Supraventricular tachycardia (SVT) means that from time to time your
heart beats very fast for a reason other than exercise, high fever, or stress.
For most people who have SVT, the heart still works normally to pump blood through the body.
Atrioventricular reciprocating tachycardia (AVRT),
During an episode of SVT, the heart's electrical system
doesn't work right, causing the heart to beat very fast. The heart beats at
least 100 beats a minute and may reach 300 beats a minute. After treatment
or on its own, the heart usually returns to a normal rate of 60 to 100 beats a
SVT may start and end quickly, and you may not have
symptoms. SVT becomes a problem when it happens often, lasts a long time, or
SVT also is called paroxysmal supraventricular
tachycardia (PSVT) or paroxysmal atrial tachycardia (PAT).
Other symptoms include near-fainting or fainting (syncope), shortness of breath, chest pain, throat
tightness, and sweating.
How is SVT diagnosed?
Your doctor will diagnose
SVT by asking you questions about your health and symptoms, doing a physical
exam, and perhaps giving you tests. Your doctor:
Will ask if anything triggers the fast heart
rate, how long it lasts, if it starts and stops suddenly, and if the beats are
regular or irregular.
May do a test called an
electrocardiogram (EKG, ECG). This test measures the
heart's electrical activity and can record SVT episodes.
If you do not have an episode of SVT while you're at the
doctor's office, your doctor probably will ask you to wear a portable electrocardiogram (EKG), also called an ambulatory electrocardiogram. When
you have an episode, the device will record it.
Your doctor also
may do tests to find the cause of the SVT. These may include blood tests, a
X-ray, and an
echocardiogram, which shows the heart in motion.
How is it treated?
Some SVTs don't cause
symptoms, and you may not need treatment. If you do have symptoms, your doctor
probably will recommend treatment.
To treat sudden episodes of
SVT, your doctor may:
Prescribe a medicine to take when the SVT
Show you how you can slow your heart rate on your own. You
may be able to do this by coughing, gagging, or putting your face in ice-cold
water. These are called vagal maneuvers.
If these treatments don't work, you may have to go to your
doctor's office or the emergency room. You may get a fast-acting medicine such
as adenosine or verapamil. If the SVT is serious, you may have
electrical cardioversion, which uses an electrical
current to reset the heart rhythm.
If you often have episodes of
SVT, you may need to:
Take medicine every day to prevent the
episodes or slow your heart rate.
Try catheter ablation. This
procedure destroys a tiny part of the heart that causes the problem.
What can you do at home to prevent SVT?
You can try some things at home to help prevent SVT by avoiding the things that trigger it. Examples of things you can try:
Limit or do not drink alcohol.
Avoid over-the-counter decongestants, herbal remedies, diet
pills, and "pep" pills.
Don't use illegal drugs, such as cocaine,
ecstasy, or methamphetamine.
To find your triggers, keep a diary of your heart rate and
your symptoms. You might find, for example, that smoking or alcohol causes
your SVT episodes.
For most people, moderate amounts of caffeine do not trigger SVT. So most people do not have to avoid chocolate or caffeinated coffee, tea, or soft drinks.
Health Tools help you make wise health decisions or take action to improve your health.
Decision Points focus on key medical care decisions that are important to many health problems.
Two common types of
supraventricular tachycardia—atrioventricular reciprocating tachycardia (AVRT) and
atrioventricular nodal reentrant tachycardia (AVNRT)—are caused by an abnormal
electrical pathway in the heart and often occur in
people who do not have any other type of heart disease. What causes this
abnormal pathway might not be clear.
Other types of supraventricular tachycardia may be
Overly high levels of the
heart medicine digoxin (such as Lanoxin) or the
bronchodilator theophylline .
Other serious health problems, such as
chronic obstructive pulmonary disease,
pneumonia, or metabolic problems.
Heart surgery in the upper chambers of the heart, such as surgery for a congenital heart defect.
supraventricular tachycardia include:
A racing or fluttering feeling in the chest
(pressure, tightness, pain).
Lightheadedness or dizziness.
Shortness of breath.
A pounding pulse. You
may feel or see your pulse beating, especially at your neck, where large blood
vessels are close to the skin.
Tightness or fullness in the
What Increases Your Risk
Some lifestyle factors can
raise your risk of having an episode of
supraventricular tachycardia, such as overuse of
nicotine or alcohol, or use of illegal drugs, such as stimulants like
cocaine or methamphetamine.
Decongestants that contain stimulants
should also be avoided, including oxymetazoline (such as Afrin and other
brands) and pseudoephedrine (such as Sudafed and other brands). Doctors also
warn against using nonprescription diet pills or "pep" pills, because many
contain ephedra, ephedrine, the herb ma huang, or other
Conditions that affect the lungs, such as
chronic obstructive pulmonary disease (COPD),
heart failure, and
pulmonary embolism, can raise your risk for multifocal
atrial tachycardia (MAT), a type of supraventricular tachycardia.
