Supraventricular Tachycardias – Prof. Basri Amasyalı

Supraventricular Tachycardias Ankara

First of all, it is necessary to explain what tachycardia is. “Tachycardia”, which is also known as “heart palpitations” colloquially, is a phenomenon where the heart beats faster than normal. Tachycardias originate in two main areas in the heart. One of them is the atria of the heart. The other is the ventricles of the heart. The heart has two atria and tachycardias originating from these are called “Supraventricular Tachycardias”. Supraventricular tachycardias are a general definition and under this main heading, there are many types of supraventricular tachycardias originating from the atria of the heart. In the medical language, the abbreviation “SVT” is frequently used instead of supraventricular tachycardia. In the past, abbreviations “PAT” were used instead of “SVT”. In fact, some patients still complain that “I have PAT”.

A rapid beat of the heart or tachycardia does not always indicate a problem. In some cases, the heart rate increases to provide the energy the body needs. This situation can be perceived as palpitation by some people. But this is completely normal and is a physiological response of the body. If we will give example, walking rapidly, climbing stairs, consuming excessive food, mood changes such as fear and excitement, and stressful life can be said. These are commonly referred to as “sinus tachycardias”. What we want to explain under the title of supraventricular tachycardia here are the conditions that are outside of these and are considered as rhythm disorders and require treatment. In the rest of our article, we will give detailed information about supraventricular tachycardia. For the diagnosis and treatment of the supraventricular tachycardias, you can contact the clinic of Prof. Basri Amasyalı in Ankara.

What is Tachycardia?

Before defining SVT, it will be good to open this topic a little more to be able to understand what tachycardia is and why it occurs. Tachycardia is essentially the heart rhythm beating faster than normal for various reasons. A heart the healthy person beats 60 to 100 times per minute under normal conditions. If the heart rate rises above 100, this is called “tachycardia” or “palpitation”. As I mentioned before, tachycardia does not always indicate a pathological condition. It is decided whether the event is pathological or not, depending on the underlying cause and the type of tachycardia. For this reason, it is recommended that patients who feel recurrent heart palpitations see a specialist without wasting time.

What is Sinus Tachycardia?

Sinus tachycardia is a tachycardia that is one of the responses of the body to certain situations and is considered normal. As I mentioned above, it is accepted as a physiological response of the body (heart) in mood changes such as stress, exercise, excitement, some traumas and fear. However, we should not look at every sinus tachycardia event as a natural reaction. Anemia, thyroid diseases, ongoing inflammatory conditions in the body, and febrile diseases can also stimulate the heart and lead to the development of “sinus tachycardia”. The natural impulse of the heart comes from the right atrium called the “sinus node” and described as the “SA node” in the medical language. At this point, there are hundreds of specialized cells having capable of self-excitation. These are called pacemaker cells. These cells are equipped with a very complex neural network. The heart determines how many alerts per minute it will generate, second by second, according to the signals coming from these neural networks. That’s why our heart rate changes second by second according to our body activity. As a result, sinus tachycardia is the response of the heart to any event. Therefore, sinus tachycardias are not included in a rhythm disorder group. Therefore, no operation is performed on the heart in cases such as sinus tachycardia. Treatment is directed towards the cause. In other words, whatever the event that caused the emergence of sinus tachycardia, our treatment should be directed to that event.

What are Tachycardia Symptoms?

Excessive acceleration of the heart causes some physiological responses in the body. These are;

Rapid heartbeat, as if scared or excited, even at rest
Dizziness
Feeling a pause in the heart
Shortness of breath
Chest pain and feeling of tightness
Fainting

What is Supraventricular Tachycardia?

Supraventricular tachycardia is a term used to describe pathological palpitations or rhythm disturbances originating from the atria of the heart. It can originate from both atria of the heart. It happens because the points or regions within the auricles that do not normally have the ability to generate a warning have the ability to generate a warning. These focuses or points should not normally be present. Some of these focuses are congenital, and some are formed in our heart due to some diseases and factors that are passed on afterwards. These focuses bypass the “SA node” or “sinus node”, which is the center of the heart responsible for normal stimulus formation, and cause the heart to beat extremely fast with the stimulus they create. These palpitation attacks usually come in bouts. It gets better again after 10-15 minutes. During an attack of palpitation, the heart rate is usually around 150 to 200 per minute. However, it can be above 250 or below 150. Such tachycardias are generally not life-threatening. However, it should be absolutely treated. Because, such arrhythmias that develop as a result of pathology in the electrical system of the heart can lead to serious sequelae in the heart in the long term.

How to Diagnose Supraventricular Tachycardia?

Since the attacks last for 10-15 minutes, in people who experience SVT, this attack usually ends until they go to the emergency services of the hospitals, and the ECG taken when the patients come to the emergency room is normal. If the complaint of the patient cannot be evaluated well, unfortunately, the correct diagnosis cannot be made in these patients and the underlying rhythm disorder is missed. Sometimes, the patients with rhythm disorders can be mistakenly diagnosed with “panic attacks”, and unfortunately these patients are followed incorrectly for many years. Therefore, care should be taken and the patients who experience heart palpitations in attacks should be seen by a heart disease specialist who has experience in terms of rhythm disorders.

