SVT treatment involves two parts: immediate stopping of SVT either with “home remedies” or by health care providers, and long-term treatment that may involve regular medication or catheter ablation.

Story by: Chris L. Johnsrude, M.D. on March 27, 2019

Supraventricular tachycardia (SVT) isn’t life-threatening for otherwise healthy children if they receive proper care. Infants and children with various types of other heart disease are most at risk of fast heartbeats due to SVT.

SVT treatment includes short-term methods to stop the episode, and long-term treatment to prevent future spells.

“Home remedies” for SVT

There are a few ways a parent or caregiver can provide SVT treatment at home, and these involve stimulating the vagus nerve to return the heart rate back to normal. If your child looks ill during SVT or SVT doesn’t stop with these methods, your child will need care from a professional health care provider. Speak with your cardiologist about guidelines for when to seek emergency care.

Ice for young infants

A cold ice pack to the face (may take two adults to do this in infants or young children)

• Fill a sandwich-size sealable plastic bag halfway with crushed ice.
• Pour a little bit of cold water into the bag to just cover the ice.
• Squeeze the remaining air out of the bag, and seal it.
• Apply the ice pack over much of the face, from the upper lip, over the nose, eyes and forehead — being careful not to cover the mouth so the child can continue to breathe. Infants will not like this, and will put up a fight. Sometimes another adult may be needed to hold the child while the ice pack is applied.
• Hold the ice pack in place for 10 to 20 seconds.
• Remove the bag and allow the child (and adults) to rest.
• Calm the child down and recheck the pulse rate to see whether the heart beat has slowed.
• If SVT is still present, repeat up to two more times as necessary.

Tricks for older children and teens

Practice these with your child he or she isn’t having SVT symptoms so the child is prepared and more cooperative if one of these steps is needed.

• Pretend to have a bowel movement by taking a deep breath and then bearing down or straining (hold it for 10 seconds if possible).
• Blow up a balloon.
• Pretend to blow up a balloon. The child forms a tight seal with his or her lips around the thumb or small straw, blowing hard.
• Have the child do a headstand, or carefully hold the child upside down for 20 to 30 seconds.
• Older children can place their face (not entire head) in a sink filled with ice water and blow through the nose, trying to keep the face in the water for 15 seconds.
• Less fun: Have the older child place a finger in the back of the throat and gag or retch. It’s not necessary for the child to actually vomit.

Long-term SVT treatments

In some cases, no long-term treatment is needed as long as the patient and family know how to recognize SVT, can try any of the home remedies and have discussed with their cardiologist scenarios that would lead to an emergency department visit.

Read more: How to spot supraventricular tachycardia in your child

In many cases, the cardiologist will recommend medication or a procedure to correct the issue.

There are numerous medications that are usually helpful in preventing SVT recurrence. Medications like digoxin or a beta blocker can be given to older, otherwise healthy children as an outpatient. Some patients will be hospitalized and monitored closely when starting medication, especially very young children, very sick children or at any age when starting one of the other more potent medications.

If SVT continues to be a problem, the cardiologist will often recommend the child undergo a catheter-based procedure that can usually cure the underlying cause of the SVT. The procedure includes an electrophysiology study to understand or diagnose the specific type of SVT, followed by catheter ablation which can eliminate the cause of SVT. A specially trained cardiologist (called an electrophysiologist) threads catheters (thin wires) through the blood vessels up to the heart to accomplish these procedures.

Chris L. Johnsrude, M.D., is an associate professor in the University of Louisville Department of Pediatrics and serves as director of the pediatric arrhythmia service at Norton Children’s Hospital.