Paroxysmal Supraventricular Tachycardia (PSVT)

  • 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: Daniel Lee Kulick, MD, FACC, FSCAI
    Daniel Lee Kulick, MD, FACC, FSCAI

    Daniel Lee Kulick, MD, FACC, FSCAI

    Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.

  • 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.

PSVT Treatment: Ablation

Ablation is used to treat abnormal heart rhythms, or arrhythmias. The type of arrhythmia and the presence of other heart disease will determine whether ablation can be performed surgically or non-surgically.

Non-surgical ablation, used for many types of arrhythmias, is performed in a special lab called the electrophysiology (EP) laboratory.

  • During this non-surgical procedure a catheter is inserted into a specific area of the heart.
  • A special machine directs energy through the catheter to small areas of the heart muscle that causes the abnormal heart rhythm.
  • This energy "disconnects" the pathway of the abnormal rhythm. It can also be used to disconnect the electrical pathway between the upper chambers (atria) and the lower chambers (ventricles) of the heart.

What is paroxysmal supraventricular tachycardia (PSVT)?

The heart is a two-stage electrical pump. A coordinated electrical signal is required for the heart muscle cells to contract in a coordinated way and generate a heartbeat. Normally, an electrical signal is generated in special pacemaker cells found in the sinoatrial (SA) node located in the right atrium or upper chamber of the heart. This impulse spreads to the whole atrial muscle causing it to contract and push blood into the ventricle or the lower chamber of the heart. The electrical signal continues to a junction box between the atrium and ventricle (the AV node), where there is a slight delay that allows the ventricle to fill before it contracts and pumps blood to the body. The signal continues throughout the ventricles and causes them to beat and push blood to the body.

What causes paroxysmal supraventricular tachycardia (PSVT)?

In paroxysmal supraventricular tachycardia (PSVT), abnormal conduction of that electricity causes the atrium, and secondarily the ventricles, to beat very rapidly. It is referred to as paroxysmal, because the rapid rate can occur sporadically and without warning and may also stop on its own. The rapid heartbeat may last a few seconds or many hours. Often the PSVT resolves before the patient reaches a health care professional.

In many patients with PSVT, there is a “wiring” problem in the AV node and instead of having just one pathway for electricity to travel to the ventricle, there are two. This allows electricity to circle back and cause the atrium to beat more quickly than it should normally. PSVT is one of many electrical abnormalities that cause the atrium to beat too quickly. These abnormalities were once lumped together and called paroxysmal atrial tachycardia or PAT but, as more has been learned about the electrical wiring of the heart, terminology has been updated to better reflect the specific abnormal rhythm. Some examples include atrial tachycardia, multifocal atrial tachycardia, atrial fibrillation, atrial flutter, and Wolff-Parkinson-White (WPW) syndrome. As well, there are numerous abnormalities in the AV node that cause rapid heartbeats and palpitations. PSVT and other electrical abnormalities located in the atrium or AV node should not be confused with ventricular tachycardia, which arises from the ventricle and is potentially life-threatening.

Picture of the interior of the heart and chambers of the heart.
Picture of the interior of the heart and chambers of the heart.
Medically Reviewed by a Doctor on 3/14/2016

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