Do you sometimes feel like your heart is beating very fast for no reason? Or do you feel like something is spinning in your chest, and you have difficulty breathing? This can sometimes be accompanied by things like dizziness, a slight tightness in your chest, etc. These things are not just random things. This could be a symptom of a condition called AVNRT (Atrioventricular Nodal Reentrant Tachycardia) that we are going to talk about today. Don't worry, let's talk about this simply.
What is AVNRT (Atrioventricular Nodal Reentrant Tachycardia)?
Simply put, AVNRT is a condition in which your heart suddenly starts beating very fast due to a small change in your heart's electrical system. It is one of a larger group of conditions called Supraventricular Tachycardia (SVT) , which are rapid heart rhythms that start in the upper chambers of the heart (the atria). In fact, AVNRT is the most common type of SVT.
Normally, when we are at rest, our heart beats between 60 and 100 times per minute. But in someone with AVNRT, suddenly, without any warning, the heart rate can jump from 140 to 280 beats per minute, or even faster. Imagine that! It can last for a while, and sometimes it can last a little longer.
AVNRT and SVT are conditions that belong to the larger category of arrhythmias . An arrhythmia is any condition in which the heart beats irregularly, meaning it beats too fast, too slow, or in an unusual way.
Who is more likely to develop AVNRT?
Actually, anyone can develop this condition called AVNRT. However, it is slightly more common in women than in men. Also, young, healthy adults with no other major illnesses can also develop this condition. So, don't think, "I'm healthy, this won't happen to me."
Why does AVNRT occur? What happens in the heart?
The rate and rhythm of our heart beat are controlled by a very complex electrical system. This begins with a special group of muscle fibers called the Sinoatrial node (SA node) in the upper right chamber (atrium) of the heart. This SA node acts as our heart's natural pacemaker.
In a healthy heart, an electrical signal from this SA node causes the two upper chambers of the heart (atria) to contract, pushing blood into the lower chambers (veins). This electrical signal then travels along special pathways to a place called the Atrioventricular node (AV node) . This AV node is like a gate between the upper and lower chambers. From there, the signal travels to the lower chambers (veins) and causes them to contract. That's how a normal heart pumps blood throughout the body in an orderly manner.
However, if there is a problem with this electrical system, the heart can beat irregularly. That is, it can either speed up, slow down, or the rhythm can become chaotic. That is what we call arrhythmia.
In AVNRT, there is something called an extra, small electrical pathway (reentrant circuit) near the AV node. This can be something that is present at birth. Sometimes, due to a premature contraction of the heart, the electrical signal enters this extra pathway and starts to go around in circles. Think of it like a short circuit in a small electrical circuit. That's when the heart suddenly starts beating faster, and it can stay that way.
Since several people in some families have this condition, there is suspicion that AVNRT may be hereditary, but the exact genetic cause has not yet been identified.
What are the symptoms of AVNRT?
AVNRT is not a continuous condition. It is an episodic condition . This means that the rapid heartbeat may come on suddenly and then stop for a short time. Some people have these symptoms for years, but it can take a while to figure out exactly what is going on.
These are the most common symptoms:
- Discomfort in the neck or chest , a feeling of being suffocated.
- Dizziness , sometimes a feeling of lightheadedness.
- A very fast heartbeat (around 140-280 beats per minute).
- Palpitations - This is the feeling of your heart beating. This can be felt in different ways.
- Polyuria - This means passing urine frequently and in large amounts. This is caused by certain hormonal changes in the body when the heart beats faster.
- Difficulty breathing , feeling like you're suffocating.
What do these palpitations feel like?
People with AVNRT describe this heart rhythm as:
- It feels like something is going up and down inside the chest (flip-flopping) .
- Fluttering lightly, like a butterfly flying.
- A feeling of tightness or fullness in the neck or throat.
- Like pounding a drum loudly.
- The heart beats fast like in a race (Racing) .
Very rarely, in severe cases, AVNRT can cause more serious symptoms and complications. For example:
- Chest pain .
- Confusion .
- Loss of consciousness (Syncope) .
- Low blood pressure (Hypotension) .
- Shock - This is very rare.
How do doctors diagnose AVNRT?
To find out if you have AVNRT or another arrhythmia, a doctor will do the following:
1. Asking about your medical history: You will be asked questions about any previous illnesses you have had, any recent symptoms you have had, and any medications, vitamins, supplements, and drugs you are taking.
2. Physical exam: Your breathing rate, blood pressure, and heart rate will be measured. Your heart will also be listened to with a stethoscope.
3. Electrocardiogram (EKG): This is the most important test. An EKG measures the electrical activity of your heart, such as the duration and duration of each heartbeat. It can be very helpful in confirming a diagnosis, especially if you can get an EKG while your heart is beating fast.
