Supraventricular Extrasystole

By | June 10, 2022

An electrical excitation of the heart muscles that originates outside the normal excitation center (sinus node) is called an extrasystole. The origin of the excitation of the supraventricular extrasystole is “above” the division of the HIS bundle and thus mostly within the atria. If the origin is in the myocardium of the atrium, there is a corresponding phase shift of the normal rhythm, but not if the supraventricular extrasystole originates from the AV node.

What is a supraventricular extrasystole?

The normal heart rhythm is determined by the sinus node in the right atrium in the confluence area of ​​the superior vena cava as the clock generator and runs via the atria to the AV node (atrioventricular node) in the septum of the two atria close to the ventricles. The AV node transmits the contraction signal with a slight time delay via the HIS bundle, the Tawara crus and the Purkinje fibers to the ventricular muscles. For methemoglobinemia in English, please visit

An extrasystole is characterized by the fact that the source of excitation is outside the sinus node and provokes an additional heartbeat, usually harmless. Supraventricular extrasystoles (SVES) emanate from so-called ectopic excitation centers in the atria or in the area of ​​the AV node above the division of the HIS bundle into the two Tawara limbs.

The ectopic excitation centers of the supraventricular extrasystoles are thus always outside the ventricles. If the arousal center is formed by muscle cells in the atria, the electrical discharge “overrides” the sinus phase, resulting in a corresponding shift in the normal rate. If the ectopic stimulation is in the area of ​​the AV node, the sinus rhythm is not affected, so that there is no phase shift. The additional systole then occurs


Supraventricular extrasystoles are usually completely harmless and do not indicate any heart disease. SVES also occur in completely healthy people and are classified as normal. There is a wide range of causes of SVES, ranging from heavy coffee and nicotine consumption or alcohol consumption to excessive sympathetic nervous system activity to overtiredness and electrolyte imbalance.

Potassium deficiency is particularly noticeable. Frequently occurring SVES can also be caused by coronary heart disease, heart muscle inflammation or an overactive thyroid gland (hyperthyroidism). If one of the diseases that could be the cause can be diagnosed, therapy should aim at treating the causative disease.

Symptoms, Ailments & Signs

Symptoms accompanying supraventricular extrasystoles range from imperceptible to anxiety. Complaints such as sweating or nervous restlessness rarely occur. SVES are usually much less noticeable than ventricular extrasystoles, the centers of excitation of which are located in one of the ventricles.

Occasionally, extrasystoles can be felt as a failure of an expected regular systole, or there is a very rapid succession of several heartbeats in a row before the normal rhythm resumes. In some people, such symptoms can lead to psychological reactions because they develop feelings of anxiety.

Nausea, dizziness and a frequent urge to urinate can then set in. If the symptoms of supraventricular extrasystoles accumulate, it is advisable to clarify the causes, because frequent SVES can indicate a possible underlying disease of the heart or thyroid.

Diagnosis & course of disease

An important diagnostic tool for detecting SVES is the ECG (electrocardiogram), which can provide information about the type of extrasystole. However, if there is only an occasional extrasystole, it is left to chance that such an event takes place while the ECG is being recorded, is recorded and is therefore accessible for analysis.

In the many cases in which there is no extrasystole during the recording of the ECG, a so-called long-term ECG can help. It is a mobile ECG recording device that is worn on the body over a period of 24 hours and records continuously. The data is stored on a data medium and can be evaluated with the support of special software.

The computer-assisted evaluation primarily reveals cardiac arrhythmias and the number and quality of any extrasystoles. If there is a suspicion of a certain heart disease, ultrasound examinations and, for example, an examination of the coronary arteries ( angiography ) can provide further information.

Since supraventricular extrasystoles cannot be considered an independent disease, the further development of heartbeat irregularities depends on the course of the underlying disease. If there is no underlying disease, no treatment of the SVES is usually necessary.


Supraventricular extrasystole can cause a number of complications. Occasionally, those affected suffer from nervous restlessness and even states of anxiety. Complaints such as sweating or skin irritation rarely occur. A serious complication is the sometimes occurring cardiac arrhythmia, which subsides after a few seconds, but can trigger panic attacks and anxiety in some people.

As the extrasystole progresses, nausea, dizziness and a frequent urge to urinate can also occur – symptoms that significantly reduce the quality of life and increase the risk of accidents in everyday life. Further complications generally arise from the causative disease. If, for example, a heart disease is present, it can lead to life-threatening cardiac arrhythmias or even cardiac arrest or heart failure.

