Supraventricular Tachycardia (SVT)

Supraventricular Tachycardia (SVT)

SVT Symptoms? Expert Help from Dr Afzal Sohaib

Are you experiencing episodes of rapid heartbeats that leave you feeling anxious and breathless? You might be dealing with supraventricular tachycardia (SVT), a condition that affects roughly 1 in 400 people and can significantly impact your quality of life. The encouraging news is that SVT is highly treatable, and with specialist care, the vast majority of patients can return to completely normal lives.

Dr Afzal Sohaib: Consultant Cardiologist in London

I'm Dr Afzal Sohaib, a consultant cardiologist specialising in heart rhythm disorders at leading London hospitals. With years of experience treating SVT and other arrhythmias, I've helped hundreds of patients overcome this condition and regain control of their lives. Whether you're a marathon runner whose training has been disrupted, a new mother concerned about episodes during pregnancy, or a professional worried about SVT affecting your work presentations, expert help is available.

What is Supraventricular Tachycardia?

Supraventricular tachycardia is an umbrella term describing a group of abnormal heart rhythm conditions that cause episodes of very fast, regular heartbeats. The name literally means "fast heart rhythm from above the ventricles" – the episodes originate in the upper chambers of your heart rather than the main pumping chambers below.

During an SVT episode, your heart rate typically jumps dramatically from a normal 60-100 beats per minute to anywhere between 150-250 beats per minute. This sudden acceleration happens because of abnormal electrical pathways in your heart that create a sort of "electrical short circuit," causing your heart to beat much faster than it should.

What makes SVT particularly distinctive is how suddenly it starts and stops. Unlike gradually increasing heart rates during exercise, SVT episodes switch on and off like a light switch. One moment you're feeling perfectly normal, and the next your heart is racing at 180 beats per minute for no apparent reason.

Understanding the Different Types of SVT

While all forms of SVT share the characteristic of rapid, regular heartbeats, there are several distinct types, each with slightly different mechanisms:

Common Types

Atrioventricular Nodal Re-entrant Tachycardia (AVNRT) is the most frequent type, accounting for about 60% of SVT cases. This occurs when there are two electrical pathways in the AV node (the heart's natural electrical junction box), creating a circular electrical current that keeps your heart beating rapidly.

Atrioventricular Re-entrant Tachycardia (AVRT) happens when there's an extra electrical connection between the upper and lower chambers of your heart – essentially an additional wire that shouldn't be there. This extra pathway, combined with the normal one, creates the electrical circuit responsible for the rapid heartbeat.

Atrial Tachycardia originates from a specific area in the upper chambers of the heart that starts firing electrical impulses much faster than it should, overriding your heart's normal pacemaker. This can be experienced as a fast heartbeat, a palpitation sensation in the chest, breathlessness or dizziness.

There are also rarer forms of SVT that I treat in my specialist practice:

Sinus Nodal Re-entry Tachycardia involves the heart's natural pacemaker creating abnormal electrical circuits within itself.

Inappropriate Sinus Tachycardia occurs when your heart's natural pacemaker fires too quickly for the situation – for instance, reaching 130 beats per minute while you're simply sitting and reading.

Multifocal Atrial Tachycardia involves multiple areas in the upper chambers firing rapidly and irregularly.

Junctional Ectopic Tachycardia is a rare form where the electrical junction between upper and lower chambers becomes overactive.

Even these less common subtypes are within my area of expertise, and I regularly develop treatment plans for patients with these conditions.

Paroxysmal supraventricular tachycardia (PSVT) refers to episodes of SVT that come and go unpredictably, starting and stopping suddenly without warning. This is actually the most common presentation of SVT, where patients experience intermittent episodes of rapid heart rate (typically 150-250 beats per minute) that can last anywhere from a few minutes to several hours, followed by completely normal heart rhythm between episodes.

The term "paroxysmal" simply means "sudden onset and offset," which perfectly describes how most patients experience their SVT – one moment they feel perfectly normal, and the next their heart is racing at 180 beats per minute, often stopping just as suddenly as it started.

Wolff-Parkinson-White (WPW) syndrome is a specific type of SVT caused by an extra electrical pathway between the upper and lower chambers of the heart, called an "accessory pathway." This additional connection, which you're born with, creates a short circuit that allows electrical impulses to bypass the heart's normal electrical system, leading to episodes of very rapid heart rate. WPW can be identified on a standard ECG even when you're not having symptoms, showing a characteristic pattern called a "delta wave." While many people with WPW live normal lives, the condition can occasionally cause more serious arrhythmias, particularly a dangerous rhythm called ventricular fibrillation. For this reason, WPW often warrants treatment with catheter ablation, which has excellent success rates (over 95%) and can permanently eliminate both the accessory pathway and the risk of future episodes. This is particularly important for young people and athletes, where the condition could potentially pose safety risks during physical activity.

Recognising SVT Symptoms

SVT symptoms can be quite dramatic and often cause significant anxiety, particularly during the first few episodes when patients don't understand what's happening to them.

