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Supraventricular tachycardia (SVT)

Supraventricular tachycardia (SVT) is when your heart beats too fast. It’s caused by faulty electrical signals in your heart and often affects young, healthy people. SVT is a type of arrhythmia, which means an abnormal heartbeat.

Tachycardia means a rapid heart rate of more than 100 beats per minute. Supraventricular means the problem starts in the upper part of your heart, above your ventricles (the lower chambers of your heart). If you have SVT, your heart may beat at a rate of about 140 to 250 beats per minute.

SVT episodes usually don't last long and go away on their own without any treatment. They often happen in young, healthy people. You will usually get fewer episodes of SVT as you get older, but you may find that the symptoms get worse. How long an episode lasts can vary from a few seconds or minutes, to several hours.

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Different types of heart arrhythmia
Arrhythmia is a disturbance of the normal electrical rhythm of the heart
An image showing the electrical impulses in a normal heart, a heart with atrioventricular nodal re-entrant tachycardia (AVNRT) and a heart with atrioventricular re-entrant tachycardia (AVRT)

Details

  • What happens What happens during supraventricular tachycardia?

    Your heartbeat is controlled by electrical signals (impulses) that travel through your heart and make it contract. These impulses start in a part of the wall of your heart, called the sinus node. They then travel from the atria (your heart's upper chambers) to the ventricles (the lower chambers) through an area called the atrioventricular (AV) node. The AV node helps to synchronise the pumping action of your atria and ventricles.

    Supraventricular tachycardia (SVT) usually happens when there is an extra electrical pathway in your heart between your atria and your ventricles. This allows electrical signals to 'short-circuit' and re-enter your atria. The signals end up travelling around your heart in a circle. These types of SVT are referred to as re-entrant tachycardias or paroxysmal SVT. The symptoms come on suddenly and are temporary.

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  • Types Types of supraventricular tachycardia

    There are three main types of supraventricular tachycardia (SVT).

    • If the extra pathway is in your AV node, it’s called atrioventricular nodal re-entrant tachycardia (AVNRT). This is the most common type of SVT.
    • If the extra pathway connects your atria and ventricles separately from the AV node, it’s called atrioventricular re-entrant tachycardia (AVRT).
    • If the SVT originates in the tissue in your atria (in an area other than your sinus node), it’s called atrial tachycardia.
  • Symptoms Symptoms of supraventricular tachycardia

    Supraventricular tachycardia (SVT) doesn't always cause symptoms but you’re more likely to have symptoms if you already have heart disease.

    Symptoms you may get during an episode of SVT include:

    • being aware of your heart suddenly beating faster (heart palpitations)
    • feeling dizzy
    • feeling short of breath
    • chest pain
    • fainting 
    These symptoms may be caused by problems other than SVT. If you have any of these symptoms, see your GP for advice.

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  • Diagnosis Diagnosis of supraventricular tachycardia

    Your GP will ask about your symptoms and examine you. He or she will check your blood pressure, listen to your heartbeat and take your pulse. Your GP will also ask about your medical history.

    You may need to have a test called an electrocardiogram (ECG). An ECG records the electrical activity in your heart to see how well it's working. 

    If your GP suspects that you have supraventricular tachycardia (SVT), you may have some of the following tests to confirm it.

    • Blood tests. These will check for substances that may be causing SVT or other conditions that may be causing your symptoms.
    • Ambulatory ECG. This is a portable ECG that takes a recording of your heartbeat while you go about your usual daily activities, over 24 hours or longer.
    • Electrophysiological study. In this test, a thin, flexible wire (catheter) is passed through a vein in your groin or arm to your heart. The wire records your heart's electrical activity. Your doctor can use the wire to electrically stimulate your heart and trigger SVT.
    • Implantable loop recorder. This device is placed under your skin and takes a recording of your heartbeat over a much longer period.
    • Echocardiogram. This test uses ultrasound to provide a clear image of your heart muscles and valves and can show how well your heart is working. 
    Your GP can do some of these tests such as the blood tests and ambulatory ECG, but you will need to have some of the other tests in hospital. Your GP may refer you to a cardiologist for this. A cardiologist is a doctor who specialises in conditions that affect the heart.
  • Treatment Treatment of supraventricular tachycardia

    There are lots of treatments available for supraventricular tachycardia (SVT). The treatment you have will depend on your symptoms – your doctor will discuss your treatment for options with you.

    The aim of treatment is to control your heart rhythm and rate. You may not need any treatment at all, especially if your symptoms are mild and don’t happen very often.

    Self-help 

    Your doctor will give you some advice on things you can do to stop an episode, which may include one of the options below.

    • Valsalva manoeuvre. This involves breathing in and then straining out (as if going to the toilet) while holding your breath. Make sure you lie down when you do this. 
    • Fully immerse your face in ice-cold water or suck on ice cubes. 
    Your doctor may suggest you improve your heart health by:
    • drinking less alcohol and caffeine
    • not taking any illegal drugs, such as cocaine or ecstasy
    • stopping smoking (if you smoke)
    • doing 150 minutes (two and a half hours) of moderate exercise a week in bouts of 10 minutes or more 

    Physical therapies 

    If your doctor applies pressure to an artery in your neck, it may help to stop your heart beating rapidly. However, it can be dangerous to do on some people and your doctor will need to check whether you're suitable for this technique. 