In addition, your doctor may order other tests to learn more about your heart:
- Blood tests: Check for other problems that could affect your heart (e.g., thyroid problems, anemia).
- Echocardiogram (Echo): This takes pictures of the heart (like an ultrasound) to check for any problems with the heart's structure or the way it pumps blood.
- Holter monitor or other ambulatory monitor: This is a small device that you wear for a few days. It continuously records your heart rhythm while you go about your daily activities. If an arrhythmia is not present during an EKG, it can be caught with this type of device.
- Exercise stress test: Your heart rate is monitored while you run on a treadmill or ride a stationary bike. Some people may experience this rapid heartbeat during exercise.
- Electrophysiological (EP) study and cardiac mapping: This is a more complex test. It involves passing a thin wire (catheter) through a vein into the heart to pinpoint exactly where the arrhythmia is starting and how it is occurring. This test is often done before a treatment called a catheter ablation.
What treatments are available for AVNRT?
Although many people have AVNRT, not everyone needs treatment. Especially if symptoms occur only occasionally and are not too bothersome, treatment may not be necessary. However, your healthcare team may refer you for treatment in the following cases:
- If you are at risk of serious complications .
- If you have symptoms that interfere with your daily life , such as insomnia.
- If AVNRT occurs frequently or for a long time .
There are several treatment methods:
1. Vagal maneuvers: You can sometimes stop this rapid heartbeat with simple things you can do at home. For example, coughing, holding your breath (Valsalva maneuver), and putting your face in cold water . Your doctor will show you how to do these.
2. Electrical cardioversion: This involves placing paddles or patches on your chest and delivering an electrical shock to your heart. This can help restore your heart's rhythm to normal. This is often done in an emergency.
3. Medications: There are several types of medications that can control the heart rate and rhythm. For example, Adenosine injection (this is an injection given into a vein, which quickly slows down the rate), Antiarrhythmic drugs (special drugs given for arrhythmia), Calcium channel blockers , and Beta-blockers . These should be taken exactly as prescribed by your doctor.
4. Catheter ablation: This is often considered the only treatment for AVNRT. In this, similar to the EP study mentioned earlier, a thin catheter is passed through a vein in the leg or arm to the heart, the reentrant circuit is located, and a small scar is created using radiofrequency energy or cryoablation. This stops the abnormal electrical signals from going through the heart, and the arrhythmia stops. This is a successful treatment.
How can I reduce the occurrence of this condition?
There is no proven way to prevent AVNRT. However, if you have this condition, you may find that certain things make this rapid heartbeat more likely. We call these "triggers."
By avoiding these triggers, you can reduce the frequency of AVNRT attacks.
These are the triggers that affect most people:
- Alcohol
- Caffeine - found in coffee, tea, and some soft drinks.
- Certain types of exercise (you should talk to your doctor about this).
- Some herbal supplements .
- Illegal drugs (Recreational drugs) .
- Smoking or using tobacco products .
- Stress .
What is the future for people with AVNRT?
Very rarely, AVNRT can cause serious complications, such as sudden cardiac arrest. However, for most people, it is not a life-threatening condition . If managed properly, people can live a normal life.
I have AVNRT, how should I take care of myself?
Following these tips will help you manage your AVNRT condition:
- Do not use over-the-counter medications or nutritional supplements without consulting a doctor.
- Keep seeing doctors, like your cardiologist, for check-ups.
- Take all medications prescribed to you exactly and on time.
- Find out what triggers your AVNRT and try to avoid them.
- If you notice any changes in your symptoms (e.g., they are worse than before, they are more frequent), tell your doctor about it.
Can I exercise if I have AVNRT?
Exercise is very important for heart health. Most people with AVNRT can exercise . However, it's best to talk to your doctor about what kind of exercise is best for you and whether there are any restrictions.
When should I seek immediate medical attention for AVNRT?
If you have AVNRT, seek immediate medical attention if you experience any of these symptoms:
- Chest pain .
- If the heart palpitations have been going on for a long time or are occurring frequently .
- Feeling light-headed, dizzy, or faint .
- Severe difficulty breathing .
Finally, remember this.
AVNRT is a common heart rhythm disorder. In this condition, the heart suddenly starts beating much faster than normal. Although it is not life-threatening in most cases, some symptoms can be bothersome. If you have any of these symptoms, don't hesitate to see a doctor. There are many ways to manage this condition and get treatment if necessary. Take care of your heart and stay healthy!
` AVNRT, heart palpitations, rapid heartbeat, SVT, arrhythmia, heart disease, chest pain, shortness of breath, heart rhythm problems
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