What's the treatment for supraventricular tachycardia?
Treatment of supraventricular tachycardia depends on its type and cause. When supraventricular tachycardias occur suddenly and cause symptoms, vagal maneuvers, such as coughing or the Valsalva maneuver, may be tried first, in an effort to slow the heart rate. If the symptoms continue and are severe, your health care provider might give you a fast-acting antiarrhythmic medication through a vein. If the arrhythmia does not stop and symptoms are severe, electrical cardioversion
(defibrillation) may be needed.
In many cases the symptoms of SVT stop quickly, and no treatment is needed. Attempts to stop SVT by any means should only be carried out after an ECG has been performed in hospital. If symptoms last for long or are severe, medicines can be injected into a vein. These block the electrical impulses in the heart. Intravenous adenosine is the treatment of choice, with intravenous verapamil usually given when this is contraindicated, for example in asthma patients. Treatment for supraventricular tachycardia focuses on decreasing your heart rate and breaking up the electrical circuits made by the abnormal conducting pathways. Treatment can be divided into 2 broad categories: halting the acute episode and preventing any new ones. One of the most important considerations in treating an acute episode of supraventricular tachycardia is how severely your heart function has been affected.
Attacks can often be brought to an end by a technique called the Valsalva Manoeuvre. In this, the individual takes a deep breath in and then strains out with the mouth and nose closed off. Those who suffer from palpitation often find that they can prevent attacks by avoiding the items that trigger them or by drug therapy. If the attacks continue to be troublesome, further investigations may be needed. An ECG is required and, because the attacks often occur when no medical personnel are available, it may be necessary to use a portable tape recorder attached to electrodes on the chest, which the individual takes home (24 hour tape). This records the electrical activity during the attacks and the tape can be subsequently analysed. If these tests fail to identify the problem, further tests including a more detailed electrical examination of the heart may be undertaken.
If the attacks are infrequent and of short duration, no treatment may be needed. Drugs are usually effective in preventing tachycardias. Sometimes ablation of the abnormal pathways by a non-surgical method using a catheter passed into the heart from a vein, may be preferable to lifelong medication. Both electrical and radiofrequency currents used for this procedure are extremely safe, but this is currently available in only a few specialist hospital centres at present. This option should first be discussed with your general practitioner or hospital consultant. |
