Heart palpitations (due to paroxysmal atrial tachycardia)

Even healthy people’s hearts sometimes beat very fast when they are exercising or under stress – this is perfectly normal. It is called “heart palpitations” or “rapid heartbeat” (tachycardia) when the heart beats more than 100 times per minute due to an illness.

In this article we provide information about heart palpitations due to paroxysmal atrial tachycardia (paroxysmal supraventricular tachycardia). With this condition, the heart suddenly beats very fast. The heartbeat is too fast, but it remains regular. The heart palpitations usually settle on their own after a while. This form of arrhythmia does not usually have any serious complications.

But there are other, more threatening conditions that can cause heart palpitations, including atrial fibrillation. In such cases, the heartbeat is also irregular.

If the heart suddenly beats very fast, it can often be felt as a racing heart (tachycardia) or palpitations. The heart rate is usually between 180 and 200 beats per minute. But it can also be slightly below or above that. This can be alarming and uncomfortable. Possible symptoms are dizziness, nausea, chest pain, and shortness of breath. People may faint (syncope) and fall as a result but this is less common. Some people have to pass a lot of urine after an episode.

For a healthy person, how often the heart beats depends on their physical and psychological stress levels. Exercise, stress or nervousness make the heart beat faster, for example. The sinus mode in the right atrium controls how the heart rate adapts to the stress. When the heart rate rises as a result of climbing the stairs or stage fright, for example, it is called sinus tachycardia.

With paroxysmal atrial tachycardia, the cause of rapid heart is usually a disruption of the AV node. This is located between the atria and ventricles. If the AV node is working normally, it conducts impulses from the atria to the ventricles.

But two areas of tissue can form in the AV node, between which an impulse circles back and forth. The AV node then transmits too many impulses to the ventricles. This means that the heart beats very fast. Fast defective impulses can also cause this. They develop in the atria and trigger a heartbeat that is too rapid.

An extrasystole can trigger paroxysmal atrial tachycardia. This is a heartbeat that occurs outside the normal rhythm. Extrasystoles also occur in healthy people every now and then spontaneously and do not causes any symptoms.

Paroxysmal atrial tachycardia is relatively common, mainly affecting younger adults, and it is more common in women than in men.

Usually an episode comes on suddenly, lasts for a few minutes and disappears just as suddenly as it came. But with some people, tachycardia can last for more than an hour.

The time between episodes can vary – some people have several episodes a day, while others have episodes days, weeks or months apart.

The typical symptoms and how they develop usually already indicate paroxysmal atrial tachycardia. But an electrocardiogram (ECG) is needed to make a clear diagnosis, as with all arrhythmias. However, diagnosis can be more complex, since an episode will not necessarily occur when the ECG device is connected. This is why a 24-hour ECG is often performed.

Other tests can be done to determine the exact causes and rule out more serious arrhythmias – for instance, a heart ultrasound (echocardiography) or a thyroid test. A special heart catheterization can be used to examine whether there are innate additional conduction pathways between the atria and the ventricles.

To treat heart palpitations due to paroxysmal atrial tachycardia, doctors need to rule out serious arrhythmias beforehand. These would require different treatments.

People who are otherwise healthy and for whom an occasional rapid heartbeat is not a problem do not usually need any treatment.

There are also simple things people can do to end an episode themselves. It can help, for example, to drink a glass of cold water quickly or hold their nose, close their mouth and force air through for a few seconds.

These measures are also the first to be used in medical practices or hospitals. Medication is only injected when these do not work. It’s rare for an episode to have to be ended by an electric shock (cardioversion).

If the episodes are very stressful for those affected, there is the option of permanently suppressing them. Medication or cardiac catheterization are an option for this.

For more detailed information, such as how to treat rapid heartbeat, visit gesundheitsinformation.de.