Atrioventricular Reentrant Tachycardia or AVRT

Atrioventricular Reentrant Tachycardia or AVRT is a supra ventricular tachycardia that involves an extra pathway between the atria, or upper chambers of the heart, and the ventricles, or lower chambers of heart. As a result of this extra connection, AVRT makes your heart beat too fast.

This extra electrical pathway in the heart is usually present at birth. Known as an accessory pathway, this additional connection creates a circular impulse – much like a short circuit – that triggers the heart to beat more quickly than normal. Wolff Parkinson White or WPW syndrome is considered an AVRT and represents the most common form of the disorder.

How Do I know if I Have AVRT?

Accurately self-diagnosing any arrhythmia is virtually impossible and therefore a consultation with an electrophysiologist is the most important first step in understanding 1) what type of arrhythmia it is and 2) what the best treatment options are. However, AVRT can be similar, symptomatically, to other supraventricular tachycardia in that it causes a fast heartbeat and the symptoms that go along with it. Some patients describe it as their heart pounding out of their chest, experiencing chest pain or shortness of breath, being tired all the time, or fainting for no reason – known as syncope.

Most cases of AVRT are paroxysmal, meaning they do not occur consistently. As a result, the diagnostic process may be progressive. We begin with an electrocardiogram or EKG which offers us a snapshot of the heartbeat at any given time. However, if the episode occurs outside of your physician’s office, the problem may go unnoticed. As such, patients may be fitted with a portable EKG known as a Holter monitor or may be suited to an implantable device known as a loop recorder that can deliver up to three years of heart rhythm data.

Treatment for AVRT

Treatment may begin with lifestyle modification and medication. You may also learn vagus nerve exercises to stop an episode in its tracks. However, the definitive solution to AVRTs is a catheter ablation either in the form of heat-based RF ablation or cold-based cryoablation to eliminate the accessory pathway and thus the reentrant circuit.