Many experts believe that
Wolff-Parkinson-White syndrome may in some cases be
inherited. If you have a first-degree relative, which is a parent, brother, or
sister, with this disorder and he or she has symptoms, talk with your doctor
about your risk for this abnormal heart rhythm.
When to Call a Doctor
Call 911 or seek emergency services immediately if you have a fast heart rate and
Faint or feel as though you are going to
Have severe shortness of breath.
Have symptoms of a heart attack or stroke.
Call your doctor if you are having fluttering in your chest
(palpitations) that persists and does not go away quickly or if you have
If you have a pacemaker
Call your doctor right away if you have symptoms that could mean your device is not working properly, such as:
Your heartbeat is very fast or slow, skipping, or fluttering.
You feel dizzy, lightheaded, or faint.
You have shortness of breath that is new or getting worse.
Who to see
Health professionals who can evaluate symptoms of a fast or irregular
Most people who have
supraventricular tachycardia need to see a
cardiologist or electrophysiologist for follow-up care.
Exams and Tests
An exact diagnosis is important
because the treatment you receive depends on the type of tachycardia you have.
Supraventricular tachycardia can sometimes be
diagnosed simply on the basis of a
medical history and physical exam and a few
simple tests. Tests that may be done to
monitor your heart and diagnose the type of fast heart rate that you have
Electrocardiogram (EKG, ECG), which measures the electrical impulses in the heart. If an
electrocardiogram is done while the fast heart rate is occurring, it often
provides the most useful information.
Ambulatory electrocardiogram. A portable EKG, such as a Holter monitor, can record
your heart rhythm on a continuous basis, usually over a 24-hour period. If your
symptoms are infrequent, your doctor may use another type of ambulatory
electrocardiogram called a cardiac event monitor. When you have symptoms, you
activate the monitor, which records your heart rhythm.
Electrophysiology study. In this test, flexible wires are inserted into a vein, usually in
the groin, and threaded into the heart. Electrodes at the end of the wires
transmit information about the heart's electrical activity. Your doctor uses this information to see whether there is an extra electrical pathway inside the heart
and, if so, where it is located. Catheter ablation can be done during this test
to treat abnormal pathways and correct the supraventricular
Medicine trial. Giving certain medicines while you are
experiencing a fast heart rate, and monitoring what happens, may sometimes help
your doctor find out what type of fast heart rate problem you have.
After finding tachycardia, your doctor may need to search
for its cause. The specific tests needed depend on the particular tachycardia.
These tests may include:
Supraventricular tachycardia is usually treated if:
You have symptoms such as dizziness, chest
pain, or fainting (syncope) that are caused by your fast heart
Your episodes of fast heart rate are occurring more
frequently or do not revert to normal on their own.
Treatment for sudden-onset (acute) episodes
supraventricular tachycardia (SVT) start suddenly and
cause symptoms, you can try
vagal maneuvers—such as gagging, holding your breath and bearing down (Valsalva maneuver), immersing your face in ice-cold
water (diving reflex), or coughing. These
simple maneuvers stimulate the vagus nerve, which can slow conduction of
electrical impulses that control your heart rate. Your doctor will teach you
how to do vagal maneuvers safely.
Your doctor may also
prescribe a short-acting medicine that you can take by mouth if vagal maneuvers
don't work. This allows some people to manage their SVT without having to visit
the emergency room repeatedly.
If your heart rate cannot be slowed
using vagal maneuvers, you may have to go to your doctor's office or the
emergency room, where a fast-acting medicine such as adenosine can
be given. If the arrhythmia does not stop and symptoms are severe,
electrical cardioversion, which uses an electrical
current to reset the heart rhythm, may be needed.
Ongoing treatment of recurring supraventricular tachycardia
If you have recurring episodes of
supraventricular tachycardia, you may need to take
medicines, either on an as-needed basis or daily. Medicine treatment typically
calcium channel blockers, other
antiarrhythmic medicines, or
digoxin. In people who have frequent episodes, treatment
with medicines can decrease recurrences. But these medicines may have side
Many people with supraventricular tachycardia have a
catheter ablation. This procedure can stop the rhythm problem in most people. Ablation is considered safe, but it has some rare, serious risks.
Your doctors may recommend
daily doses of calcium channel blockers, beta-blockers, and/or digoxin if you
have frequent episodes of AVNRT. If these medicines are not effective in
supraventricular tachycardia from recurring, your
doctor may recommend that you take an antiarrhythmic medicine.
you take daily medicine for AVNRT or you have significant symptoms, you may
want to consider having
Treatment for atrioventricular reciprocating tachycardia (AVRT)
If supraventricular tachycardia occurs in someone
who has significant
coronary artery disease, the heart may not receive
enough blood to keep up with the demands of the increased heart rate. If this
occurs, the heart may not get enough oxygen, potentially causing chest pain
(angina) or a
Mild supraventricular tachycardia,
with short episodes that don't happen often, doesn't typically weaken the heart or lead to heart failure. But some people have a higher risk of getting heart failure, such as those who have a heart valve disease. If tachycardia is left untreated,
repeated and long episodes of tachycardia can lead to
heart failure (known
as a tachycardia-mediated cardiomyopathy). But this heart failure might be stopped, or reversed, if the supraventricular tachycardia is stopped with treatment.
