Specialist electrophysiology care
Dr Rohan WijesurendraConsultant Cardiologist & Electrophysiologist
1,500+ ablationsPersonally performed catheter ablation procedures
Oxford-based carePrivate care at Nuffield Health The Manor Hospital
NHS practiceAcademic & researchGMC registrationHospital profile
Choosing between medication and ablation for SVT
Supraventricular tachycardia (SVT) commonly causes sudden episodes of a very rapid heartbeat. Many forms are not dangerous, but attacks can be frightening, disruptive and difficult to predict.
If you have been diagnosed with SVT, you may be deciding whether to manage episodes with medication or consider catheter ablation.
Do I need treatment for SVT?
That depends on the type of SVT, how often it occurs, how severe the episodes are and how much they interfere with your life. Some people have infrequent, brief episodes and prefer no treatment. Others experience recurrent attacks, prolonged symptoms, urgent-care attendance or disruption to work, exercise, travel or everyday life.
Can medication help?
Medication can reduce episodes for some people and may be a reasonable approach. For others, medication is ineffective, causes unwanted effects or is unattractive as a long-term solution for an intermittent rhythm problem.
What does catheter ablation do?
Many common forms of SVT depend on a small electrical circuit or an abnormal electrical connection within the heart. During an electrophysiology study, the mechanism can often be identified; catheter ablation can then target the tissue responsible for the abnormal rhythm.
The likelihood of success and the risks depend on the precise type and location of the SVT. These should be discussed individually before deciding on a procedure.
Do I have to try medication first?
Not necessarily. For some forms of SVT, catheter ablation can be considered without first taking long-term medication. Someone with rare, tolerable episodes may reasonably prefer no treatment, while someone whose SVT is significantly affecting life may place greater value on a potentially definitive treatment.
What if nobody has captured my SVT on an ECG?
Intermittent palpitations are not always straightforward to diagnose. An ECG during symptoms is very helpful; ambulance, emergency-department and appropriate wearable recordings may also be useful. If the diagnosis remains uncertain, a heart-rhythm consultation can help decide what monitoring or investigation is most useful rather than proceeding directly to treatment.