include:Dizziness DizzinessDizziness is a term that is often used to describe 2 different symptoms: lightheadedness and vertigo. Lightheadedness is a feeling that you might fai...ImageRead Article Now Book Mark Article FaintingFaintingFainting is a brief loss of consciousness due to a drop in blood flow to the brain. The episode most often lasts less than a couple of minutes and y...Read Article Now Book Mark Article Exams and Tests A physical exam during a PSVT episode will show a rapid heart rate. It may also show forceful pulses in the neck.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).Heart rateThe pulse is the number of heartbeats per minute.ImageRead Article Now Book Mark Article An electrocardiogram (ECG) during symptoms shows PSVT. An electrophysiology study (EPS) may be needed for an accurate diagnosis and to find the best treatment.ElectrocardiogramAn electrocardiogram (ECG) is a test that records the electrical activity of the heart.ImageRead Article Now Book Mark Article Electrophysiology studyIntracardiac electrophysiology study (EPS) is a test to look at how well the heart's electrical signals are working. It is used to evaluate abnormal...ImageRead Article Now Book Mark Article Because PSVT comes and goes, to diagnose it people may need to wear a 24-hour Holter monitor. For longer periods of time, another type of the rhythm recording device may be used.Holter monitorA Holter monitor is a machine that continuously records the heart's rhythms. The monitor is worn for 24 to 48 hours during normal activity.ImageRead Article Now Book Mark Article Previous imagePlay SlideshowStop SlideshowNext image / Treatment PSVT that occurs only once in a while may not need treatment if you don't have symptoms or other heart problems.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.Emergency treatment to slow the heartbeat back to normal may include:Electrical cardioversion, the use of electric shock CardioversionCardioversion is a method to bring an abnormal heart rhythm back to normal.ImageRead Article Now Book Mark Article Medicines through a vein Long-term treatment for people who have repeat episodes of PSVT, or who also have heart disease, may include:Cardiac ablation, a procedure used to destroy small areas in your heart that may be causing the rapid heartbeat (currently the treatment of choice for most PSVTs) Cardiac ablationCardiac ablation is a procedure that is used to scar small areas in your heart that may be involved in your heart rhythm problems. This can prevent ...Read Article Now Book Mark Article Daily medicines to prevent repeat episodes Pacemakers to override the fast heartbeat (on occasion may be used in children with PSVT who have not responded to any other treatment) PacemakersA pacemaker is a small, battery-operated device. This device senses when your heart is beating too slowly. It sends a signal to your heart that mak...ImageRead Article Now Book Mark Article Surgery to change the pathways in the heart that send electrical signals (this may be recommended in some cases for people who need heart surgery for other reasons) Outlook (Prognosis) PSVT is generally not life threatening. If other heart disorders are present, it can lead to congestive heart failure or angina.Congestive heart failureHeart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...ImageRead Article Now Book Mark Article When to Contact a Medical Professional Contact your health care provider if: You have a sensation that your heart is beating quickly and the symptoms do not end on their own in a few minutes. You have a history of PSVT and an episode does not go away with the Valsalva maneuver or by coughing. You have other symptoms with the rapid heart rate. Symptoms return often. New symptoms develop.It is especially important to contact your provider if you also have other heart problems. Open ReferencesReferencesDalal AS, Van Hare GF. Disturbances of rate and rhythm of the heart. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 462.Kalman JM, Sanders P. Supraventricular tachycardias. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 65.Page RL, Joglar JA, Caldwell MA, et al. 2015 ACC/AHA/ HRS guideline for the management of adult patients with supraventricular tachycardia: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2016;133(14);e471-e505. PMID: 26399662 pubmed.ncbi.nlm.nih.gov/26399662/.Zimetbaum P, Goldman L. Supraventricular ectopy and tachyarrhythmias. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 52.