The hallmark symptom is palpitations – a sudden awareness of your heart beating very fast and often very hard. Patients frequently describe feeling like their heart is "trying to beat out of their chest" or "hammering against their ribs." This isn't just a slightly faster heartbeat – it's an unmistakably rapid, forceful sensation that's impossible to ignore.

Shortness of breath commonly accompanies the fast heart rate. Your heart is working much harder than usual, and many patients feel like they can't catch their breath or need to take deeper breaths than normal. This can be particularly frightening if you're someone who's normally very fit.

Dizziness and lightheadedness occur because your heart, despite beating very fast, may not be pumping blood as efficiently as when it beats at a normal rate. Some patients describe feeling like they might faint, though actual fainting is relatively uncommon with SVT.

Chest discomfort can range from a tight feeling to actual pain. This happens because your heart muscle is working much harder than usual and may not be getting quite enough oxygen to meet this increased demand.

Anxiety and a sense of panic are natural responses to these physical symptoms. Your body recognises that something unusual is happening, triggering your fight-or-flight response. Many patients describe feeling an overwhelming sense of dread or panic, particularly during their first episodes.

Awareness of rapid heart rate on devices has become increasingly common as more people wear smart watches. Patients often notice their Apple Watch or Fitbit registering heart rates of 170-200 beats per minute when they're simply sitting at their desk or lying in bed.

The Impact on Daily Life

What makes SVT particularly challenging is its unpredictability. Episodes can occur at any time, during important work presentations, while driving, on holiday, or even during intimate moments. This unpredictability often leads to significant anxiety about when the next episode might occur.

I've treated marathon runners who've had to stop mid-race due to SVT episodes, new mothers who've experienced episodes while breastfeeding (causing understandable panic), and business executives who've had to excuse themselves from crucial meetings. The condition doesn't just affect your physical wellbeing – it can impact your confidence, your career, and your ability to enjoy activities you love.

Sleep disturbances are common, particularly when episodes occur at night. Some patients develop anxiety about going to sleep, worried they might wake up with their heart racing. Others find that episodes wake them up, leaving them exhausted the following day.

Exercise limitations affect many patients, especially those who are naturally active. While exercise doesn't cause SVT (the condition is usually something you're born with), it can trigger episodes in susceptible individuals. I've seen patients who've given up running, cycling, or other sports they love because they're afraid of triggering an episode.

Social impact shouldn't be underestimated. Patients often become hyperaware of their heart rate in social situations, which can limit their enjoyment of parties, dinners, or other gatherings. Some develop anxiety about traveling, particularly flying, in case they have an episode when medical help isn't readily available.

Understanding What Causes SVT

The fundamental cause of SVT lies in your heart's electrical system. Think of your heart as having its own electrical wiring that coordinates each heartbeat. In SVT, there's typically an abnormality in this wiring that you're born with an extra electrical pathway or a problem with one of the normal pathways.

This is crucial to understand: SVT is not caused by lifestyle factors, stress, or anything you've done wrong. The electrical abnormality that predisposes you to SVT is usually present from birth, even if symptoms don't appear until later in life. Some people experience their first episode in childhood, others not until their 40s or 50s.

While the underlying electrical abnormality causes SVT, certain factors can trigger episodes in those who are predisposed:

Emotional or physical stress is one of the most common triggers. This might include work pressure, relationship difficulties, or major life changes. The stress response changes your body's electrical environment, sometimes triggering the abnormal electrical circuit.

Exercise can trigger episodes, though this is quite individual. Some patients never have exercise-induced SVT, while others find that particular types or intensities of exercise reliably trigger episodes. Interestingly, it's often not the peak of exercise that triggers SVT, but rather the period immediately after stopping intense activity.

Caffeine affects some patients significantly, while others can drink coffee without any problems. Those who are sensitive often find that even small amounts of caffeine can trigger episodes, particularly if they're not regular coffee drinkers.

Alcohol can be a trigger, especially if consumed in larger quantities or if you don't drink regularly. Some patients notice episodes the morning after drinking, when alcohol levels are falling.

Dehydration or electrolyte imbalances can create conditions that favour SVT episodes. This is why some patients notice episodes during illness, particularly if they've been vomiting or had diarrhea.

Medications occasionally trigger SVT. Some asthma inhalers, decongestants, or stimulant medications can provoke episodes in susceptible individuals.

Hormonal changes can influence SVT frequency. Some women notice changes in episode frequency around their menstrual cycle, during pregnancy, or around menopause.

While most SVT occurs in people with otherwise normal hearts, certain underlying conditions can increase the likelihood of episodes:

Coronary artery disease can create conditions that favour arrhythmias, though this is more commonly associated with other types of heart rhythm problems.

Heart valve disease can sometimes predispose to SVT, particularly if it affects the upper chambers of the heart.

Congenital heart conditions – heart abnormalities present from birth – sometimes include abnormal electrical pathways that can cause SVT.

Hyperthyroidism can increase the frequency and severity of SVT episodes by making your heart more electrically irritable.