    Emergency treatments 

    Treatments for SVT in an emergency include medicines (see below) and electrical (DC) cardioversion. This uses an electric shock to restore your rapid heartbeat back to normal. 

    Medicines 

    If your symptoms come on suddenly, your doctor may give you antiarrhythmic medicines, either as tablets or through a drip into your bloodstream. These are intended to get your heart rhythm back to normal. There are several different types of medicine that can help control your heart rate and rhythm. These include beta-blockers, calcium-channel blockers and antiarrhythmic medicines. You can also take them to prevent further SVT episodes. 

    Always read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist or doctor for advice. 

    Hospital treatment 

    In a procedure called catheter ablation, your doctor will pass a small tube called an electrode catheter into the vein in your groin. He or she will thread it up to your heart and will burn or freeze any tissue that's disrupting or causing abnormal electrical signals. This will destroy the tissue.

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  • Causes Causes of supraventricular tachycardia

    The cause of supraventricular tachycardia (SVT) isn't fully understood at present. However, certain things may lead to SVT developing, including:

    • taking certain medicines
    • emotional or physical stress
    • hormonal changes
    • alcohol
    • caffeine
    • smoking
    • taking illegal drugs, such as cocaine or ecstasy
    • problems with your heart that you may have since birth (congenital heart disease)
  • Complications Complications of supraventricular tachycardia

    Complications of supraventricular tachycardia (SVT) might happen because your heart rate isn't normal. As such, your heart may not be able to pump blood effectively around your body. This can result in low blood pressure, which may cause fainting. Low blood pressure may also result in less blood flowing to your heart. This can damage your heart muscle and cause your heart to pump less effectively, which may result in heart failure or a heart attack. Complications are rare. They may be more likely if you have other problems with your heart.

    You also have a small risk of sudden death, but usually only if you have a particular type of SVT called Wolff–Parkinson–White syndrome. See our FAQs for further information.

  • FAQs FAQs

    How long does it take to recover from catheter ablation for supraventricular tachycardia? 

    Answer

    Most people recover quickly from catheter ablation, usually within a day or two after having the procedure. 

    Explanation

    Catheter ablation is a minimally invasive procedure, which means your doctor will make only a small puncture in your groin. You will be given local anaesthesia and sedation. The anaesthetic will completely block pain from your groin area and the sedative will help you to feel relaxed. You should be able to go home on the same day as the procedure or the day after. 

    You may feel aware of your heartbeat after having catheter ablation but this should go away within a few weeks. You will usually need to take it easy for a few days after having catheter ablation. Don't drive for two days after the procedure or lift anything heavy for at least two weeks. 

    You may need to have more than one procedure to successfully treat your symptoms.

    What is sinus tachycardia and how does it relate to supraventricular tachycardia? 

    Answer 

    Sinus tachycardia means your heart beats in a normal, regular rhythm, but faster than usual. It's not related to supraventricular tachycardia (SVT) because it’s a normal response to changes in your body. It isn’t usually caused by a problem with electrical signals in your heart. 

    Explanation 

    Your heart can sometimes beat faster than normal in response to your environment or situation. Your heart rate will speed up when you:

    • do some strenuous exercise
    • feel fear or panic
    • have a fever
    • take certain medicines
    • take some types of illegal drugs (such as amphetamines)
    • have caffeine or alcohol (especially in larger quantities than usual)
    • smoke 
    Some medical conditions, such as an overactive thyroid gland (hyperthyroidism) or anaemia, for example, can also increase your heart rate. 

    Most people don't need treatment for sinus tachycardia because their heartbeat doesn’t stay raised for long and returns to normal after the stimulus has been removed. However, if it's caused by an underlying health condition, your GP will advise you about treatments. 

    Inappropriate sinus tachycardia is when your heart beats faster than usual for no apparent reason. This may be because you are abnormally sensitive to natural hormones that are present in your body. It can also happen if you have an anxiety disorder. It’s important that your GP rules out all causes of sinus tachycardia but there might be no apparent cause. 

    If you’re concerned about your heart rate, or have other symptoms, such as chest pain or dizziness, see your GP.

    What is Wolff–Parkinson–White syndrome and how do I know if I have it? 

    Answer

    Wolff–Parkinson–White syndrome is when there is an unusual connection between your atria and your ventricles, which are the upper and lower chambers of your heart. This can increase your risk of having supraventricular tachycardia (SVT) and atrial fibrillation. You might not have any symptoms of Wolff–Parkinson–White syndrome so be unaware you have it unless you have an electrocardiogram (ECG). 

    Explanation

    Wolff–Parkinson–White syndrome happens when the upper and lower chambers of your heart don’t separate properly while you're developing as a baby. This leads to an unusual connection forming between your atria and ventricles, called an accessory pathway. 

