Paroxysmal supraventricular tachycardia

Paroxysmal supraventricular tachycardia (PVT) is a type of arrhythmia characterized by a sudden paroxysmal increase in the heart muscle contraction rate. The heart rate increases to 140–250 beats per minute, while the regular heartbeat rhythm is maintained.

The occurrence of PNT is associated with the activation of a highly active ectopic focus of automatism or a focus of postdepolarization trigger activity in the myocardium. In the overwhelming majority of cases, the basis of PNT is the mechanism of repeated impulse entry and circular circulation of excitation in the myocardium (or the so-called reciprocal re-entry mechanism). In any of these cases, the occurrence of PNT is facilitated by the preliminary appearance of extrasystole.

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Of all the types of arrhythmia, PTN occurs in 95% of cases in children. In patients under 18, PTN is the most common cause leading to arrhythmogenic collapse and heart failure. There are 2.29 patients with PTN per 1000 people in the population. This disease occurs twice as often in women as in men. The risk of developing tachycardia increases at the age of over 65 years - a fivefold increase in patients who have crossed this age limit is recorded.

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With any mechanism of occurrence of paroxysmal supraventricular tachycardia, extrasystole develops beforehand. Extrasystole is the most common type of arrhythmia, which manifests itself as a disturbance of the heart rhythm and is characterized by the occurrence of single or paired premature contractions of the heart (extrasystoles). Arrhythmic contractions of the heart muscle are caused by excitation of the myocardium, which comes from a pathogenic focus of excitation. The disease is functional (neurogenic in nature).

The causes of organic paroxysmal supraventricular tachycardia are as follows:

1. Organic damage to the heart muscle and cardiac conduction pathways that have an inflammatory, dystrophic, necrotic and sclerotic nature. Such damage occurs in acute myocardial infarction, chronic ischemic heart disease, heart defects, cardiopathies, myocarditis.
2. The presence of additional abnormal conduction pathways, for example, in Wolff-Parkinson-White syndrome.
3. Presence of additional viscero-cardiac reflexes and mechanical effects (eg, additional chords, mitral valve prolapse, adhesions).
4. The occurrence of severe vegetative-humoral disorders in neurocirculatory dystonia syndrome.

The above-mentioned disorders are called intracardiac factors in the occurrence of PNT.

Experts believe that the presence of certain structural features of the heart or damage is not enough to cause paroxysmal supraventricular tachycardia. Psychoemotional factors play a major role in the development of this disease. It is known that increased sympathoadrenal activity leads to the occurrence of various forms of ectopic arrhythmia.

In childhood and adolescence, it is often difficult to diagnose the causes of paroxysmal tachycardia. In these cases, the presence of a violation of cardiac muscle contractions is defined as essential (or idiopathic). Although, specialists believe that the causes of paroxysmal supraventricular tachycardia in such patients are minimal, undiagnosed dystrophic damage to the myocardium.

Like ectasystole, PNT can also occur in healthy people due to pathogenic factors. During intense physical or mental stress, during strong and long-term stress. These causes are called extracardiac. These factors also include smoking and abuse of alcohol, strong tea, coffee and spicy food.

When tachycardia occurs, it is necessary to check the level of thyroid hormones in the blood. Although thyrotoxicosis is almost never the only reason for the occurrence of PNT. But when choosing a therapy, difficulties may arise that are associated with the need to stabilize the hormonal level.

Diseases of some other organs can cause paroxysmal tachycardia. For example, prolapsed kidney and other kidney diseases, lung diseases (acute and especially chronic), dysfunctions and diseases of the gastrointestinal tract. The above-mentioned diseases of internal organs are extracardiac factors; as a result of suffering from such diseases, paroxysmal supraventricular tachycardia occurs as a complication.