Heart failure can create electrical instability, though again, this more commonly causes other types of arrhythmias.

It's worth emphasising that the vast majority of my SVT patients have completely normal heart structure and function – the problem is purely electrical.

How We Diagnose SVT

Diagnosing SVT requires capturing your heart rhythm during an episode, which can sometimes be challenging since episodes often stop before you reach medical attention. However, modern technology has made this significantly easier than it used to be.

The gold standard for SVT diagnosis is an ECG recorded during an episode. This shows the characteristic pattern of rapid, regular heartbeats that definitively confirms the diagnosis. If you're fortunate enough to have an episode while in a medical setting – perhaps at your GP surgery, A&E, or during a planned hospital visit – we can capture this crucial information.

However, most episodes occur at unpredictable times, which is where other monitoring strategies become essential.

24-hour Holter monitors are traditional devices that record your heart rhythm continuously for a full day. While useful, they only capture a single 24-hour period, so they may miss episodes if your SVT is infrequent.

Longer-term event monitors can be worn for weeks or even months, significantly increasing our chances of capturing an episode. These devices are particularly valuable for patients who have episodes every few weeks or months.

Loop recorders are small devices that can be implanted under the skin and monitor your heart rhythm continuously for up to three years. We typically reserve these for patients with very infrequent but concerning symptoms.

Apple Watches and similar devices have revolutionised SVT diagnosis. While they don't provide medical-grade ECGs, they're remarkably good at detecting rapid heart rates. Many of my patients first become aware of their SVT through their smartwatch alerts.

The Apple Watch's ECG function can sometimes capture enough information to suggest SVT, though it's not sufficient for definitive diagnosis. However, it's an excellent tool for monitoring episode frequency and duration.

Kardia devices are small, portable ECG monitors that can record medical-grade ECGs. If you feel an episode starting, you can place your fingers on the device and record a proper ECG that can be sent directly to me for analysis.

Smartphone apps can also be helpful for recording basic rhythm information, though they're generally less reliable than dedicated devices.

Electrophysiology studies are specialized procedures we sometimes use when the diagnosis is unclear or when we're planning treatment. During this procedure, we insert thin wires through blood vessels in your groin and position them inside your heart to study the electrical system in detail.

This allows us to not only confirm the diagnosis but also determine exactly where the abnormal electrical pathway is located and how best to treat it. We can often trigger SVT episodes deliberately during the study, allowing us to see precisely what's happening electrically.

One important aspect of diagnosis is distinguishing SVT from other conditions that can cause rapid heartbeats:

Panic attacks can cause heart rates to increase and symptoms that feel very similar to SVT. However, panic-related tachycardia usually builds up gradually and is associated with other anxiety symptoms. SVT, in contrast, starts and stops suddenly and often occurs without any anxiety preceding it.

Atrial fibrillation causes rapid heartbeats but with an irregular rhythm, whereas SVT is characteristically regular. The ECG patterns are quite different.

Sinus tachycardia is simply your normal heart rhythm running faster than usual, often in response to stress, exercise, fever, or other stimuli. Unlike SVT, it builds up and slows down gradually.

How Serious is SVT?

This is often the first question patients ask, and I'm pleased to reassure you that SVT is generally a benign condition. SVT is not life-threatening in the vast majority of cases. It won't cause a heart attack, and it won't damage your heart if treated appropriately.

However, this doesn't mean SVT should be ignored or that it doesn't significantly impact quality of life. The condition can be highly disruptive and, in certain circumstances, does require urgent medical attention.

While SVT itself isn't dangerous, there are situations where it requires immediate medical care:

Prolonged episodes lasting several hours can occasionally put strain on your heart. If your heart beats at 180-200 beats per minute for many hours, it may not be able to maintain adequate blood flow to your body.

Very rapid rates above 220-250 beats per minute, while rare, can be more concerning and typically require urgent medical attention.

Associated symptoms such as chest pain, severe shortness of breath, or loss of consciousness during episodes warrant immediate medical review.

Underlying heart disease can make SVT episodes more concerning. If you have coronary artery disease, heart failure, or significant valve disease, rapid heart rates may not be tolerated as well.

Heart failure is a potential long-term complication if SVT episodes are very frequent and prolonged. This happens because constantly rapid heart rates can eventually weaken the heart muscle. However, this is quite rare and usually only occurs in patients with very frequent, long-lasting episodes that remain untreated for extended periods.

The good news is that if heart function does become impaired due to frequent SVT, it typically improves significantly once the SVT is effectively treated.

Quality of life impact is often the most significant "complication" of SVT. The unpredictability of episodes can lead to anxiety, avoidance of activities, and significant lifestyle limitations. Many patients describe feeling like they're "walking on eggshells," never knowing when an episode might occur.

You should seek urgent medical help if:

  • Your heart rate is very fast and doesn't slow down with rest or simple manoeuvers
  • You experience chest pain, severe shortness of breath, or feel like you might faint
  • You lose consciousness during an episode
  • You have prolonged episodes that don't respond to your usual treatments

In such cases, calling 999 or attending A&E is entirely appropriate. The medical team can provide immediate treatments to stop the episode and ensure you're safe.