    If you have a normal heart, electrical impulses only travel in one direction. This is from your upper chambers to your lower chambers, through an area called the atrioventricular (AV) node. If you have Wolff–Parkinson–White syndrome, the accessory pathway creates a circuit. This allows impulses to travel back up to your atria and activate the muscles before your next heartbeat and can cause symptoms of SVT. However, you may not even know you have Wolff–Parkinson–White syndrome unless this shows up on an ECG. 

    One type of treatment for Wolff–Parkinson–White syndrome is catheter ablation. If you have this, your doctor will pass a small tube called an electrode catheter into the vein in your groin. He or she will then thread it up to your heart. Once there, your doctor can either burn or freeze any tissue that's disrupting or causing abnormal electrical signals. If you don't want to have this procedure, your doctor may prescribe you antiarrhythmic medicines to help get your heart rhythm back to normal.

    Can I travel if I have supraventricular tachycardia?

    Answer

    Yes, you should be able to travel if you have supraventricular tachycardia (SVT) but this will depend on your symptoms.

    Explanation

    Most people with SVT can travel by driving or flying, for example, but there may be restrictions if you have troublesome symptoms.

    If you have SVT, it may affect your ability to control a vehicle so it may not be safe for you to drive. If you don't have any symptoms of SVT, you can carry on driving and don't need to notify the Drivers and Vehicle Licensing Agency (DVLA). However, if you have had symptoms, such as feeling dizzy or fainting, you must stop driving and let the DVLA know. You may be allowed to drive again if your doctor finds a cause of your SVT and you have had successful treatment. This means your treatment has controlled your condition for at least four weeks. The rules for driving with SVT are much stricter if you drive a bus or lorry for work. You can contact the DVLA for more information. 

    Most people with SVT are able to fly safely and flying doesn't increase your risk of having an SVT episode. If you have occasional symptoms that are generally well controlled and you don't have many episodes, there aren't any travel restrictions on you flying. If you have more episodes of SVT, you may need to take medicines to make sure you can fly safely. If you need to take medicines in your hand luggage, you may need to get a letter from your doctor. You will also need to contact your airline before you travel.

    If you're unsure whether or not it's safe for you to travel, ask your GP or heart specialist.

  • Resources Resources

    Further information

    Sources

    • Paroxysmal supraventricular tachycardias. PatientPlus. www.patient.co.uk/patientplus.asp, reviewed 10 December 2013 
    • Paroxysmal supraventricular tachycardia. Medscape. www.emedicine.medscape.com, published 27 March 2014 
    • Types of arrhythmia. National Heart Lung and Blood Institute. www.nhlbi.nih.gov, accessed 1 July 2011 
    • Ventricular tachycardia. Medscape. www.emedicine.medscape.com, published 2 May 2014 
    • Smith G, Dyson K, Taylor D, et al. Effectiveness of the valsalva manoeuvre for reversion of supraventricular tachycardia. Cochrane Database of Systematic Reviews 2013, Issue 3. doi:10.1002/14651858.CD009502.pub2
    • Reentrant supraventricular tachycardias (svt, psvt). The Merck Manuals. www.merckmanuals.com, published July 2012 
    • ECG identification of conduction disorders. PatientPlus. www.patient.co.uk/patientplus.asp, reviewed 25 January 2013 
    • Map of Medicine. Tachyarrhythmias. International View. London: Map of Medicine; 2014 (Issue 4) 
    • Assessment of tachycardia. BMJ Best Practice. www.bestpractice.bmj.com, published 18 August 2014 
    • Start active, stay active: A report on physical activity for health from the four home countries’ chief medical officers. Department of Health, 2011. www.gov.uk
    • Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. www.medicinescomplete.com, accessed 23 January 2015 (online version) 
    • Blomström-Lundqvist C, Scheinman M, Aliot E, et al. ACC/AHA/ESC guidelines for the management of patients with supraventricular arrhythmias. Eur Heart J 2003; 24:1857–97. doi:10.1016/j.ehj.2003.08.002
    • Ablation therapy for arrhythmias. PatientPlus. www.patient.co.uk/patientplus.asp, reviewed 19 July 2012 
    • Catheter ablation. Arrhythmia Alliance. www.heartrhythmcharity.org.uk, accessed 2012 
    • What to expect after catheter ablation. National Heart Lung and Blood Institute. www.nhlbi.nih.gov, accessed 5 March 2012 
    • Tachycardia - fast heart rate. American Heart Association. www.heart.org, accessed 17 November 2014 
    • Wolff–Parkinson–White syndrome. PatientPlus. www.patient.co.uk/patientplus.asp, reviewed 14 March 2012 
    • Wolff–Parkinson–White syndrome. BMJ Best Practice. www.bestpractice.bmj.com, published 25 March 2014 
    • DVLA’s current medical guidelines for professionals – conditions a to c. Driver and Vehicle Licensing Agency. www.gov.uk, accessed 28 November 2014 
    • Smith D, Toff W, Joy M, et al. Fitness to fly for passengers with cardiovascular disease. Heart 2010; 96:ii1–16. www.bcs.com 
    • Holidays and travel. British Heart Foundation. www.bhf.org.uk, accessed 27 January 2015
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