Paroxysmal Tachycardia: Causes, Treatment, and Management Tips

Pulse frequency syndrome

My mother is 61 years old.
In August 1989, February 1991, and June 1991, she experienced episodes of heart rate exceeding 180 beats per minute.
During these episodes, she had polyuria and felt as if the surrounding environment was shaking like an earthquake.
During the most recent episode, the physician administered Adenosine (Adenocor 6mg/2ml) twice, which resulted in immediate improvement.
However, the dosage in February 1991 was half of this amount.
I would like to ask the physician if this medication has any side effects.
During the first episode, the doctor mentioned it was "just a panic attack" and that the injection could help.
During the second episode, another physician suggested a "burning" method that could provide a permanent solution, but it carries high risks.
The third physician stated that increasing the dosage each time is very dangerous, and that the likelihood of recurrence increases with age.
I would like to ask the physician: 1.
Can this condition be controlled with medication? 2.
What precautions should be taken in daily life? 3.
What are the causes of this condition? Thank you for your response! I greatly appreciate it.

Qiuqiu, 30~39 year old female. Ask Date: 2002/06/13

Dr. Zhong Yuxun reply Cardiology

Dear Miss Qiu,
From your letter, I understand that your mother is diagnosed with Paroxysmal Supraventricular Tachycardia (PSVT).
The mechanism of this condition involves an additional electrical conduction pathway in the heart, which conducts impulses at a much faster rate than normal heartbeats, reaching 180 to 250 beats per minute.
The exact cause of this condition remains unclear; it may be congenital but is not hereditary.

During acute episodes, Adenosine (Adenocard) is the first-line treatment administered intravenously.
For prevention of episodes, oral medications can be used regularly.
If the frequency of episodes is high, catheter ablation may be considered to eliminate the condition through radiofrequency ablation.
Most major medical centers in the country are equipped to perform this procedure, which has a success rate of up to 95% and a low risk of approximately 0.1%.
The occurrence of this condition is not directly related to daily activities; however, it is advisable to avoid stimulants and strenuous work.
Most importantly, regular follow-up with a cardiologist is essential for ongoing management and treatment.

Reply Date: 2002/06/13

More Info

Paroxysmal tachycardia (PT) is a condition characterized by episodes of rapid heart rate, typically exceeding 100 beats per minute, that can occur suddenly and may last for a few seconds to several hours. Understanding the causes, treatment options, and management strategies for this condition is crucial, especially for individuals like your mother, who has experienced multiple episodes.

Causes of Paroxysmal Tachycardia
Paroxysmal tachycardia can arise from various underlying factors, including:
1. Electrical Abnormalities: The heart has an electrical conduction system that controls heartbeats. Abnormalities in this system can lead to episodes of tachycardia. Conditions such as atrial fibrillation, atrial flutter, or reentrant circuits can trigger these episodes.

2. Structural Heart Disease: Conditions like coronary artery disease, heart valve disorders, or cardiomyopathy can predispose individuals to tachycardia.

3. Electrolyte Imbalances: Abnormal levels of potassium, magnesium, or calcium can affect heart rhythm.

4. Stimulants: Caffeine, nicotine, and certain medications can provoke episodes of tachycardia.

5. Stress and Anxiety: Emotional stress or anxiety can lead to increased heart rate and trigger episodes.

6. Hormonal Changes: Conditions such as hyperthyroidism can also lead to increased heart rates.

Treatment Options
The treatment for paroxysmal tachycardia typically involves both acute management during episodes and long-term strategies to prevent recurrence:
1. Acute Management: As you mentioned, your mother was treated with Adenosine (Adenocor), which is commonly used to terminate certain types of tachycardia. Adenosine works by temporarily blocking the electrical conduction through the atrioventricular (AV) node, allowing the heart to reset its rhythm. While generally safe, it can cause side effects such as flushing, shortness of breath, or chest discomfort. The dosage may vary based on the severity of the episode and the physician's discretion.

2. Medications for Long-term Control: Beta-blockers, calcium channel blockers, or antiarrhythmic medications may be prescribed to help manage heart rate and prevent future episodes. The choice of medication depends on the specific type of tachycardia and the patient's overall health.

3. Catheter Ablation: For patients with recurrent episodes that are difficult to control with medication, catheter ablation may be considered. This procedure involves destroying the small areas of heart tissue that are causing the abnormal electrical signals. While effective, it carries risks and is typically reserved for more severe cases.

Lifestyle Management
In addition to medical treatment, lifestyle modifications can play a significant role in managing paroxysmal tachycardia:
1. Avoid Stimulants: Reducing or eliminating caffeine, nicotine, and certain medications that can provoke tachycardia is advisable.

2. Stay Hydrated: Dehydration can lead to electrolyte imbalances, which may trigger episodes.

3. Stress Management: Techniques such as yoga, meditation, or deep-breathing exercises can help manage stress and anxiety, potentially reducing the frequency of episodes.

4. Regular Check-ups: Regular follow-ups with a healthcare provider are essential to monitor heart health and adjust treatment as necessary.

5. Educate and Prepare: Understanding the condition and recognizing the signs of an impending episode can empower your mother to seek timely medical attention.

Conclusion
Paroxysmal tachycardia can be managed effectively with a combination of acute treatment, long-term medication, and lifestyle adjustments. It is essential for your mother to work closely with her healthcare provider to develop a personalized management plan that addresses her specific needs and concerns. Regular monitoring and open communication with her doctor will help ensure that her condition is well-managed and that she can maintain a good quality of life. If her symptoms persist or worsen, further evaluation, including potential electrophysiological studies, may be warranted to explore more definitive treatment options.

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