What are the Types of Supraventricular Tachycardias?

Supraventricular tachycardia is one of the common types of tachycardia and there are four main types. These are atrial fibrillation, paroxysmal supraventricular tachycardia, atrial flutter and Wolff – Parkinson – White syndrome.

Atrial Fibrillation (AF)

Atrial Fibrillation patients are also called “AF patients” for short. AF is a rhythm disorder caused by irregular electrical signals in the atria or chambers in the upper part of the heart, called the atria. These electrical signals cause the atria to contract rapidly and irregularly. So much so that the speed of the atria rises to over 350 per minute and an extremely irregular electric current occurs in the atria. If we translate this situation into a language we can understand, during AF, the atria lose their effective contraction functions and become a dead space. Atrial fibrillation comes in attacks in the first years of the person. The attacks resolve spontaneously after a few minutes or hours. As the disease progresses, the attacks become permanent and do not improve without intervention. Finally, “atrial fibrillation” becomes permanent in some patients. In this case, it is now referred to as “chronic atrial fibrillation”. For this reason, the patient with atrial fibrillation should be followed very closely. The aim is to prevent the patient from entering the chronic process or to postpone it as much as possible. Therefore, patients with atrial fibrillation should be ablated immediately if necessary. AF ablation is currently the most effective treatment option.

Paroxysmal Supraventricular Tachycardia (PSVT)

It is one of the common types of SVT. The heart rate is between 140 and 240 beats per minute. It is a sudden onset and abrupt ending tachycardia disorder. The most common type is called AVNRT. In this type of tachycardia, very good results can be obtained with ablation. The rhythm disorder can be completely eliminated in almost all patients and the patients do not experience the same rhythm disorder for a lifetime. The biggest unfortunate thing for these patients is that the attacks occur in short seizures from time to time, and therefore the rhythm disorder is noticed late in most patients, as I mentioned before. The attacks occur sometimes every 3 months and sometimes once a year. When the attacks occur, the palpitation starts suddenly and disappears after a few minutes. Some patients express palpitations as feeling like my heart will burst, while others say that I feel like my heart is beating in my throat. Since the palpitations are in attacks, it sometimes takes years for the problem to be fully determined in such patients. For this reason, the patients who have palpitations in attacks should see a heart disease specialist who is experienced in this regard and has experience in rhythm as soon as possible. The problem can be revealed with some analyzes to be made and the “EPS” to be made at the end. For more detailed information on this subject, “What is EPS? You can access it from the “section.

Atrial Flutter

It is a type of heart palpitation where the atria of the heart beat at a very high rate. Unlike AF, the rate of palpitation is quite regular in this type of rhythm disorder. In other words, the person’s heart rate is almost the same in every measurement, and this is usually between 150 and 200 per minute. Atrial flutter, like atrial fibrillation, can resolve spontaneously, but atrial flutter is usually persistent and does not resolve spontaneously much if left untreated. Occasional episodes of atrial fibrillation are also common in patients with atrial flutter.

Wolff – Parkinson – White Syndrome

It is a congenital rhythm disorder. Normally, the electrical impulse that occurs in the heart valves passes through a single point to the ventricles and this point is called the “AV node”. In such patients, there is a second cable that allows the electrical impulse to pass from the atria to the ventricles. The people with WPW syndrome have this second wire congenitally, but in most patients, this extra wire does not cause palpitations until adulthood. But in rare cases, this cable can cause life-threatening palpitations even when the person is only 1 year old. In the people with WPW syndrome, there is a short circuit between the heart’s own main cable and this extra cable, and people can experience serious palpitations that are life-threatening. Ablation gives excellent results in patients with WPW syndrome, and almost all patients have a definitive result with ablation. By making EPS, this extra cable is located and the extra cable is eliminated by burning or freezing. The patients with WPW syndrome are permanently relieved of life-threatening risk to ablation.

What is the Risk of Supraventricular Tachycardias?

Supraventricular tachycardias are relatively benign types of palpitations and are not as life-threatening as ventricular tachycardias. But some types of SVT are life-threatening. These are patients with WPW syndrome and patients with AF. However, the most important point to keep in mind is this. All SVTs can damage the structure of our heart over time. The growth of the atria of our heart and the damage that develops in the valves can reach serious dimensions over time. Because every attack of rhythm disorder seriously increases the pressure values in the atria of our heart, and as a result, serious damage occurs in the atria. Therefore, treatment should not be late.

Treatment of Supraventricular Tachycardias

There are two main topics in the treatment of supraventricular tachycardias. These are drug treatment and ablation treatment. One of these treatment approaches is preferred according to the type of SVT, patient history, and other concomitant cardiac and non-cardiac diseases. Currently, ablation is the most effective treatment for many SVT patients. Because the drug treatments only keep the problem under pressure, it does not eliminate the problem that causes SVT. Ablation completely removes the focus causing tachycardia. It is possible to get rid of palpitations for life with ablation treatment specially planned by physicians who are experts in the field of arrhythmia. For more detailed information about supraventricular tachycardias and treatment methods, you can call our clinic in Ankara and make an appointment.