Causes, symptoms and treatment of supraventricular tachycardia

A common heart rhythm disorderthe name supraventricular tachycardia. As a rule, it is presented with repeated episodes of increasing frequency of heartbeat and severity in the area of ​​the organ. Although CBT is usually not life threatening, many patients suffer from recurring symptoms that have a significant impact on their quality of life. The vague and sporadic nature of episodes of tachycardia can cause considerable anxiety in many individuals.

Suddenly, a fast heartbeat is characterized by CBT,and in most patients the diagnosis can be made with a high degree of certainty only on the history of the disease. Multiple attempts at electrocardiographic studies may be useless.

The incidence of CBT is about 35 cases per100 000 population per year, the prevalence is 2.25 per 1,000 inhabitants. Usually manifested as a repeated paroxysm of supraventricular tachycardia, the symptoms of which lead to an acute course of the disease. The main types of SVT: Wolff-Parkinson-White syndrome, supraventricular, or supraventricular extrasystole, tachycardia atrioventricular nodal rientry.

How does the heart work?

The vital organ consists of four chambers -two atria and two ventricles. Each heartbeat begins with tiny electrical impulses produced in the sinoatrial node. He is a pacemaker in the upper part of the right atrium. The electrical impulse spreads through the heart muscle, causing it to work. Initially, it moves along the atria, passing into the atrioventricular node, which acts as a distributor. Then it passes through the atrioventricular bundle, acting as a conductor, giving impulses to the ventricles. In turn, the ventricles begin to pump blood into the arteries.

What is supraventricular tachycardia, and what are the causes of its occurrence?

This disease means fast heartbeatabove the ventricle, not controlled by the sinoatrial node. Another part of the heart blocks electrical impulses in the pacemaker. The source begins above the ventricles, extending to them. In most cases, CBT begins in early adulthood. Supraventricular tachycardia of children is also common. However, it can occur at any age. This is a rare disease, but the exact number of victims is unknown.

Supraventricular supraventricular tachycardia is caused by the following reasons:

• Medicines. These include some inhalers, herbal supplements and cold remedies.
• Drinking lots of caffeine and alcohol.
• Stress or emotional upset.
• Smoking.

Atrioventricular and atrial type of CBT. Wolff-Parkinson-White syndrome

AVURT is the most common typesupraventricular tachycardia. Most often observed in people over 20 years and in women who are over 30. Occurs when there is a shortage of electrical impulse in the heart center. Often manifested in completely healthy individuals. Instead of subsequent normal activation and impulse delivery, the synotrial node starts an additional current around this short circuit. This means that the heart rate will rise rapidly, and then all symptoms of CBT will manifest.

Atrial tachycardia is less thancommon type. It occurs in a small area of ​​tissue, anywhere in both atria of the heart. In most cases, the causes are unknown. However, it can occur in those areas where the myocardial infarction was previously transferred, or there are problems with the heart valve. Wolff-Parkinson-White syndrome develops very quickly. There are symptoms of dizziness, loss of consciousness is possible. Sudden death is a complication of this condition, but this phenomenon is extremely rare.

Clinical manifestations

Symptoms of supraventricular tachycardia can last several seconds, minutes or even hours.

The following manifestations are possible:

• The pulse becomes 140-200 beats per minute.
• Sometimes it can be faster.
• Sensation of heart pounding.
• Dizziness, shortness of breath.

SVT usually starts suddenly, without visiblereasons. Paroxysmal supraventricular tachycardia is manifested by pulsation in the neck or head region, and can also be accompanied by chest discomfort (unusual pains), shortness of breath, anxiety. Often lowers blood pressure due to rapid heart rate, especially if it persists for several hours. In some cases, this leads to fainting or collapse.

The severity of symptoms is strongvaries depending on the function and frequency of contractions, the duration of supraventricular tachycardia, concomitant heart disease. Individual perception of the patient also matters. Myocardial ischemia may occur.

Diagnosis of the disease

There are several ways to diagnose thisdiseases like supraventricular tachycardia: ECG, echocardiogram, cardiac testing with exercise. In many cases, the results of the study are usually normal.

An electrocardiograph examines the rhythm and electricalactivity of the organ. This is a painless procedure and takes a few minutes. If paroxysmal supraventricular tachycardia occurred during ECG, the device can confirm the diagnosis and thereby exclude other causes of rapid heartbeat.