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The clinical picture of paroxysmal supraventricular tachycardia is characterized by the presence of the following symptoms:

1. A rapid heartbeat begins with a "push" or "stab" in the heart, a feeling of stopping or turning over.
2. The heart rate increases to 250 beats per minute.
3. There are interruptions in the heartbeat.
4. The pulse is weak and often impossible to feel.
5. Unmotivated anxiety, shortness of breath, weakness, dizziness, tinnitus, and sweating occur.
6. There is pain in the chest area or angina pectoris occurs.
7. With severe tachycardia, blood pressure decreases.
8. During an attack, the pulse has a constant, stable frequency that does not change over time.
9. Frequent and profuse urination occurs; manifestations of flatulence are possible.

The minimum duration of paroxysmal supraventricular tachycardia is three cardiac cycles. Such manifestations are called "runs" of tachycardia. Usually, attacks of paroxysmal supraventricular tachycardia last from several hours to several days. A longer manifestation of tachycardia is also possible, up to several months,

Symptoms of supraventricular paroxysmal tachycardia most often disappear spontaneously and on their own. In some cases, with attacks lasting for several days, a fatal outcome is possible if no treatment is taken.

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There are two main types of paroxysmal tachycardia:

• ventricular.
• supraventricular (supraventricular).

This classification arose due to the localization of pathological excitation. PNT, in comparison with the gastrointestinal tract, proceeds more gently and favorably, and a greater number of cases of positive dynamics in the treatment of PNT are also recorded. Since paroxysmal supraventricular tachycardia is less often associated with organic heart disease and left ventricular dysfunction. And yet, PNT is potentially life-threatening, since it is characterized by sudden manifestations that can lead to disability of the patient or his death (in 2-5% of cases).

Paroxysmal supraventricular tachycardia has two subtypes:

• atrial paroxysmal tachycardia – in 15-20% of cases.
• atrioventricular (atrioventricular) paroxysmal tachycardia – in 80-85% of patients.
• The division into subtypes of PNT is determined by the localization of the pathological zone or circulating excitation wave.

Depending on the nature of the disease, three forms are distinguished:

• acute (paroxysmal).
• constantly recurring (chronic).
• continuously recurring, which develops continuously over several years.

Taking into account the mechanism of disease development, three types of PNT are distinguished:

• reciprocal (associated with the re-entry mechanism in the sinus node).
• ectopic (or focal).
• multifocal (or multi-focal).

The diagnosis of "paroxysmal supraventricular tachycardia" is established if the patient complains of sudden attacks of rapid, sharp heartbeat. Confirmation can be obtained using the following methods: physical examination and instrumental diagnostics.

At the initial stage, it is often enough to collect anamnesis. A characteristic sign of PNT is the occurrence of palpitations, “as if a switch had been clicked”. It is important to find out during the examination of the patient how suddenly the disturbance in heart rhythm occurs. At the beginning of collecting data on the symptoms that appear, patients may claim that the disturbance in heartbeat occurs suddenly. But with a detailed and thorough questioning of patients, it sometimes turns out that the change in heart rhythm occurs gradually, over several minutes. These symptoms are characteristic of another disease called sinus tachycardia.

PNT is diagnosed using external signs and vegetative manifestations of the disease. This type of tachycardia is characterized by increased sweating, frequent urination, nausea, dizziness, noise in the head, etc.

Physical examination

If the heart rate exceeds 150 beats per minute during auscultation, this excludes the diagnosis of "sinus tachycardia". A heart rate of more than 200 beats per minute refutes the diagnosis of "gastric tachycardia". But auscultation does not allow one to identify the source of tachycardia, and does not always distinguish sinus tachycardia from paroxysmal tachycardia.

When measuring the pulse, it is almost impossible to count it, it is so frequent. At the same time, the pulse is soft and weakly filled.

Vagus tests are used during physical examination. They are mechanical stimulation of the vagus nerve receptors, which is carried out in the form of pressure. This procedure causes a rapid and reflexive increase in the tone of the above-mentioned nerve. Vagus tests use the method of pressing on the carotid sinus, the Valsalva test, pressing on the eyeball and other methods.