Treatment Options for SVT

The approach to treating SVT depends on several factors: how frequent your episodes are, how long they last, how much they impact your life, and your personal preferences regarding treatment options. The excellent news is that we have highly effective treatments available, ranging from simple lifestyle measures to definitive cures.

Vagal manoeuvres are simple techniques that can often stop SVT episodes by stimulating your vagus nerve, which helps regulate heart rate. These are safe, effective first-aid measures that I teach all my patients:

The Valsalva manoeuvre involves taking a deep breath and bearing down as if you're straining on the toilet or trying to blow up a balloon. Hold this for 10-15 seconds, then release suddenly. This often stops SVT episodes immediately.

Carotid sinus massage involves gently massaging the side of your neck where you can feel your pulse. This should only be done if you've been properly taught the technique, as incorrect pressure can be dangerous.

Cold water techniques can be remarkably effective. Some patients find that splashing very cold water on their face or even immersing their face in cold water stops episodes. The cold stimulates the vagus nerve and often terminates SVT.

Breath-holding techniques sometimes work. Try taking a deep breath and holding it for as long as comfortable, then releasing slowly.

Positional changes help some patients. Lying flat and raising your legs above heart level can sometimes stop episodes.

These techniques are most effective when used as soon as you feel an episode starting. With practice, many patients become quite skilled at stopping their own episodes.

Beta-blockers are often the first-line medication treatment. Drugs like bisoprolol or metoprolol work by blocking the effects of adrenaline on your heart, making it less likely for SVT episodes to start and reducing their intensity if they do occur.

These medications are taken daily and can significantly reduce episode frequency. Most patients tolerate them well, though some experience side effects like fatigue, particularly when starting treatment. The doses used for SVT are typically quite modest.

Calcium channel blockers such as verapamil are an alternative daily medication that can be very effective for preventing SVT episodes. They work by affecting the electrical conduction in your heart.

"Pill-in-the-pocket" therapy involves taking medication only when an episode starts, rather than daily prevention. Flecainide is commonly used for this approach. Patients carry tablets with them and take them at the first sign of an episode.

This approach works well for patients who have infrequent episodes but want a reliable way to stop them. The medication typically stops episodes within 30-60 minutes.

Emergency medications used in hospital settings include adenosine, which is given by injection and often stops SVT episodes within seconds. This is typically used in A&E when episodes don't respond to vagal manoeuvres.

For many patients, catheter ablation offers a permanent cure for SVT. This is a keyhole procedure that corrects the underlying electrical abnormality responsible for your episodes.

How the procedure works: We insert thin, flexible wires called catheters through blood vessels in your groin and guide them to your heart using X-ray guidance. Once positioned correctly, we use these catheters to create precise burns (using heat) or freeze zones (using cold) that eliminate the abnormal electrical pathway causing your SVT.

Success rates for SVT ablation are excellent – around 95% for most types of SVT. This means that 95 out of 100 patients are completely cured and never have SVT episodes again. For the small percentage where the first procedure doesn't work, a repeat procedure is often successful.

The procedure experience: SVT ablation typically takes 1-1.5 hours and is performed under local anaesthetic with mild sedation. You'll be awake but relaxed and shouldn't feel any significant discomfort.

During the procedure, we deliberately trigger your SVT so we can study it and locate the exact source of the problem. This sounds alarming, but remember that we're in a controlled environment with immediate access to treatments if needed.

The actual ablation – the moment we eliminate the abnormal pathway – sometimes causes brief discomfort, but we use strong pain relief to minimise this.

Recovery is typically straightforward. Most patients go home the same day, though some stay overnight for observation. I recommend taking things easy for about a week, avoiding heavy lifting or vigorous exercise to allow the puncture sites in your groin to heal properly.

Returning to normal activities: After the initial week of rest, most people can gradually return to all their normal activities. Some patients feel back to their usual energy levels within days, while others take 3-4 weeks to feel completely themselves again.

Risks and complications: Serious complications from SVT ablation are very rare – less than 1% of procedures. Minor complications like bleeding or bruising at the groin puncture sites occur in about 2-3% of cases.

The most significant risks include damage to the normal electrical conduction system of the heart (potentially requiring a pacemaker), damage to blood vessels, or bleeding around the heart. These complications are extremely rare but are important to discuss before proceeding.

For infrequent episodes that don't significantly impact your life, we might recommend a "watch and wait" approach with vagal manoeuvres for episode management.

For regular but tolerable episodes, daily medication is often an excellent choice, particularly if you prefer to avoid procedures.

For frequent or very symptomatic episodes, ablation is usually the best option, offering the prospect of a permanent cure.

For patients whose episodes significantly impact their work, sports, or quality of life, I generally recommend proceeding directly to ablation rather than trying medications first.

Special Considerations

Athletes often prefer ablation because they want to avoid daily medications that might affect their performance. The procedure allows them to return to training without restrictions.

