Palpitations are a subjective feeling in which people feel their heart is pounding really fast, along with some accompanying discomfort. These palpitations can appear for many reasons and can be supported by ECG findings as arrhythmias, or they can be a result of an entirely subjective representation of normal heartbeats.
The most common cause of this phenomenon is Paroxysmal Supraventricular Tachycardia (PSVT) which will be further discussed here.
What Is PSVT?
PSVT is an arrhythmia which consists of episodes of rapid heart rate originating in a portion of the heart above the ventricles. It can produce a heart rhythm of 120-250 beats per minute, which manifests as an unpleasant feeling combined with anxiety, shortness of breath, dizziness, and chest pain or tightness.
These symptoms usually start suddenly and last for several minutes, but they can go on for up to several hours as well. After that, the symptoms usually disappear the way they started: suddenly. PSVT episodes can be provoked by excess caffeine use, energy drinks, drug use, smoking, and alcohol. PSVT can appear at any age, but it usually affects young, otherwise healthy persons.
How Is PSVT Diagnosed?
Except during an episode of PSVT, the person has no symptoms and there are no tests that can diagnose arrhythmia. ECG findings are completely normal, as well as all the other functional tests of the heart. If the patient is examined during the episode, the diagnosis will certainly be made, given that ECG findings are very specific. In most cases, however, the episode of PSVT will pass before getting to the doctor's office. Therefore, if PSVT is suspected, it needs to be evaluated in the form of the patient wearing a 24-hour Holter monitor. This special monitor will record ECG continuously for 24 hours in order to catch the PSVT episode.
Treatment Of PSVT
The frequency of PSVT episodes and the severity of symptoms determine whether any treatment is necessary. If PSVT occurs rarely and a person does not suffer from other heart-related conditions, treatment might not be needed at all. In these cases, only lifestyle changes are suggested. Those come in the form of avoiding caffeine, smoking, alcohol, and energy drinks.
Medications that regulate heart rhythm (antiarrhythmics) can be used for mild cases, and cardiac ablation is recommended as a permanent solution in many patients with severe problems. During cardiac ablation, small scars are made using a catheter in the parts of the heart muscle that are overactive. In some patients who do not respond to any treatment, a pacemaker is placed to replace the PSVT rhythm.
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