Paroxysmal supraventricular tachycardia

Paroxysmal supraventricular tachycardia, also referred to as supraventricular tachycardia, is a kind of arrhythmia. Patients with this disease may suffer a sudden increase in heart rate (usually more than 150 beats per minute) under certain conditions and last periods of time (few seconds to hours) and then suddenly return to normal.


What causes supraventricular tachycardia? There are two main causes of supraventricular tachycardia: one is the existence of a muscle bundle (usually no thicker than a human hair) between the atrium and ventricle. This extra muscle, as an extra wire was to cause a short circuit, we call it the atrioventricular bypass, or the bypass. Although congenital with the bypass, the majority of these people without a tachycardia, only a small part of people can find evidence of the existence of bypass while accepting electrocardiogram tests, known as pre-excitation syndrome. In the second condition, two different paths present in the region of the atrioventricular node and form the atrioventricular node double path. This kind of circumstance often is in middle age or more later, mostly with acquired aging concern, also have part of the congenital factor.


Whether with an atrioventricular bypass or an atrioventricular junction dual pathway, patients may not have an episode of tachycardia for many years or only one episode for a long time. This is mainly because the bypass or double path is only a condition; this disease also needs a critical incentive - premature beat! Both atrial and ventricular premature beats may cause supraventricular tachycardia. Premature beats also correlated to aging concern. This is the main reason why supraventricular episodes become more frequent in many patients as they age increase.


In general, supraventricular tachycardia is a benign disease that does not result in death but may affect the patient's quality of life. Supraventricular tachycardia can be troublesome in the case of weakness, cardiac dysfunction, or pregnancy.


During the onset of the disease, patients can stop it by holding their breath, stimulating the throat with fingers, causing retching, and jumping. Eye compressions and neck massages are also useful to terminate the supraventricular tachycardia, but they can lead to retinal detachment or even syncope if not done correctly.


When feeling the sudden fast heartbeat, one should count pulse or heartbeat by themself, at the same time to do electrocardiogram as soon as possible in nearby hospital, which can help to diagnose. If it turns out to be supraventricular tachycardia, the doctor will usually give you an injection to stop it. Occasionally, esophageal stimulation is also used to terminate it.


The medicine can only temporarily control supraventricular tachycardia. To eradicate the disease, catheter ablation is necessary.


Many patients with supraventricular tachycardia are worried about their ablation, and even some doctors say it is complicated, but this concern is entirely unnecessary. Ablation for supraventricular tachycardia is an easy procedure for all physicians engaged in electrophysiology. Most of the tertiary hospitals can perform it. Most of the supraventricular tachycardia is relatively easy to treat, and only a few cases that are particularly close to the atrioventricular node or fascicles are at risk, but these patients are rare.


This operation was performed with local anesthesia, and doctors only need puncture veins from neck, chest, and thighs several times and placement the catheters. After confirming the bypass or atrioventricular junction dual pathway, then RF or frozen energy is delivered to produce reliable lesions. The success rate is generally above 95%, even is close to 100% in the high-level specialized hospitals. Most experienced physicians can perform ablation safely and successfully, even if the bypass or double path is close to the atrioventricular node. Only a minimal number of right epicardial bypasses may fail, and the left epicardial bypasses are more likely to succeed. Very few patients may need ablation twice for special reasons, but this is rare.


For supraventricular tachycardia ablation, the difference between doctors has mainly reflected in the duration time of the procedure and the severity of the patients' pain. The average doctor may take 2-3 hours or more to complete a supraventricular tachycardia ablation, while a high-level doctor usually only needs the patient to lie on the operating table for 30 minutes to an hour. Fuwai hospital is one of the largest EP center, Prof. Yao Yan, the director of the EP team in WardⅠ, initially performed the ablation strategy with three-dimension model and unilateral femoral vein method. The whole operation entirely through the side femoral vein, so there is no need to perform punctures from the neck, chest, and also no need to puncture arteries, which reduce the suffering of patients significantly. The patient can be discharged from the hospital on the same day or the next day after operation. In addition, Our team present "full three-dimensional electrophysiology" firsty in the world. During the operation, the exposure of X-ray is extremely small, which is especially meaningful for children, women and patients at high risk of tumors. The cost of this ablation is generally between  ¥20,000 and  ¥30,000.