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Paroxysmal Supraventricular Tachycardia (PSVT)

Last updated May 7, 2018

Approved by: Krish Tangella MD, MBA, FCAP

Paroxysmal supraventricular tachycardia (PSVT) is a heart condition that results in random, uncontrollable episodes of rapid heart rate. During these episodes heart rate can increase to 160-280 (sometime greater) beats per minutes.

What are the other Names for this Condition? (Also known as/Synonyms)

  • Supraventricular Tachycardia (SVT)
  • Wolff-Parkinson-White Syndrome (WPW)
  • Atrial Tachycardia

What is Paroxysmal Supraventricular Tachycardia? (Definition/Background Information)

  • Paroxysmal supraventricular tachycardia (PSVT) is a heart condition that results in random, uncontrollable episodes of rapid heart rate. During these episodes heart rate can increase to 160-280 (sometime greater) beats per minutes.
  • The origin of the abnormal heart rate can be from any heart tissue other than the ventricles or lower chambers of the heart.
  • There are two different forms of PSVT:
    • AV node reentrant taachycardia (AVNRT): an electrical short circuit forms between the AV node and the ventricle
    • Wolff-Parkinson-White Syndrome (WPW): extra accessory pathway is present that connects bottom and top chambers of the heart

Who gets Paroxysmal Supraventricular Tachycardia? (Age and Sex Distribution)

  • Males and females in their 20s and 30s are most susceptible to developing PSVT, although it can occur in people of all ages.
  • Females are more commonly affected than men.
  • No racial, geographical or ethnic predilection is noted.

What are the Risk Factors for Paroxysmal Supraventricular Tachycardia? (Predisposing Factors)

Common risk factors of paroxysmal supraventricular tachycardia include:

  • Stress and Anxiety
  • Physical fatigue
  • Hyperactive thyroid gland (Primary Hyperthyroidism and Secondary Hyperthyroidism)
  • Excessive caffeine use
  • Excessive alcohol use
  • Smoking
  • Low potassium (Hypokalemia) and low magnesium (hypomagnesemia) levels in the blood

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Paroxysmal Supraventricular Tachycardia? (Etiology)

  • Paroxysmal supraventricular tachycardia (PSVT) can be caused by many different heart defects.
  • In a normally structured heart, the atrioventricular (AV) node connects the upper chambers of the heart to the bottom chambers. In individuals with AVNRT, an electrical short circuit is formed in this connection. This leads to extra impulses going through the circuit, leading to a higher than normal heart rate.
  • If there are multiple pathways that connect the top and bottom chambers, the heart can beat too soon or too quickly, leading to PSVT. This is commonly seen in individuals with Wolf Parkinson White syndrome (WPW). 

What are the Signs and Symptoms of Paroxysmal Supraventricular Tachycardia?

Common signs and symptoms of Paroxysmal supraventricular tachycardia (PSVT) include:

  • Racing heartbeat
  • Abrupt start and stop to abnormal heart rate
  • Shortness of breath, Chest discomfort, Dizziness
  • Anxiety and Fainting

How is Paroxysmal Supraventricular Tachycardia Diagnosed?

Most individuals with Paroxysmal supraventricular tachycardia (PSVT) are first diagnosed when they have their first episode. At this time, a medical professional will conduct a physical examination. If a heart rate over 100 beats per minute is noted, PSVT is suspected.

  • To confirm the diagnosis, a variety of tests can be conducted. These include:
    • Electrocardiogram (EKG/ECG)
    • Holter monitor
    • Cardiac event monitor
    • Electrophysiology (EP) study

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Paroxysmal Supraventricular Tachycardia?

  • Complications may occur in Paroxysmal Supraventicular Tachycardia (PSVT) if other heart disorders are present. These can include heart failure or chest pain (angina). 

How is Paroxysmal Supraventricular Tachycardia Treated?

  • Medical treatment for Paroxysmal Supraventicular Tachycardia (PSVT) is not always necessary as episodes are sporadic and vary in length.
  • Individuals can perform various techniques themselves to try and reduce their heartbeat. These can include:
    • The Valsalva maneuver: holding one’s breath and straining
    • Coughing
    • Submerging the face in ice water for a very short duration ( less than 5 seconds)
  • If episodes are prolonged, emergency medical treatment is also available. Electric shocks may be used to slow the heartbeat. Intravenous medicines may also be administered.
  • If episodes are frequent, long-term treatment is suggested. These options include:
    • Cardiac ablation
    • Daily medications
    • Pacemakers insertions
    • Surgery

How can Paroxysmal Supraventricular Tachycardia be Prevented?

  • It is difficult to prevent Paroxysmal Supraventicular Tachycardia (PSVT) from happening. Individuals should avoid smoking, excessive caffeine or alcohol intake, and illicit drug use as they may increase the risk of PSVT.

What is the Prognosis of Paroxysmal Supraventricular Tachycardia? (Outcomes/Resolutions)

  • Most cases of Paroxysmal Supraventicular Tachycardia (PSVT) are not life threatening. With proper management of symptoms, individuals are able to lead normal lives.

Additional and Relevant Useful Information for Paroxysmal Supraventricular Tachycardia:

The following DoveMed website link is a useful resource for additional information:


What are some Useful Resources for Additional Information?

References and Information Sources used for the Article:

Helpful Peer-Reviewed Medical Articles:

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Sept. 23, 2013
Last updated: May 7, 2018