Atrioventricular Nodal Reentry Tachycardia
Atrioventricular nodal reentry tachycardia (AVNRT) is a type of irregular heartbeat, also called an arrhythmia. It is the most common type of supraventricular tachycardia (SVT).
People with AVNRT have a very fast heartbeat that often starts and ends suddenly. In AVNRT, the heart beats more than 100 times a minute. The condition is due to a change in heart signaling.
AVNRT tends to occur more often in young women. But anyone can have it at any age. AVNRT may not need treatment. When treatment is needed, it may include specific actions or movements, medicines, or a heart procedure.
A very fast heartbeat is the most common symptom of atrioventricular nodal reentry tachycardia (AVNRT). In AVNRT, the heart can beat between 120 to 280 times a minute. The fast heartbeat usually starts suddenly.
AVNRT does not always cause symptoms. When symptoms do show up, they may include:
- A pounding feeling in the neck.
- Pounding or fluttering heartbeat, called palpitations.
- Chest pressure, tightness or pain.
- Dizziness or lightheadedness.
- Shortness of breath.
- Sweating.
- Weakness or extreme tiredness.
- Fainting or almost fainting.
Symptoms of AVNRT may be mild in children. Some symptoms include sweating, trouble feeding, changes in skin color and a fast heartbeat.
When to see a doctor
Make an appointment for a healthcare checkup if you have unexplained changes in your heartbeat.
Also see a healthcare professional if an infant or child has these symptoms:
- Fast heartbeat.
- Sweating for no reason.
- Changes in feeding.
- Changes in skin color.
Call 911 or your local emergency number if you a very fast heartbeat that lasts for several minutes or happens with these symptoms:
- Chest pain.
- Dizziness.
- Trouble breathing.
- Weakness.
Atrioventricular nodal reentry tachycardia (AVNRT) is caused by faulty electrical signaling in the heart. Electrical signals control the heartbeat.
Usually, electrical signals in the heart follow a specific pathway. In AVNRT, there is an extra signaling pathway, called a reentrant circuit. The extra pathway makes the heart beat too early. This stops the heart from pumping blood like it should.
Healthcare professionals aren’t sure why some people have the extra pathway that causes AVNRT. Sometimes, changes in the heart’s structure may cause it.
Atrioventricular nodal reentry tachycardia (AVNRT) is more common in young women. But anyone can get it.
Some health conditions or treatments may increase the risk of AVNRT. These include:
- Coronary artery disease, heart valve disease and other heart diseases.
- Heart failure.
- Heart condition present at birth, called a congenital heart defect.
- Previous heart, lung or throat surgery.
- Obstructive sleep apnea.
- Thyroid disease.
- Lung diseases such as chronic obstructive pulmonary disease (COPD).
- Diabetes that is not controlled.
- Some medicines, including those used to treat asthma, allergies and colds.
Other things that may increase the risk of AVNRT include:
- Emotional stress.
- Caffeine.
- Excessive alcohol use, which is defined as 15 or more drinks a week for men and eight or more drinks a week for women.
- Smoking and using nicotine.
- Stimulant drugs, including cocaine and methamphetamine.
Possible complications of AVNRT are:
- Worsening of existing heart disease.
- Sudden stopping of all heart activity, called sudden cardiac arrest.
To diagnose atrioventricular nodal reentry tachycardia (AVNRT), a healthcare professional examines you and asks questions about your symptoms and medical history. The healthcare professional listens to your heart and lungs using a stethoscope.
Tests are often done to check heart health.
Tests
Tests used to diagnose atrioventricular nodal reentry tachycardia (AVNRT) may include:
- Blood tests. Blood tests can check for thyroid disease and other conditions that can cause an irregular heartbeat.
- Electrocardiogram (ECG or EKG). This simple test checks the electrical activity of the heart. It shows how fast or slow the heart is beating.
