Supraventricular Tachycardia
Supraventricular tachycardia starts suddenly with a high heart rate, and if you have other heart disorders can lead to angina (chest pain) or heart failure. Rapid heartbeat is called tachycardia, which is called tachyarrhythmia if it is accompanied by an irregular and abnormal heartbeat.
In this article we will talk about one of the types of tachyarrhythmias called supraventricular tachycardia and sometimes it is also called attack supraventricular tachycardia.
What is supraventricular tachycardia?
It is a type of irregularity in the contraction of the heart muscle (arrhythmia) that can be found in the upper part of the ventricles. Supraventricular tachycardia starts and ends suddenly, which is why they are called Supraventricular tachycardia. The heart rate in these attacks is sometimes more than two hundred and fifty beats per minute.
To better understand the cause of this arrhythmia, let's talk briefly about the normal heart rate:
How is a normal heartbeat created?
Our heart is a four-chambered organ separated by walls. The upper two chambers of the heart, where blood enters, are called the atrium (right and left), and the two lower chambers of the heart are called the ventricles (right and left). The right atriums and right ventricles are connected by the tricuspid valve, and the left ventricle and left atrium are connected by the mitral valve, but there is a wall between the two ventricles and the two atria.
In order for the heart to contract efficiently to pump blood, all four chambers must contract regularly and together.
The stimulus for the onset of contraction is an electrical signal emitted from an area of the right atrium called the SA node. This signal stimulates the atria in a special order and the atria contract.
This signal then stops for a while as it travels down the heart to a place called the AV node, and then stimulates the ventricles to contract in a special order.
Now anything that happens to the ventricles that disrupts this order and causes irregular heartbeat or increased heart rate is called supraventricular tachyarrhythmia (like Wolff-Parkinson-White syndrome).
Causes of irregular heartbeat:
Sometimes people are born with abnormalities in the electrical conduction pathway through the heart.
Sometimes people experience this tachyarrhythmia after heart surgery due to the formation of scar-like tissue in the heart.
Sometimes the following factors are involved in the onset of a sudden attack of supraventricular tachycardia:
- smoking
- drug use
- Drinking alcohol
- heavy stress
- Sudden fear
- Some medications:
Like asthma medications
Decongestant
Cocaine and methamphetamines
What are the symptoms of supraventricular tachycardia?
The heart beats more than 100 beats per minute in supraventricular tachycardia, sometimes reaching more than 250 beats per minute.
While the number of normal heart beats per minute is between sixty to one hundred
When the heart rate increases, the heart does not have the opportunity to dilate and blood enters between its contractions, so there is no blood in the heart that enters the body's arteries with successive contractions, which is why in tachycardia (when the heart rate increases more) than 100 per minute) not enough blood will reach the cells of the body and the following symptoms will be caused by supraventricular tachycardia:
- Dizziness
- Light-headedness
- Chest pain
- Fatigue
- Shortness of breath
- Anxiety
- Feeling of excessive and irregular heartbeats
How is supraventricular tachycardia diagnosed?
We said that these tachycardias appear invasively, so one of the things that a cardiologist uses to diagnose supraventricular tachycardia is a 24-hour Holter monitoring, which means that your heart activity is displayed on the monitor overnight.
It is important to obtain an accurate history of the patient before any diagnostic procedure, the following questions should be asked in these cases:
- How symptoms start (gradual or sudden)
- The type of symptoms you have during the attack
- The duration of each attack
- Questions about family history
also:
- Examination and hearing of heart sounds
- Thyroid test
- Blood pressure assessment
Specialized diagnostic procedures include the following:
- monitoring
- ECG
- Electrophysiological studies
Treatment of supraventricular tachycardia
When you have a sudden heart attack, you can use the following treatments to control and stop your rapid heartbeat:
Valsalva maneuver or Vagal maneuver:
Imagine yourself sitting on a toilet bowl, closing your mouth and (pushing???)
- Blow in a bag.
- Sit down and lean forward and cough.
- Apply ice and cold water on your face.
Drug treatment of supraventricular tachycardia:
Sometimes it is not possible to control an arrhythmia with the above treatments. In these cases, we use drugs to restore the normal rhythm of the heart:
Oral antiarrhythmic drugs such as:
Injectable antiarrhythmic drugs that should only be used in a well-equipped hospital, such as:
- Adenosine (adenosine adenocardium??)
- Or verapamil
In the following, we will examine more specialized treatment methods. These methods include:
Cardioversion:
Sometimes the heart with ventricular tachycardia cannot be returned to normal rhythm with vagal maneuvers and medications. In these cases, we shock the heart by placing pedals or pads on the chest. This method is used in emergency patients who do not respond to maneuvers and medications.
Ablation:
Sometimes it is necessary to destroy the foci that produce abnormal signals in the heart. This method, which involves inserting a catheter into the heart cavity through the arteries of your thigh, is called an ablation catheter.
Insert heart pacemaker:
In a small number of patients with supraventricular tachycardia, it is necessary to use a pacemaker. A pacemaker is a small device that is implanted under the skin and when the heart rhythm becomes abnormal, it normalizes the heart rhythm by releasing an electric pulse.
In addition to the above methods, sometimes a defibrillator implant (cardioverter) and surgery are required
Cardioverter:
If the patient is at risk of recurrent life-threatening attacks of supraventricular tachycardia, using Implantable cardioverter defibrillator or an ICD is required. The device is implanted in the chest during surgery and returns it to normal as soon as the heart rhythm becomes abnormal.
How to prevent supraventricular heart failure?
Have a healthy lifestyle:
- Exercise and physical activity as part of your daily routine.
- Eat healthy foods and avoid sweets, prepared foods, processed meats and fast foods.
- Fill your diet with fruits, cereals and vegetables.
- Stop smoking.
- Avoid excessive alcohol consumption.
- Stop using recreational drugs including cocaine, marijuana and amphetamines.
- Limit your caffeine intake.
- Control your high blood pressure, hyperlipidemia and diabetes by seeing your doctor regularly.
- Do not get fat
- Control your stress
- Have a regular check-in schedule