Paroxysmal supraventricular tachycardia (PSVT) is an umbrella term for several heart conditions where the heart beats faster than expected. A PSVT episode starts in the heart’s upper chambers. Doctors may refer to it as arrhythmia because it causes an atypical heart rhythm.

There are many different types of PSVT. Some are more common in young people, while others are more common in older individuals.

Most people’s resting heart rate is 60–100 beats per minute (BPM). PSVT causes a rise in heart rate to over 100 BPM for no apparent reason.

People may use supraventricular tachycardia (SVT) to refer to PSVT. Paroxysmal means that the event may happen from time to time.

In this article, we examine PSVT and its causes. We also look at the symptoms of PSVT and how doctors diagnose and treat the condition.

A graph showing heart rate.Share on Pinterest
Xiththi Sakdi Xacha La Leis/EyeEm/Getty Images

Episodes of PSVT can occur at any age. Typically, the heart muscles contract as they receive electrical signals from the sinus node. When PSVT occurs, the electrical pathway causes a fast heart rate. These episodes originate from the heart’s atria, or upper chambers.

Some conditions that may lead to PSVT include:

A PSVT heart may also result from the following conditions:

  • Atrioventricular nodal reentrant tachycardia: A type of atypical fast heart rhythm that is the most common cause of PSVT. It is not life threatening but could cause lightheadedness or fainting.
  • Wolff-Parkinson-White syndrome: This syndrome occurs when a person is born with an extra electrical pathway that affects their heartbeat. It is one of the most common causes of a fast heart rate in children. Those who have the Wolff-Parkinson-White syndrome do not usually have other cardiac problems.
  • Atrial tachycardia: A fast heartbeat where electrical impulses originate from the atria. It is most likely to occur in people with structural heart disease or ischemic coronary artery disease but can also occur in hearts with a typical structure.

The American Heart Association (AHA) states that SVT does not always cause symptoms, but people may experience the following:

  • fainting
  • lightheadedness
  • chest tightness
  • shortness of breath
  • heart palpitations

Symptoms vary depending on the condition’s severity, duration, and type of PSVT episodes. However, for most people, PSVT can cause pain and discomfort in the neck and chest.

A PSVT heartbeat could race to around 120–130 BPM, and some types of the condition can even cause a faster heartbeat.

An office EKG may not help detect PSVT, as these episodes happen occasionally. That said, a doctor may recommend wearing a rhythm monitor that records a person’s heart rhythm as they go about their everyday life.

EKG monitors include the following:

  • Holter monitor: This battery-operated device can monitor the heart’s rhythm for 48 hours or longer. According to the AHA, a Holter monitor can help medical professionals check if the body responds well to treatment and determine the cause of a fast heart rate. The monitor can also tell if the heart is receiving enough oxygen.
  • Event monitor: This device can be suitable for a slow or fast heart rate. The AHA states that event monitors can also tell if a pacemaker is working correctly. People may have to wear this recorder for up to 1 month. Doctors can then decide on a treatment plan or if a person needs more tests.
  • Implantable loop recorder: Doctors place an implantable monitor beneath the skin that can record the heart’s activity for several years.

A cardiac ultrasound or EKG may also be helpful if an individual reports chest pains, shortness of breath, or hypotension, which refers to low blood pressure. A physician may also perform this test in the case of chest trauma.

The National Heart, Lung, and Blood Institute (NHLBI) states that healthcare professionals may perform a physical exam and check if there is leg or foot swelling, which may indicate an enlarged heart. They may also listen to the heartbeat and check if the person has a heart murmur.

Whether someone requires treatment depends on the type of PSVT they have. People may not require treatment if their symptoms are not severe and their PSVT episodes do not happen frequently.

If necessary, doctors may prescribe medications to treat the condition, such as hyperthyroidism, which is causing the PSVT episode. They may also prescribe beta-blockers to treat the symptoms of arrhythmia.

If PSVT episodes last only a few minutes, a person could try:

  • reducing their caffeine and alcohol intake
  • resting
  • quitting smoking, if applicable

Catheter ablation, also known as cardiac ablation and radiofrequency ablation, is an option to treat PSVT episodes. During this procedure, doctors insert a tube into the heart to remove the tissues causing the heart to beat faster or slower than expected.

Catheter ablation may benefit those who cannot have medication or have an arrhythmia that originates from the heart’s upper chambers.

Doctors may perform a carotid massage by applying pressure on the neck’s artery to reset the heart’s signals. However, researchers from a 2017 study stated this may be unsafe for those who have had a stroke in the past 3 months.

Medications that cardiologists may offer to slow the heart rate include:

Authors of an older article from 2013 note that PSVT is a common heart condition but is not life threatening. Individuals may develop symptoms that can affect their daily activities and cause anxiety. They may require hospitalization if they have low systolic blood pressure or low serum sodium.

One article states that paroxysmal atrial fibrillation, a type of PSVT, may increase the risk of stroke.

Additionally, anxiety may be one of the symptoms that people with PSVT develop.

People who have concerns about their heart health should speak with a doctor.

The Centers for Disease Control and Prevention (CDC) urge people to call the emergency department if they or someone else are experiencing heart attack symptoms, such as:

  • shortness of breath
  • pain or discomfort in the neck, jaw, or back
  • lightheadedness or dizziness
  • chest pain

A choking sensation, swollen ankles, or stomach pain may also indicate that an individual has heart disease.

Additionally, people with a high risk of developing arrhythmia may consider discussing preventive measures and possible treatment options with a cardiologist. The NHLBI lists some conditions that may be risk factors for arrhythmias, including:

  • low or high blood sugar levels
  • dehydration
  • anxiety
  • vomiting

PSVT refers to arrhythmias that cause the heart to beat faster than expected. Its symptoms may appear without warning.

It may be more common in individuals with anxiety, hyperthyroidism, or those who have had a heart attack.

It is important to consult a cardiologist for a checkup and discuss any risk factors and possible treatment options.