The vagus nerve is connected to the atrium and the atrioventricular node. Increased tone of the nerve slows the atrial contraction rate and atrioventricular conduction, which results in a decrease in the ventricular contraction rate. This facilitates the interpretation of the supraventricular rhythm, which allows for a correct diagnosis of tachycardia. A comprehensive diagnosis can be performed, which increases the importance of vagal tests. In this case, a prolonged ECG and auscultation of the heart are performed together with stimulation of the vagus nerve. Such diagnostics are performed before, during and after vagal tests. With PNT, a sudden cessation of arrhythmic contractions occurs and the sinus rhythm is restored. In some cases, no changes in the heart muscle contraction rate occur during diagnostics. This is due to the "all or nothing" law, which is characteristic of the clinical picture of this type of tachycardia.

It is important to remember that vagus tests can provoke unexpected complications not only in patients, but also in healthy people. There are a number of cases that have ended in death. In rare cases, when pressure is applied to the carotid sinus in elderly patients, thrombosis of the cerebral vessels may occur. Stimulation of the vagus nerve can lead to a decrease in the cardiac output. And this, in turn, in some cases leads to a sudden decrease in blood pressure. An attack of acute left ventricular failure may occur.

Instrumental diagnostics

Instrumental diagnostics of PNT is carried out using the following methods:

1. Study of heart function using an electrocardiogram.
2. Holter monitoring.
3. Exercise ECG tests or stress tests.
4. Echocardiography.
5. Transesophageal cardiac stimulation.
6. Intracardiac electrophysiological study.
7. Magnetic resonance imaging (MRI) of the heart.
8. Multispiral CT cardiography (MSCT of the heart).

Supraventricular paroxysmal tachycardia on ECG

One of the main methods for diagnosing paroxysmal tachycardia is electrocardiography.

Conducting an electrocardiogram is a non-invasive method of examination, which has proven itself to be fast and painless. The essence of this method is to check the electrical conductivity of the heart. 12 electrodes are placed on the patient's body - his chest, arms and legs - thanks to which it is possible to obtain a schematic image of the heart's activity at different points. With the help of an electrocardiogram, it is possible to establish a diagnosis of PNT, as well as to identify its causes.

Supraventricular paroxysmal tachycardia on ECG has the following signs, which are clearly visible on the electrocardiogram tape:

1. The initial onset of the paroxysm is abrupt and the end of the attack is the same.
2. A heart rate of more than 140 beats per minute is observed.
3. Regular heartbeat rhythm.
4. Typically, QRS complexes are normal in appearance.
5. P waves are different in visual diagnostics. In paroxysmal tachycardia of the atrioventricular form, P waves are located after the QRS complexes or are superimposed on them. In atrial tachycardia, P waves are located before the QRS complexes, but have a changed or deformed appearance.

Emergency care for paroxysmal supraventricular tachycardia

In some attacks of PNT, emergency medical care is required, since the attack does not pass on its own, and the patient's condition worsens. Treatment is provided on site by an ambulance team that arrives. If the paroxysmal attack occurs for the first time or there is a suspicion that the patient needs to be hospitalized, a cardiology ambulance team is additionally called. In this case, the following methods of emergency care for paroxysmal supraventricular tachycardia are used:

