Supraventricular Arrhythmias: A Patient-Friendly Explanation

Introduction

Supraventricular arrhythmias (SVAs) are abnormal heart rhythms that originate above the ventricles, typically in the atria or the atrioventricular (AV) node. Understanding these conditions is essential as they can affect heart function and overall health.

Causes and Risk Factors

SVAs can be caused by a variety of factors, including:

• Structural heart diseases (e.g., coronary artery disease, heart failure, valve defects)
• Electrical conduction abnormalities
• High blood pressure (hypertension)
• Excessive alcohol or caffeine intake
• Thyroid disorders (hyperthyroidism)
• Electrolyte imbalances
• Genetic predisposition
• Medications, such as stimulants or decongestants

Types of Supraventricular Arrhythmias

1. Atrial Fibrillation (AFib) – The most common SVA, characterized by rapid, irregular heartbeats, which can increase stroke risk.
2. Atrial Flutter – A more organized but still rapid atrial rhythm, typically presenting with “flutter waves” on an ECG.
3. Paroxysmal Supraventricular Tachycardia (PSVT) – A sudden, rapid heart rate that often starts and stops abruptly.
4. Wolff-Parkinson-White (WPW) Syndrome – A condition with an extra electrical pathway in the heart, leading to episodes of tachycardia.
5. Multifocal Atrial Tachycardia (MAT) – A rhythm disorder often found in patients with lung disease, featuring multiple abnormal electrical signals in the atria.

Symptoms

Symptoms of SVAs can vary but often include:

• Palpitations (rapid or irregular heartbeat)
• Dizziness or lightheadedness
• Shortness of breath
• Chest discomfort
• Fatigue
• In severe cases, fainting (syncope)

Diagnosis

Diagnosis typically involves:

• Electrocardiogram (ECG) – A key test to record heart rhythm.
• Holter monitor – A continuous ECG recording over 24–48 hours to catch intermittent arrhythmias.
• Event monitor – Used for longer periods when arrhythmias are infrequent.
• Electrophysiological study (EPS) – Helps detect the source of the arrhythmia.
• Echocardiogram – Evaluates heart function and structure.

Treatment Options

Treatment depends on the type and severity of the arrhythmia:

1. Lifestyle Changes
   • Reducing caffeine and alcohol intake
   • Managing stress
   • Maintaining a healthy weight
2. Medications
   • Beta-blockers (e.g., metoprolol)
   • Calcium channel blockers (e.g., verapamil)
   • Antiarrhythmic drugs (e.g., amiodarone)
   • Anticoagulants (for stroke prevention in AFib patients)
3. Medical Procedures
   • Cardioversion – Electrical or chemical resetting of heart rhythm
   • Catheter Ablation – A procedure to destroy abnormal electrical pathways
   • Pacemaker or ICD (Implantable Cardioverter Defibrillator) – For severe cases

Conclusion

Supraventricular arrhythmias are common but manageable. Proper diagnosis and treatment can reduce symptoms and complications. If you suspect an arrhythmia, consult a cardiologist to determine the best course of action.

Source recommendations

1. American Heart Association Guidelines on Arrhythmias

1. https://www.heart.org/en/health-topics/arrhythmia
2. https://www.ahajournals.org/doi/10.1161/CIR.0000000000001193
3. https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia
4. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000549
5. https://pubmed.ncbi.nlm.nih.gov/29084733/

2. European Society of Cardiology Guidelines for Supraventricular Arrhythmias

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Supraventricular-Tachycardia
2. https://academic.oup.com/eurheartj/article/41/5/655/5556821
3. https://www.ahajournals.org/doi/10.1161/cir.0000000000000311
4. https://pubmed.ncbi.nlm.nih.gov/31504425/
5. https://www.acc.org/Latest-in-Cardiology/ten-points-to-remember/2019/09/10/12/36/2019-ESC-Guidelines-for-Supraventricular-Tachycardia