Ask an Expert: Is Tachycardia dangerous?

Q: “My 14-year-old daughter has been diagnosed with tachycardia. Both her pediatrician and a specialist have told us that her tachycardia is not dangerous. However, when I hear reports of young people dying of heart arrhythmias, I become frightened all over again. How can I reassure myself that this is not dangerous?”

Answer from Blair Halperin, M.D., medical director of Providence Heart and Vascular Institute’s Center for the Advanced Treatment of Atrial Fibrillation at Providence St. Vincent Medical Center: As a parent, you can’t help but be concerned. But learning as much as you can about your daughter’s condition can go a long way toward relieving many of your fears. Find out: 
  • What is tachycardia?      
  • What kind of tachycardia does your daughter have?
  • What are the options for treatment?
What is tachycardia?
Tachycardia means nothing more than fast heart rate (tachy means fast, and cardia has to do with the heart). When the heart beats more than 100 times per minute, that’s called tachycardia.

There are several types of tachycardia. There’s the kind that happens to all of us when we’re exercising or experiencing stress, anxiety, fear or excitement. Under these conditions, it’s normal for the heart rate to speed up. This is called “sinus tachycardia.”

There are also abnormal types, where the heart seems to speed up for no reason. These tachycardias are a type of arrhythmia — a heart rhythm disorder, usually caused by a glitch in the electrical system that controls the heartbeat. Normally, electrical signals flow smoothly along a pathway from the heart’s upper chambers (the atria) to its lower chambers (the ventricles) to trigger a steady, rhythmic heartbeat. But a short-circuit anywhere along this path can throw off the normal pace or rhythm of the heart.

When tachycardia is caused by a short-circuit in the atria, it’s called atrial tachycardia or supraventricular tachycardia (supraventricular means “above the ventricles”). In most cases, this type of tachycardia is just a nuisance problem.

When tachycardia is caused by a short-circuit in the ventricles, it’s called ventricular tachycardia. This type of tachycardia is more likely to pose a danger, although not all do.

If you know exactly what type of tachycardia your daughter has, you can make informed decisions about treatments that can minimize her risks — which should be very reassuring for you.

What kind of tachycardia does your daughter have?
Both a pediatrician and a specialist have told you that your daughter’s tachycardia is not dangerous — yet you remain frightened. To reassure yourself, make sure your daughter’s condition has been thoroughly evaluated. In addition to a medical history and physical exam, a thorough assessment of tachycardia should include: 
  • An assessment of overall heart health. A person who has a healthy heart and cardiovascular system is less likely to have a dangerous tachycardia. The dangerous types are more likely to occur in people who have heart disease or reduced pumping function.
  • Documentation of the heart’s rhythm. This is usually done with a portable heart rhythm monitor (EKG), which records the heart rate over a period of time to document exactly what is happening during a tachycardia episode.
  • An evaluation of the symptoms. The most common symptom of tachycardia is palpitations — the feeling that the heart is racing or fluttering. Other symptoms sometimes include lightheadedness, shortness of breath and fatigue.
By correlating all of this information, and looking at the symptoms your daughter experiences at the moment that a tachycardia episode is occurring, a physician can confirm what type of tachycardia your daughter has, reassure you about whether it is dangerous or not, and recommend the best options for treatment.

What are the options for treatment?
Once you’ve done all of this, and you’ve been reassured that the tachycardia is not dangerous, the next question is, is it bothersome enough to consider treatment? If the episodes don’t bother your daughter much — for example, if they only occur once a year, or only last a couple of minutes a few times a year, and the symptoms are minor — then your daughter may prefer not to treat it. But if the episodes happen fairly often, last a long time, or cause a lot of anxiety, then treatment may be beneficial and reassuring.

Depending on the type of tachycardia, treatment options might include antiarrhythmic medications or a procedure called catheter ablation, which permanently eliminates the tissue that was causing the short-circuit in the electrical pathway. For many arrhythmias, catheter ablation is first-line therapy, correcting the problem and allowing people to avoid daily medications and their potential side effects.

Still worried?
If you’ve done all of these things and you still feel frightened, consider seeking a second opinion. Another opinion is always worthwhile if there is concern about the initial evaluation, or if procedures are recommended that you have questions about or are uncomfortable with.

On a final note, I can tell you that it’s very common for atrial tachycardias to be diagnosed in the early teens years. On the other hand, it’s uncommon for young people to die from tachycardias. In addition, the conditions that cause the life-threatening types of tachycardias are often treatable. That’s why it’s so important — and so reassuring — to know that your daughter has been thoroughly evaluated.