• Vagus tests help to stop an attack. First of all, the Valsalva test is used, when you need to strain and hold your breath for 20 or 30 seconds. This is the most effective test. Deep, rhythmic breathing can also help. The Ashner test is also used, which is pressing on the eyeballs for five seconds. You can also squat. The use of vagus tests is contraindicated in the following diseases: conduction disorders, severe heart failure, sick sinus syndrome, stroke, cerebrovascular insufficiency, glaucoma.
• If your face is in cold water for 10–20–30 seconds, this will help stop an attack of PNT.
• Massage one of the carotid sinuses. Massage is contraindicated if there is a sharp decrease in pulse and noise appears over the carotid artery.
• If all the above actions do not produce results, then the attack must be stopped using transesophageal cardiac stimulation (TECS) or electropulse therapy (EPT). TECS is also used when it is impossible to use arrhythmic drugs due to intolerance. The use of TECS is indicated when there is evidence of conduction disturbance during the exit from the attack.
• To most effectively stop an attack of PNT, it is necessary to determine its form – PNT with narrow or wide QRS complexes.
• In case of PNT with narrow QRS complexes, the following drugs should be administered intravenously: adenosine phosphate, verapamil, procainamide, etc. Without an electrocardiographic examination, the use of drugs is possible only in extreme, critical cases. Or when there is evidence that this drug was used on the patient during previous attacks, and the procedure did not cause complications. Constant monitoring of the patient's condition using an ECG is necessary. If there is no effect from the administration of drugs, then chewed tablets should be used, namely propranolol, atenolol, verapamil, etc. In any case, these procedures are carried out only by the ambulance team that arrived to the patient.
• In case of an attack of PNT with wide QRS complexes, there is a suspicion of ventricular paroxysmal tachycardia. Therefore, the tactics of stopping the attack in this case are somewhat different. Electropulse therapy is effective, as is transesophageal cardiac stimulation. Medications are used that stop both attacks of supraventricular and ventricular PT. The most commonly used drugs are procainamide and/or amiodarone. In case of unspecified tachycardia with wide complexes, adenosine, ajmaline, lidocaine, sotalol are used.

Indications for hospitalization of the patient are as follows:

• An attack of PNT cannot be stopped on the spot.
• An attack of PNT is accompanied by acute cardiac or cardiovascular failure.

Patients who have attacks of PNT at least twice a month are subject to mandatory planned hospitalization. In the hospital, the patient undergoes an in-depth diagnostic examination, during which he is prescribed treatment.

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Treatment of paroxysmal supraventricular tachycardia

Regime and diet

• If tachycardia occurs, you should lead a certain lifestyle.
• First of all, you need to give up smoking and drinking alcohol.
• It is necessary to ensure that a balanced psycho-emotional state is maintained throughout the day and stress is avoided. To strengthen the psyche, it is useful to engage in autogenic training and other types of self-regulation. It is also possible to take sedatives prescribed by a doctor.
• It is important to maintain a stable daily routine, get enough sleep, and avoid staying up late watching TV or using social media. There should be enough time during the day to rest or take a nap if the patient needs it.
• Include feasible physical activity in your daily routine, namely, morning exercises, evening walks in the fresh air, swimming in a pool or open water.
• It is imperative to monitor your cholesterol and blood sugar levels.
• It is necessary to maintain optimal body weight.
• Food should be taken in small portions 4-5 times a day. Because an overfilled stomach begins to irritate the receptors of the nerves responsible for the work of the heart, which can lead to an attack of tachycardia.
• To avoid overeating, you need to avoid reading books, watching TV and working on the computer while eating. When you focus only on the process of eating, it is much easier to feel full and stop in time.
• You should not eat food at night; it is advisable to have your last meal two to three hours before bedtime.

It is necessary to exclude from consumption products that provoke the appearance of tachycardia:

• tea and coffee.
• foods containing starch and sugar, high-calorie foods – baked goods, chips, crackers, chocolate bars, sweets, and so on.
• fatty foods – fatty meat, mayonnaise, sour cream, lard, margarine; you should limit your consumption of butter.

Most of these products contain “bad” cholesterol, which negatively affects the condition of the heart muscle.

It is necessary to minimize salt consumption, replacing it with spices if necessary (for example, dried seaweed). Salt should be added only to ready-made dishes.

You should also exclude from your diet:

• canned and refined foods, as they contain large amounts of fat, salt and other products that are dangerous for the heart.
• fried food.

The diet for patients with paroxysmal supraventricular tachycardia should include a large amount of low-fat and plant foods.