If left untreated, a thyroid disease can throw a wide variety of bodily processes out of balance and lead to serious complications. Whether undesirable side effects occur during treatment depends on the cause of the supraventricular extrasystole. Diseases of the internal organs are usually treated with medication or surgery – both associated with risks and side effects. Some patients are also allergic to the substances and materials used.

When should you go to the doctor?

The affected person needs a doctor’s consultation as soon as symptoms such as sweating, inner restlessness, irritability or general malaise occur. If states of anxiety or panic suddenly develop, this is considered unusual and should be discussed with a doctor. Disorders of cardiac activity, changes in blood pressure and a rapid decrease in physical performance must be examined and treated. Sudden and unmediated tachycardia, which then turns into normal cardiac activity, is considered a warning signal from the organism. The affected person should consult a doctor to clarify the cause of these unusual contractions of the heart.

Dizziness, unsteady gait, vomiting or nausea are further signs of an existing health condition. A doctor’s visit is necessary as soon as the symptoms persist, recur or increase. If the impairments lead to emotional or psychological problems, a doctor must also be informed of the changes. Changes in behavior, a feeling of illness and an aggressive appearance should be examined more closely.

Characteristic of this disease is a sudden onset of symptoms, which is accompanied by an abrupt subsidence of the irregularities. Even though you are free of symptoms after a short time, you should consult a doctor because heart failure can occur in severe cases.

Treatment & Therapy

Normally, supraventricular extrasystoles do not need to be treated. Therapy is only indicated if there is an underlying disease that requires treatment. For example, if more than 10,000 extrasystoles are counted over a period of 24 hours in a long-term ECG, there is usually an underlying disease.

If no heart disease or thyroid disease can be detected, it is advisable to check your lifestyle with regard to coffee and alcohol consumption and the duration and frequency of stronger stress phases. Light physical activity and relaxation exercises can reduce the frequency of extrasystoles that cannot be assigned to a specific disease. In all other cases, therapy is aimed at treating the underlying disease. After healing, the number of extrasystoles reduces by itself.


Specific preventive measures that could prevent the too frequent occurrence of supraventricular extrasystoles do not exist. Basically, a “natural” way of life is recommended, in which phases with increased stress potential alternate with phases of relative relaxation.

This is the only way to ensure a balance between our unconscious sympathetic and parasympathetic nervous systems. A natural and healthy lifestyle naturally includes a minimum amount of exercise and a diet that also contains natural foods.


The supraventricular extrasystole is usually a harmless finding that does not require follow-up care. However, if the cause of the cardiac arrhythmia is known and a noticeable palpitations are a psychological burden for those affected, follow-up care options are available. On the one hand, these serve to minimize the risk of the occurrence of the supraventricular extrasystole and, on the other hand, to cope with the symptom psychologically.

Stress is often the trigger for supraventricular extrasystoles. Those affected can often do a lot to reduce it. In addition to reducing private and professional obligations as best as possible, relaxation exercises are a good option. These include, for example, progressive muscle relaxation according to Jacobsen or imaginary journeys, both of which also have instructions on CD.

Endurance training can also have a positive effect on the frequency of occurrence of supraventricular extrasystoles. Jogging, walking and cycling are ideal. It is also important to drink enough water. For body, mind and soul, yoga can also be helpful with regard to the supraventricular extrasystoles through a mixture of asanas (physical exercises), pranayama (breathing exercises), meditation and deep relaxation.

Anyone who suffers mentally from heart palpitations is often in good hands in a self-help group. Contact with like-minded people offers a valuable exchange and can reduce fears so that the supraventricular extrasystole does not develop into a massive cardiac neurosis in the person concerned.

You can do that yourself

Supraventricular extrasystole is a common and harmless finding. Once it has been clarified by a general practitioner, internalist or cardiologist, it usually no longer needs to be checked or treated. However, there are cases in which the supraventricular extrasystole is very disturbing for the person concerned, sometimes even frightening him. Here are some ways that self-help can reduce extrasystoles.

Sport is often helpful. The supraventricular extrasystoles often occur when adrenaline is produced in the body due to stress and excitement. Sport, especially dosed endurance training, is able to lower the level of adrenaline in the body. This is also particularly helpful when perceived supraventricular extrasystoles disturb the patient’s sleep. Relaxation methods such as progressive muscle relaxation or yoga can also help to positively influence the supraventricular extrasystole or at least eliminate the fear of harmless heart palpitations.

If the fear gets out of hand, we recommend going to a psychologist or a naturopath. Behavioral therapy or naturopathic methods can be used here to learn how to better deal with heart palpitations from a psychological point of view. The serenity that can be learned in this context is ideal for a stress-free design of everyday life and work, which in turn can have a positive effect on heart reactions.

Supraventricular Extrasystole