Key result
Catheter ablation followed by cognitive-behavioral therapy resolves PSVT and comorbid panic disorder in preliminary cases.
Why the study?
Panic disorder and paroxysmal supraventricular tachycardia can co-occur and may be misdiagnosed due to overlapping symptoms, necessitating differential diagnostic criteria and understanding of their neuropsychophysiological interactions.
Case Report (n=2)
May support sequential ablation then CBT for comorbid PSVT and panic disorder; hypothesis-generating and requires confirmation before practice change.
Panic disorder (PD) is characterised by sudden attacks of intense fear with somatic symptoms including palpitations and tachycardia. Reciprocally, palpitations caused by paroxysmal supraventricular tachycardia (PSVT) are commonly associated with anxiety and may therefore be misdiagnosed as PD. As demonstrated by two case reports, PSVT and PD can occur comorbidly in a chronological sequence, with PSVT possibly precipitating and maintaining PD via interoceptive processes or, alternatively, with PD increasing the risk for PSVT by elevating stress levels. As both PSVT and PD require different treatments, potentially helpful differential clinical diagnostic criteria are proposed.
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Domschke et al. (2010) conducted a case report in Paroxysmal supraventricular tachycardia and panic disorder (n=2). Radiofrequency catheter ablation and cognitive-behavioral psychotherapy was evaluated on Symptom resolution. In two patients, radiofrequency catheter ablation eliminated PSVT symptoms, and subsequent cognitive-behavioral psychotherapy completely resolved comorbid panic disorder symptoms.
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