Paroxysmal Supraventricular Tachycardia: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Paroxysmal Supraventricular Tachycardia?
A cardiologist, a doctor who treats heart conditions, usually treats paroxysmal supraventricular tachycardia (PSVT). A primary care doctor can do the first checks and refer you. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is paroxysmal supraventricular tachycardia?
Paroxysmal supraventricular tachycardia (PSVT) is an episode of a rapid heart rate. It starts in a part of the heart above the ventricles, which are the lower chambers. "Paroxysmal" means from time to time. A normal resting heart rate is 60 to 100 beats per minute. With this condition, the heart rate suddenly goes above 100. Between episodes, the heart rate is normal. The NHS says it is not usually serious, but some people may need treatment.
Symptoms
Symptoms most often start and stop suddenly. They can last for a few minutes or several hours. Symptoms may include:
- Palpitations, which is the feeling of your heartbeat, often fast or racing.
- A rapid pulse.
- Chest tightness.
- Shortness of breath.
- Anxiety.
- Dizziness or fainting.
- Feeling weak or tired.
Some people have no other symptoms besides the fast heartbeat.
Causes and who gets it
PSVT happens when the electrical system that controls the heart rhythm is not working properly. It can happen at any age. It often starts for the first time in children and young adults. It can also occur with Wolff-Parkinson-White syndrome, which often causes symptoms in young people and infants. Too high a dose of the heart medicine digoxin can also be a cause.
Alcohol, caffeine, illicit stimulant drugs, and smoking raise your risk. Episodes can be triggered by caffeine, alcohol, or drugs, but often there is no obvious trigger.
How doctors diagnose it
An electrocardiogram (ECG) taken during symptoms shows PSVT. An ECG records the heart's electrical signals. An electrophysiology study (EPS) may be needed for an accurate diagnosis and to find the best treatment. Because PSVT comes and goes, you may need to wear a 24-hour Holter monitor. This is a small device that records your heart rhythm. For longer periods, another type of rhythm recording device may be used.
Treatment
PSVT that happens only once in a while may not need treatment if you have no symptoms or other heart problems. You can try these techniques to interrupt a fast heartbeat during an episode:
- The Valsalva maneuver, which means holding your breath and straining, as if you were trying to have a bowel movement.
- Coughing while sitting with your upper body bent forward.
- Splashing ice water on your face.
Emergency treatment to slow the heartbeat back to normal may include an electric shock, called cardioversion, or medicines through a vein. People with repeat episodes may need cardiac ablation. This procedure destroys small areas in the heart that may be causing the rapid heartbeat. Ablation is currently the treatment of choice for most PSVTs. Daily medicines to prevent repeat episodes are another option. You should avoid smoking, caffeine, alcohol, and illicit drugs.
When to see a doctor
Call 911 or go to the emergency room if you have a fast heartbeat with shortness of breath, chest pain, or feeling faint. Also call if you have been diagnosed with PSVT and an episode lasts longer than usual.
See a doctor if you keep getting a fast heartbeat. It is important to get it checked out. Contact your provider if symptoms return often or new symptoms develop. This matters most if you also have other heart problems.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can record your symptoms, arrange a first heart tracing or monitor, and help you reach a cardiologist. This doctor can also help you track triggers like caffeine over time.
Common questions
Is paroxysmal supraventricular tachycardia dangerous?
Usually not. PSVT is generally not life threatening. If other heart disorders are present, it can lead to congestive heart failure or angina.
Can I stop a PSVT episode myself?
Sometimes, yes. You can try the Valsalva maneuver, coughing while sitting with your upper body bent forward, or splashing ice water on your face. If you have chest pain, shortness of breath, or feel faint with a fast heartbeat, call 911.
Does PSVT always need treatment?
No. PSVT that happens only once in a while may not need treatment if you have no symptoms or other heart problems.
Can caffeine or alcohol trigger PSVT?
Yes. Caffeine and alcohol can trigger episodes, and they raise your risk of PSVT.
Can catheter ablation cure PSVT?
In most people, yes. The NHS says catheter ablation permanently cures the problem in most people. Thin tubes are placed through a vein or artery into the heart, and heat or freezing is used to correct the electrical problem.
Sources
- MedlinePlus - Paroxysmal supraventricular tachycardia (PSVT)
- MedlinePlus - Arrhythmia
- NHS - Supraventricular tachycardia (SVT)
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
