Physical methods to terminate supraventricular tachycardia

  Paroxysmal supraventricular tachycardia is a relatively common arrhythmia that is characterized by “sudden onset and stop” episodes. During an episode of tachycardia, the heart rate may reach 140-250 beats per minute, and some patients may experience palpitations only, while others may have more severe symptoms, including chest tightness and even syncope. The cause of supraventricular tachycardia is that the heart has other conduction pathways between the atria and ventricles in addition to the normal conduction pathways. This may be due to a “longitudinal separation” of the heart’s own conduction pathways, creating two pathways. The tachycardia occurs when the electrical activity in the two pathways “bends back”.  If a patient has never had a clear diagnosis of tachycardia, it is important to go to the hospital for the first time to confirm the diagnosis. For patients with a clear diagnosis of “paroxysmal supraventricular tachycardia”, if the tachycardia continues unabated, go to the nearest hospital for “rhythm transfer therapy”. For doctors, this is a disease that can be easily converted to a normal rhythm, and can be quickly reversed with the use of cardioplegia, Ebodine, and ATP.  However, some patients who are far away from the hospital when tachycardia strikes, or who do not have access to emergency care, can try to stop the onset of supraventricular tachycardia by using some neurostimulation methods. The first step is to ask the patient to sit or lie down to avoid the risk of a long interval of transient heartbeats immediately after the transient rhythm. Neurostimulation consists of doing the wah maneuver, which is holding the breath after a deep inhalation and doing a forceful exhalation without termination of the tachycardia, which can be done in several consecutive sets. The back wall of the throat and the base of the tongue can also be stimulated with a hand or other soft object to produce a feeling of nausea and desire to vomit. Some other maneuvers are also effective in terminating supraventricular tachycardia, such as massaging the carotid sinus (this maneuver should be done with caution and is not suitable for elderly patients), compressing the eyeballs, and washing the face with cold water. These maneuvers are different, but they have a similar effect in that they stimulate increased excitability of the vagus nerve. The effect of the vagus nerve on the heart is to slow down the heart rate and decrease the conduction velocity of the cardiac conduction pathway, which in turn prolongs the conduction pathway’s overdue period and can effectively terminate the tachycardia. But again, do these actions while sitting or lying down, because stimulation of the vagus nerve, some patients can experience a transient slowing of the heart rate and a drop in blood pressure, triggering syncope, so the above symptoms should not be overused. If the tachycardia does not end after applying the appropriate stimulation, please seek medical attention as soon as possible.