Paroxysmal Supraventricular Tachycardia - Treatment

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What is the treatment for paroxysmal supraventricular tachycardia (PSVT)?

There is a stepwise approach to treating the rapid heartbeat of PSVT.

Vasovagal maneuvers stimulate the vagus nerve and can slow the heart rate. Some options include holding one's breath and bearing down as if to have a bowel movement or splashing cold water on the face. A care professional might cautiously massage the carotid artery in the neck, but in older patients, there is a risk of stroke and this procedure is usually reserved for younger patients.

Depending upon the heart rhythm, medications can be injected intravenously to reset the AV node or to decrease heart muscle excitability. Adenosine is a short-acting medication that is commonly used as a first-line drug to treat PSVT. Other treatment options for other atrial tachycardias include calcium channel blockers, beta blockers, digoxin, and amiodarone.

If the PSVT does not convert with intravenous medication or if the patient has low blood pressure or complains of chest pain or shortness of breath, cardioversion may be required. This means that an electrical shock is given that resets the heart's electrical system to beat with a regular rate and rhythm.

Return to Paroxysmal Supraventricular Tachycardia (PSVT)

See what others are saying

Comment from: Maggie68, 45-54 Female (Patient) Published: August 25

Over the past year, I've started having episodes of rapid heartbeat, but they would only last 30 seconds to a couple minutes. I would do the vagal maneuvers and sometimes it worked, other times my heart rate would normalize on its own. I have had maybe 6 to 8 episodes since they started, and told my primary care physician (PCP), so she ordered a 48 hour Holter monitor for me. Unfortunately, because they are so random and I can go weeks/months without one, the monitor detected nothing. About 10 days ago, I was at a wound care clinic for hyperbaric oxygen treatment. Before my treatment started, my heart rate sped up, was 185, and the technician called the doctor in. He checked my pulse, said I was sweating profusely (I was cold though), and asked if I was lightheaded or had shortness of breath (I didn't/wasn't). They called 911 and EMTs (emergency medical technicians) came, my heart rate was up to 220 by the time I was in the ambulance and they administered adenosine (which was very scary and weird). In the emergency room my heart rate was back to 130, then 100. I had a CAT scan with contrast to check for clots (negative), they said it was PSVT (paroxysmal supraventricular tachycardia). I saw a cardiologist the other day, he referred me for an echocardiogram, and prescribed Cardizem, a calcium channel blocker. I'm nervous about taking it because I took one for hypertension when I was 30 (Plendil) when my PCP and I were trying to figure out the best blood pressure drug for me, and I had a bad reaction. Cardizem is molecularly different from Plendil, but I'm still nervous. I'm seeing a cardiac electrophysiologist on Thursday, for a second opinion (I figured it won't hurt). Since my bad episode 10 days ago, I haven't had another, but am trying to stay calm and relaxed.

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Comment from: Jeff, 65-74 Male (Patient) Published: December 01

I had a triple heart bypass 2 years ago and I have also had 4 cardioversions for paroxysmal supraventricular tachycardia (PSVT). I now have found out that my late mother had PSVT. She was told she couldn't fly, wonder if the same will apply to me. My cardiologist hasn't told me not to fly.

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