Young patients frequently choose ablation because they prefer not to take daily medication for decades. The procedure offers a one-time solution to a lifelong problem.

Patients planning pregnancy should discuss treatment options carefully, as some medications aren't suitable during pregnancy, while ablation before pregnancy eliminates these concerns.

Professional drivers need to consider DVLA regulations, which may affect their ability to drive professionally until SVT is adequately controlled.

Living with SVT: Practical Advice

Recognise early warning signs: Many patients develop a sense of when an episode is starting – perhaps a fluttering sensation or a feeling that their heart rhythm is changing. Learning to recognise these early signs allows you to use vagal manoeuvres most effectively.

Stay calm: Easier said than done, but panic can make episodes feel worse and last longer. Remember that SVT episodes always stop eventually, and they're not dangerous in the vast majority of cases.

Find your most effective vagal manoeuvre: Different techniques work better for different people. Experiment during episodes to find which approach works best for you.

Consider your environment: If you feel an episode starting while driving, pull over safely before attempting vagal manoeuvres. If you're in a meeting, excuse yourself rather than trying to manage the episode while continuing to work.

Identify and avoid triggers: Keep a diary of episodes, noting what you were doing, what you'd eaten or drunk, your stress levels, and any other factors that might be relevant. Over time, patterns often emerge.

Manage stress effectively: Since stress is a common trigger, developing good stress management techniques can reduce episode frequency. This might include regular exercise, meditation, adequate sleep, or professional stress management support.

Stay hydrated: Dehydration can trigger episodes in some patients, particularly during illness or hot weather.

Moderate caffeine and alcohol: If these are triggers for you, consider reducing or eliminating them. However, many patients can continue enjoying coffee and alcohol in moderation without problems.

Maintain good general health: Regular exercise, a healthy diet, adequate sleep, and maintaining a healthy weight all contribute to overall heart health and may reduce episode frequency.

Inform relevant colleagues: If your job involves safety-critical activities, consider discussing your condition with occupational health services. They can advise on any necessary precautions.

Plan for episodes: If you have an important presentation or meeting, consider taking a "pill-in-the-pocket" medication beforehand if your doctor has prescribed this approach.

Know your limitations: Some patients find that high-stress work situations trigger episodes. It's worth considering whether career changes might improve your quality of life.

Don't assume you need to stop exercising: Many patients with SVT can continue their normal exercise routines without problems. However, some may need to modify their approach.

Warm up gradually: Sudden, intense exercise is more likely to trigger episodes than gradual increases in activity.

Cool down properly: The period immediately after intense exercise can be a trigger time for some patients.

Stay hydrated: This is particularly important during exercise.

Competitive athletes: If you're a serious athlete, discuss your training schedule and competition plans with your cardiologist. Ablation might be the best option to avoid any restrictions.

Carry documentation: If you take medications or have had procedures, carry a summary of your condition and treatment.

Plan for time zones: If you take daily medications, plan how you'll manage timing when crossing time zones.

Know how to access help: Research medical facilities at your destination, particularly for longer trips.

Consider travel insurance: Ensure your policy covers your existing condition.

Pre-pregnancy counselling: If you're planning pregnancy, discuss your treatment options beforehand. Some medications aren't suitable during pregnancy.

SVT during pregnancy: Episodes can become more or less frequent during pregnancy due to hormonal and circulatory changes.

Treatment during pregnancy: Vagal manoeuvres remain safe and effective. Some medications can be used if needed, though the choice is more limited.

Delivery planning: Most women with SVT have completely normal deliveries. However, it's worth discussing your condition with your obstetric team.

When to Seek Urgent Medical Help

Understanding when SVT requires immediate medical attention is crucial for your safety and peace of mind.

Emergency Situations

Call 999 immediately if:

  • You lose consciousness during an episode
  • You experience severe chest pain that doesn't improve when the episode stops
  • You have extreme difficulty breathing
  • You feel like you might collapse or faint
  • An episode lasts longer than usual and doesn't respond to your normal management techniques

Seek Urgent Medical Review if:

  • Episodes are becoming much more frequent
  • Episodes are lasting longer than usual
  • You're experiencing new symptoms during episodes
  • Your usual medications or vagal manoeuvres are no longer working
  • You're feeling increasingly anxious about your condition

When to Contact Your Cardiologist:

  • You want to discuss treatment options
  • Your current treatment isn't controlling episodes adequately
  • You're experiencing side effects from medications
  • Your life circumstances have changed (new job, pregnancy plans, etc.)
  • You simply want reassurance or to discuss concerns

Prevention and Long-term Management

Keep an episode diary: Record the date, time, duration, and circumstances of each episode. Note:

  • What you were doing when it started
  • What you'd eaten or drunk in the previous few hours
  • Your stress levels
  • Sleep quality the night before
  • Any medications or supplements taken
  • For women, timing in relation to menstrual cycle

Look for patterns: Over time, you may notice that episodes cluster around certain activities, times of day, or life circumstances.