The following foods should be included in your diet to support healthy heart function:

• foods rich in magnesium and potassium – dried apricots, buckwheat porridge, honey, pumpkin, zucchini.
• products containing Omega 3 unsaturated fatty acids – sea fish, flax seed, walnuts, canola oil.
• Products containing Omega 6 unsaturated fatty acids – vegetable oils, various seeds and soy.
• monounsaturated fats – these are found in sufficient quantities in cashews, almonds, peanuts, avocados and oils from various types of nuts.
• Low-fat foods – skim milk, yogurt and cottage cheese.
• various types of porridge, which contain a large amount of useful substances, as well as fresh and stewed vegetables.
• It is necessary to introduce some amount of freshly squeezed juices into the diet, as they are rich in vitamins and minerals.
• There are several useful recipes that should be included in the diet of patients with tachycardia.
• Take 200 grams of dried apricots, walnuts, raisins, lemon and May honey. Grind everything and mix in a blender, pour into a jar and store in the refrigerator. Take one tablespoon twice a day.
• A good remedy for tachycardia is celery root. You need to prepare salads with it: grate it on a coarse grater and add greens - celery leaves, dill and parsley. Salad should be salted and seasoned with low-fat yogurt (or put a small amount of low-fat sour cream).

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Drug treatment of paroxysmal supraventricular tachycardia

It is important to remember that the intake of medications, as well as their dosage, is prescribed by a doctor.

In the treatment of PNT, sedatives are used: tranquilizers, bromine, barbiturates.

Drug treatment begins with the use of beta-blockers:

• Atenolol – daily dose 50-100 mg in 4 doses or propranolol (anaprilin, obzidan) – daily dose 40-120 mg in 3 doses.
• Metoprolol (vasocardin, egilok) – 50-100 mg 4 times a day.

Patients who do not have myocardial damage and heart failure are prescribed quinidine. The average dose is 0.2 - 0.3 grams 3-4 times a day. The course of treatment is several weeks or months.

Quinidine bisulfate (quinidine duret, quinidine duriles), as the latest generation of drugs, cause fewer side effects from the gastrointestinal tract, and also have a higher concentration in the patient's blood. Quinidine duret is used at 0.6 grams 2 times a day.

When treating patients with damaged myocardium and heart failure, as well as pregnant women, it is recommended to use foxglove preparations - isoptin. The daily dose of the drug is from 120 to 480 mg per day and is used in 4 doses. It is also good to use digoxin - 0.25 grams per day.

The best results are achieved by combining foxglove and quinidine.

The medicinal product procainamide is prescribed for use as follows: 1 or 2 dragees, dosage 0.25 grams, 4 times a day.

The following medications are also prescribed:

• Aymaline – 50 mg 4-6 times a day.
• Verapamil – 120 mg 3-4 times a day.
• Sotalol – 20–80 mg 3–4 times.
• Propafenone – 90-250 mg, 3-4 times a day.
• Allapinin – 15 – 30 mg, 3-4 times a day.
• Etacizin – 50 mg, 3 times a day.

Experts recommend a long course of treatment with potassium preparations; potassium chloride, panangin, and tromkardin are used. These drugs are prescribed in combination with some of the main antiarrhythmic drugs. Potassium chloride in a 10% solution is used in a dosage of 20 ml 3 or 4 times a day for a long course of treatment.

Physiotherapy for paroxysmal supraventricular tachycardia

In the treatment of paroxysmal supraventricular tachycardia, water procedures are actively used:

• medicinal baths.
• whirlpool baths.
• dousing.
• rubbing.
• circular shower.

Treatment of paroxysmal supraventricular tachycardia with folk methods

It happens that patients suffering from paroxysmal supraventricular tachycardia are contraindicated to some drugs prescribed by the doctor. Traditional medicine will come to the aid of patients. Here are several recipes that patients can easily use to alleviate their condition.

