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Paroxysmal Supraventricular Tachycardia
(PSVT)

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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Daniel Lee Kulick, MD, FACC, FSCAI

Daniel Lee Kulick, MD, FACC, FSCAI

Dr. Kulick received his undergraduate and medical degrees from the University of Southern California, School of Medicine. He performed his residency in internal medicine at the Harbor-University of California Los Angeles Medical Center and a fellowship in the section of cardiology at the Los Angeles County-University of Southern California Medical Center. He is board certified in Internal Medicine and Cardiology.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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What is paroxysmal supraventricular tachycardia (PSVT)?

Normally, an electrical signal is generated in special pacemaker cells in the upper chamber (atrium) of the heart. This impulse causes the atrium to beat in a coordinated fashion and push blood into the ventricles (the lower heart chambers). The electrical signal continues to a junction box between the atrium and ventricle (the AV node), where there is a slight delay. This allows the atrium to contract and send blood to the ventricle. The signal continues throughout the ventricles and causing them to beat and push blood to the body.

In paroxysmal supraventricular tachycardia (PSVT), abnormal conduction of that electricity causes the atrium, and secondarily the ventricles, to beat very rapidly. It is paroxysmal, because the rapid rate can occur sporadically and without warning. It may last a few seconds or many hours. Often the PSVT resolves before the patient reaches a healthcare provider. The abnormal conduction pathways may occur anywhere in the atrium or around the AV node.

PSVT was once also called paroxysmal atrial tachycardia or PAT. As more has been learned about the electrical wiring of the heart, terminology has changed, and the term PAT is more often reserved for a specific type of circular electrical conduction pattern occurring in the true atrial tissue, and not the AV node.

Regardless of the terminology, the rhythm disturbance occurs in the AV node, or in the atrium above, and should not be confused with ventricular tachycardia, which arises from the ventricle and is life-threatening.

What are the symptoms of paroxysmal supraventricular tachycardia (PSVT)?

PSVT often presents with the complaints of palpitations described as a rapid heart rate often felt in the throat and may be associated with:

• lightheadedness,
  
  
• weakness,
  
  
• shortness of breath, and
  
  
• chest pressure.