Work with your doctor: Share your diary with your cardiologist. Sometimes patterns that aren't obvious to patients become clear to experienced doctors.

Develop coping strategies: This might include regular exercise, meditation, yoga, or professional counselling if stress is a significant issue in your life.

Consider the bigger picture: Sometimes SVT episodes are a sign that overall life stress needs addressing. This might involve career changes, relationship counselling, or other major life adjustments.

Build support networks: Having family and friends who understand your condition can significantly reduce anxiety about episodes.

Prognosis is excellent: With appropriate treatment, the vast majority of patients with SVT lead completely normal lives.

Treatment is highly effective: Whether you choose medications or ablation, effective treatments are available.

Technology continues to improve: New techniques and technologies are constantly being developed, making treatment even more effective and safer.

Most patients choose ablation eventually: While medications can be very effective, many patients ultimately opt for ablation because they prefer a permanent solution.

Why Choose Specialist Private Care?

As a specialist in cardiac electrophysiology, I focus exclusively on heart rhythm problems like SVT. This specialisation means I see these conditions every day and have extensive experience with all treatment options, from the simplest to the most complex cases.

Advanced training: My fellowship training in electrophysiology involved intensive study of heart rhythm disorders and thousands of hours of hands-on experience with ablation procedures.

High-volume practice: I perform hundreds of ablation procedures each year, which translates to better outcomes and lower complication rates for my patients.

Access to latest techniques: Private practice allows me to use the most advanced technologies and techniques, often before they're widely available in the NHS.

Quick appointments: While NHS waiting times for cardiology consultations can extend to months, I typically see private patients within days or weeks.

Fast-track procedures: If ablation is recommended, private treatment usually means procedures can be scheduled within weeks rather than the months or even years that NHS patients might wait.

Urgent access when needed: If you're having frequent or concerning episodes, urgent appointments and procedures can often be arranged at short notice.

Extended consultation times: Private appointments allow adequate time to discuss your condition thoroughly, explore all treatment options, and address all your concerns without feeling rushed.

Continuity of care: You'll see the same consultant throughout your treatment journey, ensuring consistent, personalised care.

Direct access: My private patients have direct contact details and can reach me or my team when concerns arise.

Modern hospitals: Private hospitals typically have the latest equipment and most comfortable facilities.

Advanced monitoring: Access to the most sophisticated monitoring and diagnostic equipment.

General anaesthesia for procedures: Unlike some NHS centres that may use sedation, private practice allows me to offer general anaesthesia for ablation procedures, ensuring maximum comfort.

Coordinated care: Private practice allows seamless coordination between different specialists if you need additional consultations.

Detailed follow-up: Comprehensive post-procedure care and long-term follow-up to ensure optimal outcomes.

Family involvement: Time to involve family members in discussions and decisions about your care.

Cost Considerations and Value

Initial consultation: Typically £250-350, including detailed assessment and treatment planning.

Diagnostic tests: Additional costs for ECGs, echocardiograms, or monitoring devices as needed.

Ablation procedures: Complete treatment including procedure, hospital stay, and follow-up typically costs £8,000-12,000 for SVT ablation.

Insurance coverage: Many private health insurance policies cover SVT treatment. Check your policy details or contact your insurer for clarification.

Quality of life: The rapid resolution of symptoms and return to normal activities often justifies the investment for many patients.

Career considerations: For professionals where SVT affects work performance, quick treatment can prevent career impact.

Peace of mind: The reassurance of expert care and definitive treatment is invaluable for many patients.

Family considerations: Reducing anxiety for family members who worry about your episodes.

Payment plans: Many private hospitals offer payment plans to spread costs over time.

Health savings accounts: If you have a health savings account, SVT treatment typically qualifies for coverage.

Employer benefits: Some employers offer health cash plans that contribute to private medical costs.

Getting Started: Your Next Steps

Booking Your Initial Consultation

Your first consultation will typically last 30 minutes and include:

What to bring:
  • Any previous ECGs or heart monitoring results
  • List of current medications
  • Summary of your symptoms and their frequency
  • Details of any triggers you've identified
  • List of questions you'd like to discuss
What to expect:
  • Detailed discussion of your symptoms and their impact on your life
  • Physical examination including heart and pulse assessment
  • Review of any previous tests or investigations
  • Discussion of all treatment options
  • Development of a personalised treatment plan

Symptom diary: Start keeping a record of episodes, including frequency, duration, triggers, and symptoms.

Medication list: Compile a complete list of all medications, supplements, and over-the-counter remedies you take.

Questions to consider:

  • How will treatment affect my work/sport/lifestyle?
  • What are the success rates for different treatment options?
  • What are the risks and benefits of each approach?
  • How long will recovery take?
  • What happens if the first treatment doesn't work?

Treatment planning: We'll develop a personalised treatment plan based on your symptoms, lifestyle, and preferences.

Scheduling procedures: If ablation is recommended, we can typically schedule this within 2-4 weeks.

Ongoing support: My team provides comprehensive support throughout your treatment journey.