• Using lovage: take 40 grams of plant roots and pour 1 liter of hot water (but not boiling water). The infusion should be kept for 8 hours, and then filtered. Take the drink during the day in small portions until the health condition improves.
• Pour three glasses of viburnum berries into a three-liter jar and pour two liters of boiling water. After this, you need to carefully close the jar, wrap it up and leave it for six hours. Then you need to strain the infusion into an enamel bowl and also squeeze the berries there. Then add 0.5 liters of quality honey to the infusion and put it in the refrigerator for storage. Take the infusion before meals three times a day, one third of a glass. The course of treatment is one month, then you need to take a break for ten days and repeat taking the infusion. Thus, it is necessary to conduct three courses of treatment.
• The hawthorn method of treatment has also proven itself. In the pharmacy, you should buy alcohol tinctures of hawthorn, motherwort and valerian (one bottle each). Then you need to thoroughly mix the tinctures and leave them in the refrigerator for one day. The medicine should be taken three times a day, one teaspoon half an hour before meals.
• It is good to use rosehip infusion in the treatment of tachycardia. You need to take 2 tablespoons of rosehip, place them in a thermos and pour half a liter of boiling water. Leave to brew for one hour, and then add 2 tablespoons of hawthorn. The resulting infusion should be drunk in small portions during the day and brew a fresh drink daily. You need to drink the infusion for three months, and then take a break for one year.

Treatment of paroxysmal supraventricular tachycardia at home

In case of an attack of paroxysmal tachycardia, it is necessary to resort to self-help and mutual assistance:

• First of all, you need to calm down; the most important thing at this moment is to gain physical and emotional peace.
• In case of sudden weakness, nausea and dizziness, you need to sit in a comfortable position or lie down in a horizontal position.
• It is essential to ensure that fresh air reaches the patient. To do this, unbutton clothing that restricts breathing and open a window.
• An attack of paroxysmal tachycardia can be relieved by irritating the vagus nerve using reflex methods. To do this, you need to do the following exercises: strain to squeeze the abdominal press; press on the eyeballs; hold your breath for 15-20 seconds; induce vomiting movements.
• If your doctor has shown you how to perform vagal tests, it will be useful to perform them.
• It is necessary to take the medications prescribed by the doctor and under no circumstances change the dosage of the medication on your own.
• If your health and well-being deteriorate, you should call an ambulance immediately. If you experience heart pain, sudden weakness, suffocation, loss of consciousness, or other signs of deterioration, you should call for medical help immediately.

Treatment of paroxysmal supraventricular tachycardia requires restoration of the required concentration of so-called electrolyte substances in the blood. These include potassium, calcium and chlorine. If you choose the right herbal therapy, the body will receive the necessary substances in sufficient quantities, as well as plant glycosides.

In paroxysmal tachycardia, plants containing cardiac glycosides and having a sedative (calming) effect are widely used. These include hawthorn, motherwort, valerian, mint, lemon balm. They should be used for a long time in courses with certain breaks in the form of decoctions and infusions. There are also alcohol analogues of medicinal tinctures, but due to the presence of alcohol in the drug, they cannot be used by all patients. In any case, before taking medicinal herbs, you must consult with your doctor. Since there are contraindications to taking various traditional medicine, as well as their incompatibility with pharmaceutical drugs prescribed by a doctor.

During attacks of paroxysmal tachycardia, breathing techniques should be used. For example, "yogic breathing" is good at stopping attacks of rapid heartbeat. The breathing exercise is performed as follows: inhale through one nostril (while closing the other nostril with a finger) - exhale through the other nostril.

Another modification of the breathing technique is possible, in which the inhalation and exhalation are performed rhythmically, with a breath hold. For example, inhale for 3 counts, hold for 2 counts, exhale for 3 counts, hold for 2 counts.

It is good to learn breathing exercises using the Strelnikova method or Buteyko breathing. These methods do not eliminate the cause of the disease, but they allow to alleviate the patient's condition, and also help to train the heart muscle, which significantly reduces the number and duration of attacks.

Surgical treatment of paroxysmal supraventricular tachycardia

This method is used in cases where conservative treatment has shown its ineffectiveness. Also, in case of irreversible sclerotic changes in the heart and when a heart defect is detected, surgery is recommended.

There are two types of surgical treatment – partial and radical. With the radical method of treatment, the patient gets rid of the symptoms of the disease forever. With the partial method of treatment, tachycardia attacks lose their strength and occur much less frequently; the effectiveness of the use of antiarrhythmic drugs also increases.

