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Also called Bouveret-Hoffmann syndrome, it is a term used to refer to junctional tachycardia.
It is a rapid heartbeat that does not originate in the atria or ventricles, but rather in a node responsible for the propagation of electrical impulses from the heart.
It is manifested by an increased heart rate, palpitations with an early and abrupt end, and affects mainly young patients.
Two symptoms may be involved in the appearance of this symptom and, in both cases, there is an abnormality in the increased electrical impulses that trigger the heartbeat .
Paroxysmal tachycardia or paroxysmal supraventricular tachycardia (paroxysmal SVT) is an episodic condition with a sudden onset and end.
Paroxysmal tachycardia in general is any tachyarrhythmia that requires atrial and / or atrioventricular (AV) nodal tissue for its initiation and maintenance.
It is generally a narrow complex tachycardia that has a regular and rapid rhythm; exceptions include atrial fibrillation (AF) and multifocal atrial tachycardia (MAT).
Aberrant conduction during SVT results in wide-complex tachycardia.
Paroxysmal tachycardia is a common clinical condition that occurs in people of all age groups, and treatment can be challenging. Electrophysiological studies are often necessary to determine the source of the conduction abnormalities.
The manifestations of SVT are quite variable; patients may be asymptomatic or have minor palpitations or more severe symptoms.
The results of electrophysiological studies have helped determine that the pathophysiology of SVT involves abnormalities in impulse formation and conduction pathways. The most common mechanism identified is readmission.
Rare complications of paroxysmal SVT include myocardial infarction, congestive heart failure, syncope, and sudden death.
Classification
The development of intracardiac electrophysiological studies has drastically changed the classification of SVT, and intracardiac recordings have identified the various mechanisms involved in the disease.
Depending on the site of origin of the dysrhythmia, SVT can be classified as either atrial or AV tachyarrhythmia. Another way to separate arrhythmias is to classify them into conditions that have regular or irregular rhythms.
Atrial tachyarrhythmias include the following:
- Sinus tachycardia .
- Inappropriate sinus tachycardia (IST).
- Sinus nodal reentry tachycardia (SNRT).
- Atrial tachycardia.
- Multifocal atrial tachycardia.
- Atrial flutter.
- Atrial fibrillation
Causes of paroxysmal tachycardia
Paroxysmal tachycardia occurs when electrical signals that begin in the heart’s atria fire irregularly. This affects the electrical signals transmitted from the sinoatrial node, which is your heart’s natural pacemaker.
Your heart rate will accelerate. This prevents your heart from having enough time to fill with blood before pumping blood to the rest of the body. As a result, your body may not get enough blood or oxygen.
Who is at risk for paroxysmal tachycardia?
Women have a higher risk of paroxysmal tachycardia than men. Your emotional health can also affect your risk for paroxysmal tachycardia.
If you are physically exhausted or anxious, you are at high risk for the disease. Your risk also increases if you drink excessive amounts of caffeine or alcohol on a daily basis.
Having other heart problems, such as a history of heart attacks or mitral valve disease, can increase your risk. Children with congenital heart disease are at high risk for paroxysmal tachycardia.
Symptoms of paroxysmal tachycardia
The symptoms of paroxysmal tachycardia are:
- Sudden heart racing that occurs for a few minutes to several hours, and that stops as quickly as it begins.
- An unpleasant throbbing sensation.
- Occasional discomfort.
- The syncope may occur in some cases.
Diagnosis of paroxysmal tachycardia
The diagnosis of paroxysmal tachycardia is made from the description of the symptoms by the patient. This phenomenon is of specific occurrence (hence its name: paroxysmal tachycardia), it is rare that it can be seen directly by the doctor.
In some cases where the patient is seen in an emergency, an EKG will be performed which will highlight a regular heart rate but which has increased significantly from 100 to 150 beats per minute.
Treatment of paroxysmal tachycardia
Junctional tachycardia usually heals on its own after a few hours at the most. At the time of the crisis, you can also stop using techniques called “vagal maneuvers” or with a drug, the striatum.
As for the basic treatment of the disease, use drugs such as beta-blockers or antiarrhythmics.
Medicines
If you often experience episodes of paroxysmal tachycardia and the maneuvers described above do not restore your normal heart rhythm, your doctor may prescribe medication.
These medications may include flecainide (Tambocor) or propafenone (Rythmol). They are available in some forms. Your doctor may give you an injection in his office or a pill that you can take during an episode of paroxysmal tachycardia.
Catheter ablation
In rare and extreme cases, your doctor may suggest catheter ablation. This is a non-surgical procedure that removes tissue in the area of the heart that is causing the increased heart rate.
During the procedure, your doctor will place a catheter against the trigger area. They will send radio frequency energy through the catheter to produce enough heat to destroy the precise firing area.
Lifestyle remedies
Your doctor may recommend that you reduce your intake of caffeine and alcohol, and that you stop or reduce tobacco use. They will also want to make sure that you are getting enough rest and practicing gentle exercises such as walks, among others.
