Heart Rhythm Disorders (Abnormal Heart Rhythms)

  • Medical Author:
    Benjamin Wedro, MD, FACEP, FAAEM

    Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

  • Medical Editor: Absalom D. Hepner, MD
  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Paroxysmal supraventricular tachycardia (PSVT)

Paroxysmal supraventricular tachycardia (PSVT) occurs when the pathways in the AV node or atrium allow an altered conduction of electricity, and the atrium begins firing in a fast but regular rate, sometimes more than 150 to 200 times per minute. The ventricles, sensing the electrical activity coming through the AV node, try to beat along with each electrical impulse and PSVT occurs.

This is rarely a life-threatening event, but people may feel uncomfortable when PSVT occurs. They may become lightheaded, weak, have shortness of breath, and describe a feeling of fullness in the throat. PSVT may also be tolerated and may stop on its own. If this is a first time event, activating EMS (emergency medical services) and calling 9-1-1 is important, since other tachycardias can be life threatening.

The treatment for PSVT includes attempts to stimulate the vagus nerve to slow the heart (see vasovagal syncope above) by holding one's breath and bearing down as if to have a bowel movement. Intravenous medications are often used to interrupt the episode. Many patients have PSVT due to congenital abnormalities in the electrical conduction system of the heart. External causes can include hyperthyroidism, electrolyte imbalances, and the use of caffeine, alcohol, over-the-counter cold medications containing stimulants, or illegal drugs like cocaine and methamphetamine.

Wolff-Parkinson-White (WPW) syndrome

Wolff-Parkinson-White syndrome is a specific type of PSVT, in which an inborn error of wiring has occurred near the AV node, and an accessory electrical pathway exists. The diagnosis is made by electrocardiogram (EKG) or electrophysiologic testing, and the treatment may include medication or destruction of the accessory electrical pathway by invasive catheter ablation.

Medically Reviewed by a Doctor on 2/18/2016

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