There are two types of treatment used in surgical intervention:

• Destruction of additional conduction pathways or foci of heterotopic automatism. Surgical intervention is performed using minimally invasive methods using mechanical, electrical, laser, chemical, cryogenic means. This is the so-called closed operation, which uses two types of catheters - diagnostic and therapeutic. They are inserted into the patient's body through the femoral or subclavian vein. The diagnostic catheter, with the help of a computer, allows you to determine the exact zone of tachycardia. And the therapeutic catheter is used to perform the procedure of influencing the PNT zone.
• The most common is radiofrequency ablation. The term "ablation" means removal, but this treatment procedure involves burning the area that is causing the tachycardia.
• Implantation of two types of pacemakers – an artificial pacemaker (electrocardiostimulator) and an implantable cardioverter-defibrillator. Pacemakers must operate in preset modes – paired stimulation, “capture” stimulation, etc. The devices are set to automatically turn on after the onset of an attack.

Surgery for paroxysmal supraventricular tachycardia

If drug therapy is ineffective for paroxysmal supraventricular tachycardia, surgery is prescribed. Also, in case of congenital defects in the structure of the heart muscle and cardiac conduction disorders (for example, in Wolff-Parkinson-White syndrome), surgical intervention is used.

The classic method is open-heart surgery, the purpose of which is to interrupt the conduction of impulses along additional pathways. Relief of tachycardia symptoms is achieved by cutting or removing pathological sections of the conduction system. Surgical intervention is performed using artificial blood circulation.

So, surgery for paroxysmal supraventricular tachycardia is indicated for the following symptoms:

1. The occurrence of ventricular fibrillation, even in a single case.
2. Paroxysms of atrial fibrillation that recur multiple times.
3. Persistent attacks of tachycardia that cannot be relieved by antiarrhythmic therapy.
4. The presence of congenital defects and anomalies in the development of the heart.
5. Intolerance to drugs that block an attack of tachycardia and maintain the patient's satisfactory condition between attacks.
6. The occurrence of attacks of PNT in children and adolescents, which greatly impede their physical, psycho-emotional and social development.

Prevention of paroxysmal supraventricular tachycardia is carried out with the help of a healthy lifestyle, correct daily routine and diet, which were described in detail in the section "Treatment of paroxysmal supraventricular tachycardia". A patient with PST should avoid strong psycho-emotional and physical stress, lead a gentle lifestyle, which evenly combines movement and rest. It is also necessary to exclude factors that provoke tachycardia - smoking, drinking alcohol, coffee, strong tea, etc.

Timely diagnostics and use of antiarrhythmic drugs are also methods of primary prevention of PNT. As well as treatment of the underlying disease causing attacks of paroxysmal cardiac arrest. Taking sedatives is also a preventive measure in the event of paroxysmal supraventricular tachycardia. One of the means of preventing attacks of PNT is timely surgical intervention.

There are forms of paroxysmal supraventricular tachycardia that cannot be prevented. Essential form of PNT is one of these cases, since its causes are still unknown.

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When making predictions, it is necessary to take into account the causes of occurrence and the form of PNT. The frequency of occurrence and duration of paroxysmal attacks, the presence or absence of complications, and the condition of the myocardium are taken into account. For example, with severe damage to the heart muscle, acute cardiac or cardiovascular failure may occur. There is a high risk of ventricular fibrillation and ischemia with damaged myocardium; cases of unexpected death during an attack of PNT have also been registered.

The effectiveness of treatment of the underlying disease, as well as the rate of its progression, affects the condition of the patient with PNT.

The prognosis for the course of the disease is favorable in the essential form of paroxysmal supraventricular tachycardia, although its prevention is difficult due to the absence of identified causes of the disease. Patients with PNT can be able to work and maintain an active lifestyle for several years or decades. Cases of sudden recovery from PNT are also rare.

Paroxysmal supraventricular tachycardia can slow down its progress with timely diagnosis and prevention of this disease.

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