Paroxysmal supraventricular t... Health Article

Treatment

If you do not have symptoms, PSVT may not require treatment.

If symptoms occur or if you have another heart disorders, treatment may be necessary.

If you have an episode of PSVT, a technique called the Valsalva maneuver can be used to interrupt the fast heartbeat. Hold your breath and strain, as if you were trying to have a bowel movement, or cough while sitting with your upper body bent forward.

Splashing ice water on the face has been reported by some people as helpful.

Emergency treatment of PSVT may include:

• Electrical cardioversion, the use of electric shock to restore a rapid heartbeat back to normal.
• Medicines through a vein, including adenosine and verapamil. Other medications may be used, such as procainamide, beta-blockers, and propafenone.

Long-term treatment of PSVT may include:

• Daily medications such as propafenone, flecainide, moricizine, sotalol, and amiodarone.
• Pacemakers to override the fast heartbeat; very occasionally used in children with PSVT who have not responded to any other treatment.
• Radiofrequency catheter ablation; currently the treatment of choice for most PSVT's.
• Surgery to change the pathways in the heart that send electrical signals; this may be recommended in some cases for people who need other heart surgery.

Expectations (prognosis)

PSVT is generally not life threatening, unless other heart disorders are present.

Complications

The main complication is an increased risk of heart failure.

Calling your health care provider

Call your health care provider if:

• You often have a sensation of excessive palpitations and symptoms do not end on their own in a few minutes
• You have a history of PSVT and an episode does not go away with Valsalva maneuver, or if other symptoms go along with the rapid heart rate
• Symptoms return frequently
• New symptoms develop

Prevention

Avoid smoking, caffeine, alcohol, and illicit drugs. Medications used to treat the disorder may be given as a preventive (prophylactic) treatment in people at a high risk or who have had previous episodes of PSVT.

References

Olgin JE, Zipes DP. In: Specific Arrhythmias: Diagnosis and Treatment. In: Libby P, Bonow RO, Mann DL, Zipes DP, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 8th ed. St. Louis, Mo: WB Saunders; 2007: chap. 35.