Is Your Racing Heart a Sign of Supraventricular Tachycardia?

 If you've ever experienced a sudden racing heartbeat, you know how unsettling the feeling can be.

While there are many potential causes of a fast heartbeat, one of the more common forms is supraventricular tachycardia, or SVT.

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SVT symptoms — heart palpitations, chest pain, shortness of breath, dizziness or lightheadedness — can be alarming, but the condition is usually treatable and can often be cured, says Michigan Medicine electrophysiologist Rakesh Latchamsetty, M.D.

First, he says, the type of arrhythmia responsible for the symptoms needs to be determined since different arrhythmias can be treated very differently and some can be more serious than others.

"A person experiencing a rapid heartbeat should consult with their physician, and anyone experiencing unrelenting palpitations or severe symptoms should be seen in the emergency room," says Latchamsetty.

What causes SVT?

Supraventricular tachycardia happens when abnormal electrical impulses override the heart's natural rhythm, resulting in a rapid heartbeat that begins in the upper chambers of the heart.

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While a normal resting heart rate is usually between 60 and 100 beats per minute, SVT typically causes the heart rate to exceed 100 beats per minute. Some patients experience SVT during exercise or stressful events, but for others, there's no identifiable trigger.

"For SVT, we typically see a sudden onset and termination of a regular but rapid heart rate," says Latchamsetty. "Some people experience a rapid heart rate for only a few seconds at a time, while others may have it for hours or even more than a day."

How SVT is diagnosed

SVT is typically diagnosed with an electrocardiogram, or EKG, when a patient is experiencing the fast heart rhythm.

"Ideally, the episode would be captured in the emergency room on an EKG," says Latchamsetty. "Otherwise, a patient may be given a heart rate monitor to wear as an outpatient until an episode is recorded and correctly diagnosed."

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To terminate an acute episode of SVT, some patients find success through one of several patient-initiated vagal maneuvers — simple exercises to activate the vagus nerve, which can help reset the heart's rhythm.

"Vagal maneuvers that might allow you to slow your heart rate include holding your breath and bearing down, coughing or immersing your face in cold water," says Latchamsetty.

Treatments for SVT

For patients who experience severe or recurrent SVT for long periods of time, catheter ablation is usually recommended.

During the minimally invasive procedure, a series of thin wires, or catheters, are guided into the heart through a blood vessel in the groin or neck. Radio-frequency energy is then sent to the heart to destroy the tissue responsible for the SVT.

An ablation procedure for SVT typically takes one to three hours, and most patients are able to go home the same day.

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"Some patients with SVT can suppress their episodes with medications that slow the heart rate," says Latchamsetty. Known as beta-blockers or calcium channel blockers, these medications — typically taken on a daily basis — may help reduce the number or severity of these episodes.

However, he notes, "most patients with recurrent episodes of SVT opt for a catheter ablation to avoid taking daily medications."

Whatever treatment option is chosen, ongoing follow-up with your health care provider is important, says Latchamsetty. "Symptom frequency and severity may change over time and could require a change in your treatment plan."