Since it is not always possible to diagnose the presence ofdiseases in hospital conditions, the patient is recommended to try to identify the disease with a portable electrocardiograph. He will record in memory all the processes that take place with the heart within 24 hours. During the procedure, you can not swim.

You may need to useechocardiograms. It is necessary for assessing the cardiac structure and function, but usually the results are within the norm. It will also be necessary to perform some exercises necessary to determine when the tachycardia occurs (during exercise or in a calm state). Patients may complain of chest pain during CBT. These symptoms do not require a stress test or angiography. The decision on further testing should be based on the patient's history and the presence of vascular risk factors.

Existing therapy options

Most signs of CBT cease themselvesyourself, no treatment is required. Sometimes you manage to stop the symptoms with the help of various measures, including drinking cold water, holding your breath or putting your face in cold water. However, if SVT lasts a long time with strongly pronounced symptoms, it is necessary to immediately go to the hospital.

There are several ways to manage tachycardia:

• Short term.
• Long-term.
• Pharmacological.

Each of them is considered separately below.

Short-term disease management

The purpose of such treatment is the cessation of acuteattacks. This can be achieved by maneuvering, which increases tone. For example, you can apply a cold stimulus on your face. Also, with a disease such as the supraventricular form of paroxysmal tachycardia, you can do a carotid sine massage.

If such actions do not help, it is recommended to take one of these medicines:

• "Adenosine." He very quickly removes symptoms by blocking electrical impulses in the heart, but the downside is that the duration of its action is small. In rare cases, it can aggravate bronchospasm, cause atypical discomfort in the chest.
• "Verapamil", "Diltiazem". The drugs are administered intravenously for 2-3 minutes. They carry the risk of potentiating hypotension and bradycardia.

Long-term management of the disease

How is paroxysmal supraventricular tachycardia eliminated? Treatment is individualized depending on the frequency, severity of episodes and the effect of symptoms on quality of life.

The drugs are prescribed for patients who:

• Periodic symptomatic episodes of CBT, affecting the quality of life.
• Symptoms were detected using an ECG.
• Rare episodes of SVT, but the patient's professional activity can lead to the development of ailment.

Radiofrequency catheter ablation is recommendedfor most of these patients. It has a small risk of complications and is curative in most cases. The procedure, as a rule, takes 1.5 hours, can be performed under local anesthesia with sedation or under general anesthesia. Patients usually stay in the hospital at night for cardiomonitoring and monitoring.

Pharmacological management of the disease

The goal of pharmacotherapy is to reduce the incidence of episodesSVT. Only a small proportion of patients can get rid of the symptoms of such a disease as supraventricular tachycardia. Treatment includes the following recommended drugs:

• atrioventricular nodal blocking drugs;
• antiarrhythmic drugs I and III class.

Beta-blockers and calcium blockerschannels (class II and IV) are not suitable for the first line of treatment for Wolff-Parkinson-White syndrome. Randomized trials did not show the clinical superiority of any single agent. But beta-blockers and calcium channel blockers are superior to Digoxin therapy, since they provide a better blocking effect in AVURT in a state of high tonus of the sympathetic nervous system. They should not be used in patients with TPH syndrome, as this can facilitate rapid conduction through additional pathways in atrial fibrillation, which can lead to ventricular fibrillation.

Treatment of patients with Wolff-Parkinson-White syndrome

For patients with VPU syndrome, there is an alternative to the above medicines. For the treatment of such a disease recommend:

• "Flecainide."
• "Sotalol" (II and III class of action).

They are more effective than beta-blockers andcalcium channel blockers in terms of preventing SVT, but are associated with a small risk of developing ventricular tachycardia. This risk is small in patients without structural heart disease, but complications occur in 1-3% of patients taking Sotalol, especially those who use high doses.

"Amiodarone" has no role in the long-termprevention of SVT in both Wolff-Parkinson-White syndrome and other types because of the high frequency of serious toxic effects on the body with prolonged use.

Prevention of SVT episodes

You can take medication daily toprevent episodes of CBT. Various drugs can affect electrical impulses in the heart. If any remedy does not help or causes side effects, ask your doctor for help. He will advise what medicine is needed in your case.

You must inform the relevant authoritiesand stop driving behind the wheel of the car if there is a possibility of the appearance of signs of the disease while driving. Do not take medications for the prevention of SVT, it can aggravate the situation and cause other problems with the heart. The best prevention is the daily workload of the cardiovascular system with the help of physical exercises.