Frequently Asked Questions About SVT

SVT ablation has excellent success rates, typically around 95% for most common types of SVT. This means that 19 out of 20 patients are completely cured and never have SVT episodes again.

The procedure is performed under local anaesthetic with sedation, so you shouldn't experience significant pain during the procedure. Some patients feel mild discomfort when we trigger SVT for diagnostic purposes, and there may be brief discomfort during the actual ablation, but we use effective pain relief to minimise this.

Most patients can return to desk work within a few days and normal activities within a week. Full recovery, including return to vigorous exercise, typically takes 2-4 weeks.

The recurrence rate is very low – around 5% for most types of SVT. If SVT does recur, a repeat procedure is often successful.

Vagal manoeuvres remain safe during pregnancy. Some medications can be used if needed, though options are more limited. Many women choose to have ablation before becoming pregnant to avoid medication concerns during pregnancy.

Most patients take 3-7 days off work after ablation, depending on their job. Desk-based workers often return sooner than those in physically demanding roles.

You shouldn't drive for 24-48 hours after sedation. Once you feel fully recovered (usually within a week), driving is fine. Professional drivers may need DVLA notification – we can advise on specific requirements.

SVT can occasionally run in families, but most cases are sporadic. If you have children, the risk of them developing SVT is slightly higher than the general population but still relatively low. If family members develop symptoms suggestive of SVT, they should be evaluated by a cardiologist.

This is an excellent question that many patients ask. While both can cause rapid heartbeats and feelings of panic, there are key differences:

SVT typically starts and stops suddenly, like flipping a switch, whereas anxiety-related heart rate increases usually build up gradually. SVT episodes often occur without any preceding anxiety or stress, sometimes even waking people from sleep. The heart rate in SVT is characteristically very regular and often much faster (typically 150-250 beats per minute) than anxiety-related tachycardia.

However, it's worth noting that having SVT can certainly cause anxiety, and anxiety about having episodes can become a significant problem in itself. Some patients benefit from addressing both the SVT and any associated anxiety.

Yes, absolutely. Once you've recovered from the procedure (typically 2-4 weeks), you can return to all your previous activities without restrictions. Many of my patients are athletes who return to competitive sports, marathon running, and other demanding physical activities.

If daily medications don't adequately control your episodes, we have several options:

  • Adjusting medication doses or trying different medications
  • Adding "pill-in-the-pocket" therapy for breakthrough episodes
  • Proceeding to catheter ablation for a definitive cure

The beauty of SVT treatment is that we have multiple effective approaches, so there's almost always a solution that works.

? You should contact me if you notice:

  • Episodes becoming more frequent
  • Episodes lasting longer than usual
  • New symptoms during episodes
  • Episodes not responding to your usual management techniques
  • Increasing anxiety about your condition affecting your daily life

In the vast majority of cases, SVT doesn't cause other heart problems. Very rarely, if episodes are extremely frequent and prolonged over many years, it can lead to weakening of the heart muscle (cardiomyopathy). However, this is quite rare and typically reversible once the SVT is treated effectively.

After successful ablation, most patients need only occasional follow-up appointments. I typically see patients at 3 months post-procedure, then as needed. If you're taking medications, more regular monitoring may be required to ensure they remain appropriate and effective.

Research and Future Developments

The field of cardiac electrophysiology continues to evolve rapidly, with new technologies and techniques constantly being developed to make SVT treatment even more effective and safer.

3D mapping systems allow us to create detailed, three-dimensional maps of your heart's electrical activity during ablation procedures. This technology helps us locate the exact source of SVT more precisely and perform more targeted treatment.

Contact force sensing catheters provide real-time feedback about how much pressure we're applying during ablation, ensuring optimal energy delivery while minimising the risk of complications.

Cryoablation techniques use extreme cold instead of heat to eliminate abnormal electrical pathways. This approach is particularly useful for certain types of SVT and may have some safety advantages in specific situations.

Robotic ablation systems are being developed to provide even greater precision during procedures, potentially improving success rates and reducing procedure times.

Artificial intelligence is being integrated into ECG analysis, potentially allowing earlier and more accurate diagnosis of different SVT types from shorter recordings.

Improved wearable devices continue to become more sophisticated, with better ability to detect and record episodes automatically.

Smartphone integration allows for better communication between patients and healthcare providers, with automatic transmission of episode data for real-time analysis.

Current research focuses heavily on understanding what matters most to patients:

Quality of life studies help us better understand the true impact of SVT on patients' lives and the effectiveness of different treatments in improving wellbeing.

Shared decision-making tools are being developed to help patients make informed choices about their treatment options based on their individual circumstances and preferences.

Long-term outcome studies continue to refine our understanding of which patients benefit most from different treatment approaches.

My Commitment to Excellence

My practice is built on the foundation of providing the highest quality care for patients with heart rhythm disorders. This commitment manifests in several ways:

Continuous education: I regularly attend international conferences and training courses to stay current with the latest developments in electrophysiology.

Research involvement: I participate in clinical research studies that help advance our understanding of SVT and improve treatment options for future patients.

