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Supraventricular Tachycardia

Supraventricular tachycardia (SVT) is a group of rapid heart rhythms starting above the ventricles. Many re-entry episodes begin and stop abruptly, but not every fast pulse is SVT.

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Key takeaways

  • A rapid regular heartbeat may accompany pounding in the neck, light-headedness, breathlessness or chest discomfort.
  • ECG during symptoms is the best way to classify the rhythm and distinguish it from sinus tachycardia, atrial flutter or ventricular rhythm.
  • Acute treatment and recurrence prevention depend on rhythm mechanism, stability, heart disease and patient preference.

Catalogue matches do not confirm SVT or indicate that an AV-node medicine is safe during an episode.

What can trigger or mimic SVT?

Episodes may occur without a trigger, while stimulants, thyroid disease, fever, anaemia and dehydration can cause or worsen a fast pulse. The abrupt pattern and rhythm tracing are more informative than a fixed rate threshold.

How can episodes be managed?

Clinician-taught vagal manoeuvres may help selected stable re-entry SVT. Verapamil has specific acute or preventive roles but can be dangerous with low blood pressure, some heart failure or uncertain broad-complex rhythms. Catheter ablation may offer definitive treatment for recurrent symptomatic SVT.

When to seek urgent care

Seek emergency care for a rapid heartbeat with fainting, severe chest pain, marked breathlessness, confusion or ongoing deterioration. A first sustained episode also needs prompt rhythm assessment.