Paroxysmal Supraventricular Tachycardia - Diagnosis

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How is paroxysmal supraventricular tachycardia (PSVT) diagnosed?

The diagnosis of PSVT is based upon interpretation of the heart rate monitor and electrocardiogram.

Sometimes the diagnosis is difficult because the rapid heart rate resolves before the patient presents for medical care. In these cases, where there is a recurrent pattern of palpitations, the healthcare professional may suggest monitoring the patient's heart rate and rhythm as an outpatient. A Holter monitor is a small device that can be worn for 24 or 48 hours that records every heartbeat and may give a clue as to the underlying cause of the palpitations. A 30-day event monitor may also be considered, which gives a longer window to detect the rhythm. Again, a small monitor is worn, but with this device the patient triggers the recording when the palpitations begin. In some cases, specialized electrophysiology tests may be necessary to monitor the heart and try to reproduce abnormal rhythms.

For infrequent events, an implantable device (LINQ) can be placed just under the skin, and can scan for a month looking for rare rhythm changes.

Return to Paroxysmal Supraventricular Tachycardia (PSVT)

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Comment from: chargergirl, 45-54 Female (Patient) Published: December 31

I was finally diagnosed with paroxysmal supraventricular tachycardia (PSVT) after multiple emergency room (ER) visits where episodes would stop prior to examination. I went to an ER and they caught it on the EKG.

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Comment from: TwoTimeAblation, 65-74 Male (Patient) Published: January 04

For the prior two years, I felt light-headed, dizzy, and my heart beating too fast on numerous occasions. These episodes would appear weeks apart and lasted only a few seconds. When I passed out at the kitchen table, my wife drove me to the doctor. The doctor made me wear a monitor for two weeks to no avail. Therefore, at the doctor's office, I relaxed totally and my heart starting beating rapidly. The doctor called the ambulance since it was beating 300 times a minute. In the emergency room, the doctor stated it was only beating 200 times a minute when the paroxysmal supraventricular tachycardia episode came back. After several tests, the cardiologist did the first operation on 8/13/07 on the right side of my heart. Against my request to have local anesthetics, the anesthetist put me out because he said that I was too nervous. After the operation, I asked the cardiologist if he found the problem on the right side of the heart. He said no and that he would go into the left side the next day. When I asked why we didn't do it today, he simply said that he would do it the next day. On 8/14/07, the doctor went into the right side of the heart, through wall and into the left side of the heart to perform a SVT ablation. For the last two years, I felt light-headed and slightly dizzy on numerous occasions. At no time, did I feel my heart beating too fast. These episodes would appear weeks apart and lasted only a few seconds. On Tuesday, 12/15/15, I walked a mile to an apartment to install a towel bar. When I arrived, the episode came again. I waited less than a minute until I felt better. I rang the doorbell and measured the bar between the two holders. I went to the basement and cut the bar. The same episode came again for about 30 seconds but much weaker. I decided to install the bar another day and walked to the bank (half a mile). Afterward, I began to walk home about a mile away. The feeling came back several times, on and off, but weaker than before. Later when I was watching TV at home, the feeling came back stronger. I put two fingers on my pulse which was beating too fast. I got my high blood pressure machine which registered my blood pressure okay but the pulse 178 times a minute. The readings were about the same each time I tested. I got my wife to drop me at the hospital emergency entrance. When I got out the car, I stood for a few seconds until my strong episode went away. They took me right away and obtained similar readings. They performed an AV (atrioventricular) nodal slow pathway modification on 12/17/15 by the same cardiologist doctor (8/13/07 and 8/14/07).

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