- Holter monitor. This portable ECG device is worn for a day or more to record the heart’s activity during daily activities. A Holter monitor can find irregular or fast heartbeats that don’t show up on a regular electrocardiogram.
- Echocardiogram. Sound waves create pictures of the beating heart. An echocardiogram shows the heart’s size and how blood flows through the heart.
- Exercise stress tests. These tests often involve walking on a treadmill or riding a stationary bike while the heart activity is watched. Exercise tests show how the heart reacts to physical activity. If you can’t exercise, you might get medicines that affect the heart like exercise does.
- Electrophysiological study. Also called an EP study, this test can show where in the heart the irregular heartbeat starts. During this test, a doctor guides one or more flexible tubes through a blood vessel, usually in the groin, to various areas in the heart. Sensors on the tips of the tubes record the heart’s electrical signals.
Most people with atrioventricular nodal reentry tachycardia (AVNRT) don’t need treatment. But if the fast heartbeat happens often or lasts a long time, treatment may be needed.
Treatment for AVNRT may include:
- Vagal maneuvers. Simple but specific actions such as coughing, bearing down as if passing stool, gently massaging the main artery in the neck or putting an ice pack on the face can help slow down the heart rate. These actions affect the vagus nerve, which helps control the heartbeat.
- Medicines. If the fast heartbeat happens frequently, your healthcare professional may prescribe medicines to slow or control your heart rate.
- Cardioversion. Paddles or patches on the chest are used to electrically shock the heart and help reset the heart rhythm. Cardioversion is typically used when vagal maneuvers and medicines don’t work.
- Catheter ablation. This treatment may be suggested if medicines don’t work or if their side effects are too bothersome. A doctor inserts a thin, flexible tube called a catheter through a blood vessel, usually in the groin, and guides it to the heart. Sensors on the tip of the catheter use heat or cold energy to create tiny scars in the heart. The scars block irregular electrical signals and restore a typical heartbeat.
References
- Ferri FF. Supraventricular tachycardia. In: Ferri’s Clinical Advisor 2025. Elsevier; 2025. https://www.clinicalkey.com. Accessed July 14, 2024.
- AskMayoExpert. Supraventricular tachycardia. Mayo Clinic; 2024.
- Knight BP. Atrioventricular nodal reentrant tachycardia. https://www.uptodate.com/contents/search. Accessed July 14, 2024.
- Podrid PJ. Reentry and the development of cardiac arrhythmias. https://www.uptodate.com/contents/search. Accessed July 14, 2024.
- Medical review (expert opinion). Mayo Clinic. Feb. 2, 2024.
- Kalman, et al., eds. Supraventricular tachycardias. In: Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed Aug. 8, 2024.
- Dubin AM. Clinical features and diagnosis of supraventricular tachycardia (SVT) in children. https://www.uptodate.com/contents/search. Accessed July 14, 2024.
- What is an arrythmia? National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/arrhythmias. Accessed July 14, 2024.
- Symptoms, diagnosis and monitoring of arrhythmia. American Heart Association. https://www.heart.org/en/health-topics/arrhythmia/symptoms-diagnosis–monitoring-of-arrhythmia. Accessed July 14, 2024.
- Jalife J, et al., eds. Surgery for atrial fibrillation and other supraventricular tachycardias. In: Zipes and Jalife’s Cardiac Electrophysiology: From Cell to Bedside. 8th ed. Elsevier; 2022. https://www.clinicalkey.com. Accessed July16, 2024.
- Brugada J, et al. 2019 ESC guidelines for the management of patients with supraventricular tachycardia: The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). European Heart Journal. 2020; doi:10.1093/eurheartj/ehz467.
- Al-Khatib SM, et al. 2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. Circulation. 2018; doi:10.1161/CIR.0000000000000549.
- Rethinking drinking: Alcohol and your health. National Institute on Alcohol Abuse and Alcoholism. https://www.rethinkingdrinking.niaaa.nih.gov/. Accessed July 16, 2024.
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