SVT, supraventricular tachycardia, Atrial tachycardia, paroxysmal atrial tachycardia
Description: This as a quite frightening but usually safe rhythm change in the heart which suddenly starts beating faster than it should. The rate is usually 120 – 160 beats per minute and is regular. It usually starts and stops suddenly. Apart from the racing heart (which feels similar to the heart beating when you have been for a run or have had a fright, some people can feel a bit faint, breathless or can have some chest tightness. Unless there is additional heart disease it usually is quite benign.
Occasionally it can be caused by a bypass pathway in the heart which can be corrected by surgery
What your doctor can do
Investigations
- Confirm what the abnormal rhythm is with an ECG, or a Holter monitor which is an ECG recorder worn for 24 hours to see what the rhythm is.
- To identify any cause for the palpitations: an echocardiogram, blood tests or stress ECG.
- More serious palpitations may require electrophysiological testing where flexible wires are placed in the heart through the veins to localise the origin of the abnormal rhythm
Drugs
- There are a number of drugs used to treat palpitations – beta blockers, calcium blockers (verapamil, diltiazem), adenosine and rarely amiodarone. There are a number of drugs which can try to reduce the number of attacks but many of the more effective ones can have quite severe adverse effects – discuss all of these with your doctor or cardiologist. Drugs you may be asked to take include: beta blockers, flecainide, amiodarone, calcium blockers. It is best to control palpitations without needing to resort to long-term drug therapy if possible.
Procedures
- Cardioversion: an electric shock is used under general anaesthetic, to return the rhythm to normal.
- Electrophysiological therapy: catheters placed in the heart which can ablate (destroy) the bypass tracts which are the cause for the palpitations in some patients.
What you can do :
Lifestyle
- First, make sure you understand what the palpitations mean and if they are serious or just a nuisance. Reassurance can often make them disappear
- Then relax and stop worrying because stress creates adrenaline which makes palpitations much worse.
- Study to see if anything precipitates them such as vigorous exercise, some foods, coffee, cigarettes, severe stress. If you can find a cause, try to avoid it. Occasionally drinking very cold drinks can be a cause.
- Routinely it is best to try stopping alcohol and caffeine ( coffee, tea, sports drinks etc) for a while
Try techniques that may stop the palpitations.
- The supine valsalva manoevre -lie flat (preferably with the feet higher than the heart – ie on a couch with your head on the seat and feet over the arm rest), block the mouth and nose and blow (strain) hard for as long as you can. Then just relax, take deep breaths and the palpitations frequently stop. ), taking deep breaths and lying down.
- The cold dive reflex – take a deep breath and plunge face into a basin of cold water.
- Drinking a glass of ice cold water
- Other techniques sometimes suggested like rubbing the carotid sinus in the neck or rubbing they eyeballs can sometimes damage the arteries or the eyes so don’t try them.
Other
- Palpitations are very common around menopause, and some hormonal treatment may be all that is necessary to control them. (We prefer to recommend bio-identical hormones rather than synthetic HRT).
- Regular gentle exercise can sometimes reduce the incidence of palpitations.
Nutritional supplements
- A good multivitamin/multimineral will make sure that the heart has all the nutrients and minerals it requires.
- Omega 3 fish oils,1–2 grams daily, can have a rhythm-controlling effect, and may also reduce the risk of the more serious rhythm disturbances.
- Magnesium (and calcium). Magnesium is essential to keep the heart rhythm regular, therefore we use 800–1,000mg daily in all our patients with palpitations.
- CoEnzyme Q10 can improve the energy supply to the heart and may help some people with palpitations – try 100mg/day for a few weeks and see if it helps.
- Others – some suggest trying L Carnitine, Hawthorne but I know little evidence that these help, however they are unlikely to do any harm
The Nutritional supplements I use and recommend to my patients
For my patients with SVT I recommend – USANA – Cellsentials *, Biomega, Active Calcium plus, Coquinone –
Other therapies
There are a number of other therapies which you might like to look at. They have not been specifically included with this disease because some are a form of treatment which is applicable to most diseases and many focus on the mind, body, spirit, and the universe. These include - acupuncture, Ayurvedic medicine, energy healing, homeopathy, naturopathy, prayer, visualisation and some people with this condition might like to look at these topics (I have described them more fully on another page on this website click here .) With my personal experience and reading, I do not think that I can comment of whether one or a number of these might help. They fit well with most conventional and complementary treatments and I suspect some or even all of them can be extremely powerful - if performed by an experienced practitioner. My only caveat is that if in the course of one of these therapies, you are given potions or herbs, do check with your health practitioner that they will not interfere with other treatments or drugs you are receiving.Nutritional supplements
I believe in today's world that nutritional supplements are so necessary as to be an essential component of any form of both prevention and treatment. Not only is today's food lacking in nutrients because of the way it was grown and processed, but also most of us make the wrong choices in diet. It is virtually impossible to obtain optimal levels of most of the vitamins, minerals and other nutrients although many people try to do so, and even then fresh produce is not available all year round. *There are many quality supplements available on the market, including –Thorne, NFS, Douglas Labs, Xtend Life, True Star Health, USANA, and Metagenics. There are others, but do your due diligence before choosing one. USANA Health Sciences has added a new adjunct to its multivitamin and multi mineral called CellSentials. These are a patented blend of phyto-nutrients which they believe affects cell signaling and growth, and increases the production of preventative antioxidants within the cell. These should add to the value of the multi, so these are the multivitamin/mineral preparation I recommend.