You can reduce your risk of having
supraventricular tachycardia by avoiding certain
stimulants or stressors, such as nicotine, some medicines (for
example, decongestants), illegal drugs (stimulants, like methamphetamines and
cocaine), and excess alcohol.
heart rates continue, long-term medicines may be used to
help prevent a recurrence of the fast heart rate.
Living With Tachycardia
Home care includes
supraventricular tachycardia (SVT) and trying to slow your
heart when a fast heart rate occurs. To monitor your condition, you may find it
helpful to keep a
diary of your heart rate and your symptoms.
Check your pulse when you have symptoms, and record the
information in your diary. Be aware that if your heart is beating rapidly, it
may be hard to feel your pulse and get an accurate count of your actual
By keeping a diary of your heart rate and symptoms,
you may be able to identify stressors—such as drinking alcohol or smoking—that trigger episodes.
Also, it's usually important
to avoid overuse of nicotine or alcohol and the use of illegal
drugs, such as stimulants like cocaine, ecstasy, or methamphetamine.
Decongestants that contain
stimulants should also be avoided, including oxymetazoline (such as Afrin and
other brands) and pseudoephedrine (such as Sudafed and other brands). Doctors
also warn against using diet pills or "pep" pills, ephedrine, ephedra, the herb ma huang, or other stimulants.
For most people, moderate amounts of caffeine do not trigger SVT. So most people do not have to avoid chocolate, caffeinated coffee, tea, or soft drinks.
Your doctor may suggest that you try
vagal maneuvers—such as gagging, holding your breath and bearing down, or
immersing your face in cold water—to slow your heart rate. Your doctor will
help you learn these procedures so you can try them at home when your fast
heart rate occurs.
If you have symptoms, medicines may be
used to treat
For severe symptoms, such as
chest pain, shortness of breath, or feeling faint, you may be given fast-acting
antiarrhythmic medicines by health professionals in
the hospital emergency department, where your heart can be monitored.
Fast-acting antiarrhythmic medicines commonly used to slow the heart rate
during an episode include:
Long-term use of an antiarrhythmic medicine may also be
needed to reduce the chance of having more episodes of supraventricular
tachycardia or to reduce the heart rate during these episodes. Common medicines
used for this purpose include:
Open-heart surgery is rarely done for
supraventricular tachycardia. Surgery might be done if you cannot have catheter ablation or if you are having surgery for another heart condition.
An electric shock to the heart
(electrical cardioversion) may be needed if you are having severe symptoms
supraventricular tachycardia and your heart rate does
not return to normal using
vagal maneuvers or fast-acting medicines.
If you continue to have
episodes that cause serious symptoms, a procedure called catheter ablation may
be done during an
electrophysiology (EP) study. During an EP study, the
extra electrical pathway or cells in the heart that are causing the fast heart
rate can often be identified and destroyed using catheter ablation.
Blomström-Lunqvist C, et al. (2003). ACC/AHA/ESC
guidelines for the management of patients with supraventricular
arrhythmias—Executive summary: A report of the ACC/AHA/ESC Committee for
Practice Guidelines. Circulation, 108(15):
Calkins H (2011). Supraventricular tachycardia: Atrioventricular nodal reentry and Wolf-Parkinson-White syndrome. In V Fuster et al., eds., Hurst's the Heart, 13th ed., vol. 1, pp. 987–1005. New York: McGraw-Hill.
Epstein AE, et al. (2008). ACC/AHA/HRS 2008 Guidelines
for Device-Based Therapy of Cardiac Rhythm Abnormalities: A Report of the
American College of Cardiology/American Heart Association Task Force on
Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002
Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia
Devices): Developed in Collaboration With the American Association for Thoracic
Surgery and Society of Thoracic Surgeons. Circulation,
117(21): e350–e408. [Correction in Circulation, 120(5): e34–e35.]
Miller JM, Zipes DP (2012). Therapy for cardiac arrhythmias. In RO Bonow et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 1, pp. 710–744. Philadelphia: Saunders.
Olgin JE, Zipes DP (2012). Specific arrhythmias: Diagnosis and treatment. In RO Bonow et al., eds., Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 9th ed., vol. 1, pp. 771–824. Philadelphia: Saunders.
Primary Medical Reviewer
Rakesh K. Pai, MD, FACC - Cardiology, Electrophysiology
Specialist Medical Reviewer
John M. Miller, MD, FACC - Cardiology, Electrophysiology
How this information was developed to help you make better health decisions.