To diagnose supraventricular tachycardia, your doctor will review your symptoms and your medical history and conduct a physical examination. Your doctor may ask about — or test for — conditions that may trigger your SVT, such as heart disease or a problem with your thyroid gland. Your doctor may also perform heart-monitoring tests specific to arrhythmia. These may include:
- Electrocardiogram (ECG). During an ECG, sensors (electrodes) that can detect the electrical activity of your heart are attached to your chest and sometimes to your limbs. An ECG measures the timing and duration of each electrical phase in your heartbeat.
- Holter monitor. This portable ECG device can be worn for a day or more to record your heart's activity as you go about your routine.
- Event monitor. For sporadic episodes of SVT, you keep this portable ECG device available, attaching it to your body and pressing a button when you have symptoms. This lets your doctor check your heart rhythm at the time of your symptoms.
- Echocardiogram. In this noninvasive test, a hand-held device (transducer) placed on your chest uses sound waves to produce images of your heart's size, structure and motion.
- Implantable loop recorder. This device detects abnormal heart rhythms and is implanted under the skin in the chest area.
If your doctor doesn't find an arrhythmia during those tests, he or she may try to trigger your arrhythmia with other tests, which may include:
- Stress test. For some people, supraventricular tachycardia is triggered or worsened by stress or exercise. During a stress test, you'll be asked to exercise on a treadmill or stationary bicycle while your heart activity is monitored. If doctors are evaluating you to determine if coronary artery disease may be causing the arrhythmia, and you have difficulty exercising, then your doctor may use a drug to stimulate your heart in a way that's similar to exercise.
- Tilt table test. Your doctor may recommend this test if you've had fainting spells. Your heart rate and blood pressure are monitored as you lie flat on a table. The table is then tilted as if you were standing up. Your doctor observes how your heart and the nervous system that controls it respond to the change in angle.
Electrophysiological testing and mapping. In this test, doctors thread thin tubes (catheters) tipped with electrodes through your blood vessels to a variety of spots within your heart. Once in place, the electrodes can map the spread of electrical impulses through your heart.
In addition, your cardiologist can use the electrodes to stimulate your heart to beat at rates that may trigger — or halt — an arrhythmia. This allows your doctor to see the location of the arrhythmia and what may be causing it.
Cardiac catheter ablation
In catheter ablation, catheters are threaded through the blood vessels to the inner heart, and electrodes at the catheter tips map the spread of electrical impulses through the heart. Electrodes at the catheter tips transmit energy to destroy a small spot of heart tissue and create an electrical block along the pathway that's causing your arrhythmia.
Most people with supraventricular tachycardia do not require medical treatment. However, if you experience prolonged or frequent episodes, your doctor may recommend or try:
- Carotid sinus massage. Your doctor may try this type of massage that involves applying gentle pressure on the neck — where the carotid artery splits into two branches — to release certain chemicals that slow the heart rate. Don't attempt to do this on your own as it may cause blood clots that could lead to a stroke, or heart or lung injury.
Vagal maneuvers. You may be able to stop an episode of SVT by using particular maneuvers that include holding your breath and straining, dunking your face in ice water, or coughing.
These maneuvers affect the nervous system that controls your heartbeat (vagus nerves), often causing your heart rate to slow.
Cardioversion. If you're unable to stop an episode of SVT on your own using vagal maneuvers, your doctor may use cardioversion, which can be conducted as a procedure or by using medications.
In the procedure, a shock is delivered to your heart through paddles or patches on your chest. The current affects the electrical impulses in your heart and can restore a normal rhythm.
- Medications. If you experience frequent episodes of SVT, your doctor may prescribe medication to control your heart rate or restore a normal heart rhythm. It's very important to take any anti-arrhythmic medication exactly as directed by your doctor in order to minimize complications.
- Catheter ablation. In this procedure, your doctor threads one or more catheters through your blood vessels to your heart. Electrodes at the catheter tips can use heat, extreme cold or radiofrequency energy to damage (ablate) a small spot of heart tissue and create an electrical block along the pathway that's causing your arrhythmia.
In rare instances, treatment for supraventricular tachycardia may involve use of a small, implantable device called a pacemaker to emit electrical impulses that stimulate your heart to beat at a normal rate. The pacemaker is placed under the skin near the collarbone in a minor surgical procedure. An insulated wire extends from the device to the heart, where it's permanently anchored.
Lifestyle and home remedies
Your doctor may suggest that, in addition to other treatments, you make lifestyle changes that will keep your heart as healthy as possible.
These lifestyle changes may include:
- Eat heart-healthy foods. Eat a healthy diet that's low in salt and solid fats and rich in fruits, vegetables and whole grains.
- Exercise regularly. Exercise daily and increase your physical activity.
- Quit smoking. If you smoke and can't quit on your own, talk to your doctor about strategies or programs to help you break a smoking habit.
- Maintain a healthy weight. Being overweight increases your risk of developing heart disease.
- Keep blood pressure and cholesterol levels under control. Make lifestyle changes and take medications as prescribed to correct high blood pressure (hypertension) or high cholesterol.
- Drink alcohol in moderation. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger.
- Maintain follow-up care. Take your medications as prescribed and have regular follow-up appointments with your doctor. Tell your doctor if your symptoms worsen.
Research is ongoing regarding the effectiveness of several forms of complementary and alternative medical therapies for supraventricular tachycardia.
Some types of complementary and alternative therapies may be helpful to reduce stress, such as:
- Relaxation techniques
Some studies have shown that acupuncture may help reduce irregular heart rates in certain arrhythmias, but further research is needed.
The role of omega-3 fatty acids, a nutrient found mostly in fish, in the prevention and treatment of arrhythmias isn't yet clear. But it appears as though this substance may be helpful in preventing and treating some arrhythmias.
Preparing for your appointment
If you think you may have supraventricular tachycardia, make an appointment with your family doctor. If it's found early, your treatment may be easier and more effective. Eventually, however, you may be referred to a doctor trained in heart conditions (cardiologist).
If you experience an episode of SVT for more than a few minutes or it's accompanied by fainting, shortness of breath or chest pain, call 911 or your local emergency number or have someone drive you to the nearest emergency room.
Because appointments can be brief, and because there's often a lot to discuss, it's a good idea to be prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.
What you can do
- Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet. You may need to do this if your doctor orders any blood tests.
- Write down any symptoms you're experiencing, including any that may seem unrelated to heart arrhythmia.
- Write down key personal information, including a family history of heart disease, stroke, high blood pressure or diabetes, and any major stresses or recent life changes.
- Make a list of all medications, vitamins or supplements that you're taking.
- Take a family member or friend along, if possible. Sometimes it can be difficult to remember all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
- Write down questions to ask your doctor.
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For supraventricular tachycardia, some basic questions to ask your doctor include:
- What's the most likely cause of my symptoms?
- Are there other possible causes for my symptoms?
- What kinds of tests will I need? Do I need to do anything to prepare for these tests?
- What's the most appropriate treatment?
- Are there any foods or drinks that you recommend I avoid? Is there anything you suggest that I add to my diet?
- What's an appropriate level of physical activity?
- How often should I be screened for heart disease or other complications of supraventricular tachycardia?
- I have other health conditions. How can I best manage these conditions together?
- Is there a generic alternative to the medicine you're prescribing?
- Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask:
- When did you first begin experiencing symptoms?
- Have your symptoms been continuous, or do they come and go?
- How severe are your symptoms?
- Does anything seem to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
- Is there a family history of arrhythmia?
Nov. 13, 2019