Peer collaboration: I work closely with other specialists both in the UK and internationally, ensuring that my patients benefit from the collective expertise of the global electrophysiology community.

Audit and outcomes tracking: I carefully monitor the outcomes of all my procedures, constantly working to improve success rates and minimise complications.

Individualised treatment plans: I recognize that every patient is unique, with different symptoms, lifestyles, and treatment preferences. My approach is to develop treatment plans that are tailored specifically to your needs and circumstances.

Clear communication: I believe that patients should fully understand their condition and treatment options. I take the time to explain things clearly, using language that's accessible while still being medically accurate.

Shared decision-making: While I provide expert medical advice, the ultimate treatment decisions should be yours, made with full understanding of the options, risks, and benefits.

Compassionate care: I understand that SVT can be frightening and disruptive. My team and I are committed to providing not just excellent medical care, but also the emotional support that patients need.

State-of-the-art facilities: I perform procedures at leading private hospitals equipped with the most advanced electrophysiology laboratories and technology.

Minimally invasive approaches: I'm committed to using the least invasive techniques that will effectively treat your condition, minimising discomfort and recovery time.

Personalised medicine: As our understanding of SVT genetics and individual variation improves, I incorporate these insights into treatment planning.

Building Your Support Network

Education: Help your loved ones understand SVT by sharing reliable information about your condition. The more they understand, the better they can support you.

Emergency planning: Ensure family members know what to do if you have a prolonged episode or feel unwell during an episode.

Emotional support: Don't underestimate the importance of having people who understand what you're going through and can provide emotional support during challenging times.

Your GP: Maintain good communication with your GP, who plays an important role in your overall healthcare and may be the first point of contact for concerns.

Pharmacist: If you take medications for SVT, develop a good relationship with your pharmacist, who can provide valuable advice about drug interactions and side effects.

Occupational health: If your work is affected by SVT, occupational health services can provide advice and support.

British Heart Foundation: Provides excellent educational materials and support for people with heart conditions, including SVT.

Arrhythmia Alliance: A UK charity specifically focused on heart rhythm disorders, offering patient information, support groups, and advocacy.

Online communities: Many patients find support and practical advice from others with SVT through moderated online forums and social media groups.

Educational materials: I provide my patients with comprehensive written information about their condition and treatment options.

Making the Decision: Your Path Forward

The decision about how to manage your SVT is deeply personal and should take into account multiple factors:

Symptom severity and frequency: How much are episodes affecting your daily life, work, and activities you enjoy?

Age and life stage: Younger patients often prefer definitive treatment to avoid decades of medication, while older patients might be more comfortable with medical management.

Lifestyle factors: Athletes and very active individuals often benefit significantly from ablation, while less active patients might find medications perfectly adequate.

Risk tolerance: Some patients prefer the certainty of a proven procedure, while others are more comfortable trying conservative approaches first.

Professional requirements: Certain occupations may influence treatment choices due to safety requirements or medication restrictions.

Even if you're unsure about treatment, a specialist consultation provides valuable benefits:

Accurate diagnosis: Confirming that your symptoms are indeed due to SVT and ruling out other conditions.

Risk stratification: Understanding whether your particular type of SVT has any concerning features.

Education: Learning about all available treatment options and their success rates.

Peace of mind: Having expert reassurance about your condition and prognosis.

Future planning: Understanding what to expect and when to seek help.

If you recognise yourself in this description of SVT, the most important step is seeking proper evaluation and treatment. SVT is not a condition you need to "live with" – highly effective treatments are available that can restore your quality of life completely.

Don't delay: While SVT isn't immediately life-threatening, there's no benefit to postponing evaluation and treatment. The sooner appropriate treatment is started, the sooner you can return to normal life.

Choose expertise: SVT treatment has become highly specialised. Seeking care from an electrophysiology specialist ensures you receive the most current and effective treatment options.

Consider all options: Both medical and procedural treatments can be highly effective. The key is finding the approach that's right for your particular situation.

Invest in your future: Whether through private insurance or self-funding, effective SVT treatment is an investment in your long-term health and quality of life.

Your Journey to Freedom from SVT

SVT can be a disruptive and frightening condition, but it's important to remember that it's also a highly treatable one. With modern diagnostic techniques and treatment options, the vast majority of patients can achieve complete freedom from episodes and return to unrestricted, normal lives.

My commitment as your cardiologist is to provide you with expert, compassionate care throughout this journey. From initial diagnosis through treatment and long-term follow-up, I'll work with you to develop a treatment plan that fits your lifestyle, addresses your concerns, and gives you the best possible outcomes.

The first step is often the hardest – deciding to seek help. But once you've taken that step, you'll find that effective solutions are available, and the prospect of living free from SVT episodes is very real.

Remember, you don't have to live with the unpredictability and anxiety that SVT can cause. Excellent treatment options exist, and with proper care, most patients find that SVT becomes a thing of the past rather than an ongoing concern.

Take action today: Contact my practice to schedule your consultation and begin your journey toward freedom from SVT.