What happens when your heart beat 200 bpm?

Caiaimage/Martin BarraudGetty Images

"I’m in my mid-40s, push myself quite hard in training, and feel great and in good shape. However, after buying a heart rate monitor, I was shocked to find that my resting heart rate was 46, and that I could reach a maximum of 202bpm during hard efforts. Is this safe, or am I pushing myself too hard and likely to go out with a bang?"

Far from being a cause for distress, your impressive heart rate range is something to boast about! A resting rate of 46 indicates that your heart is well conditioned and efficient, with an excellent stroke volume (volume of blood pumped per beat). A useful analogy to help you understand what this means for your body is to imagine using a bucket to bail out a leaky boat. The bigger the bucket, the fewer times you must fill and tip out the bucket in order to keep the leak from sinking the boat.

Your low resting heart rate indicates that you have a big bucket. The fact that your stroke volume is relatively high, and your maximum heart rate is over 200bpm is a good thing, because it means that you have a large cardiac output (flow of blood in litres per minute = heart rate x stroke volume). Cardiac output is argued to be the main limiting factor to your maximal oxygen uptake, and the more oxygen you can process, the more efficiently you use energy – an obvious benefit for endurance performance.

To put your mind at ease, some elite cyclists have resting heart rates as low as 36bpm, and it is not unusual to see heart rates of over 200bpm. However, your 202bpm is impressive for someone in their 40s, because maximum heart rate declines as we get older. The rough rule of thumb for estimating your ‘age-predicted’ maximum heart rate is to subtract 0.8 times your age from 214 for men, or subtract 0.9 times your age from 209 for women. The fact that your maximum is higher than the number that this equation predicts is not a cause for concern. Maximum heart rates are not as fixed as is sometimes believed, and it is also thought that the decline in maximum heart rate is less marked in those who are physically active.

So far from ‘going out with a bang’, it looks as if you’ll be able to enjoy a high level of performance for many years to come.

—Dr Alison McConnell, sports and exercise physiologist

When you have tachycardia, your heart beats faster than it should for a few seconds to a few hours. Normally, your heart rate is 60 to 100 beats per minute when you’re not active. When your heart beats more than 100 times a minute, that’s tachycardia. Because your heart beats too often, it doesn’t have the time it needs to fill with blood between beats. This can be dangerous if your heart can’t supply all your cells with the blood and oxygen they need.

Your heart normally responds to electrical signals from your heart’s sinoatrial (SA) node. These signals control how often your heart beats. When you’ve had a scare or are very emotional or anxious, your heart may send signals more frequently for a short time. This is called sinus tachycardia and goes away when you calm down. Other types of tachycardia can come back regularly and can be more serious.

Supraventricular (SVT or atrial) arrhythmias

These types of tachycardias begin in the atrium or upper part of your heart, where there’s a problem with electrical signals.

Types of SVT

• Atrial fibrillation: Your chambers aren’t working together and blood clots can be created.
• Atrial flutter: Your upper chambers may beat 250 to 350 times a minute. Injured tissue gets in the way of your heart signal that’s trying to reach your upper chambers, so the signal finds a different way.
• Paroxysmal atrial tachycardia (PAT): Sometimes, electrical signals in your upper chambers aren’t working right.
• Paroxysmal supraventricular tachycardia (PSVT): Now and then, electrical signals going from the upper to the lower chambers create more heartbeats than you need. This can happen with Wolff-Parkinson-White Syndrome (WPW). You can have more than 100 (and sometimes more than 250) beats a minute with PSVT.

Ventricular arrhythmias

These types of tachycardias begin in your ventricles, your heart’s lower chambers, where there’s an electrical signal problem.

Types of ventricular tachycardias

• Ventricular tachycardia: Ventricles are beating too fast (more than 100 beats a minute).
• Ventricular fibrillation: A problem with your heart’s electrical signals keeps it from pumping the way it should.

Who does tachycardia affect?

Atrial or supraventricular tachycardias can affect:

• Women more than men.
• Children, especially those who have anxiety.
• Anyone who’s very tired or drinks a lot of alcohol or caffeine.
• Heavy smokers.

Ventricular tachycardia or fibrillation can affect:

• People who’ve had a heart attack, cardiomyopathy, myocarditis, heart failure or heart disease.
• People who smoke, have high blood pressure or diabetes.

How common is tachycardia?

About 2 million Americans have atrial fibrillation and 90,000 others per year get a supraventricular tachycardia diagnosis. Each year, an estimated 184,000 to 450,000 Americans die from ventricular arrhythmias that cause sudden cardiac death.

Some people don’t have symptoms, while others may have mild to severe symptoms.

Atrial or supraventricular tachycardia symptoms include:

• Shortness of breath.
• Chest pain.
• Dizziness.

Ventricular tachycardia or fibrillation symptoms include:

• Lightheadedness.
• Dizziness.
• Shortness of breath.
• Fainting.
• Chest pain.

What causes tachycardia?

Tachycardia has a number of causes, including:

Causes of supraventricular tachycardia (SVT):

• Stress.
• Consuming more caffeine or alcohol than your healthcare provider recommends.
• Smoking or using tobacco products.

Causes of ventricular tachycardia or fibrillation:

• Cardiomyopathy, heart attack, heart disease or other heart problems.
• Not enough blood in the coronary arteries.
• Certain medicines.

Treatments vary depending on the type of tachycardia.

Atrial or supraventricular tachycardia treatments:

• Massages or maneuvers your provider does in an office visit.
• Sleeping more.
• Drinking less alcohol or caffeine.
• Medicine.
• Ablation.

Paroxysmal supraventricular tachycardia (PSVT) treatments:

• Medicines.
• Cardioversion.
• Ablation.

Ventricular tachycardia or fibrillation treatments:

• Ablation.
• Medicine.
• Implantable cardiac defibrillator (ICD).

What can’t I drink with tachycardia?

Your healthcare provider may tell you to cut down on your caffeine or alcohol intake if you have tachycardia.

What medications are used?

Your healthcare provider may prescribe tachycardia medicines, including:

• Beta blockers.
• Calcium channel blockers.
• Blood thinners or anticoagulants (for atrial fibrillation).

After an ablation, you may have swelling, bruising or redness where your provider inserted a catheter for the procedure. Other risks include damage to your heart or blood vessels, bleeding, infection or blood clots.

After you receive an ICD, there’s a risk of infection, chest pain, dizziness or shortness of breath.

How do I take care of myself?

Follow your healthcare provider’s instructions for taking your medicines and decreasing your intake of alcohol and caffeine.

You can reduce your risk of tachycardia in the following ways:

• Control your high blood pressure and high cholesterol.
• Stop smoking and/or using tobacco products.
• Lose weight.
• Eat a healthy diet.
• Limit how much alcohol you drink.
• Manage your stress.

How can I prevent tachycardia?

Limit or avoid alcohol, smoking, caffeine and herbal supplements your provider doesn’t approve of. All of these can trigger tachycardia. Taking care of your heart problems or finding alternatives to medicines that cause a problem can help you prevent some forms of tachycardia.

Depending on which type of tachycardia you have, you may have harmless symptoms, very dangerous symptoms (ventricular tachycardia or fibrillation) or something in between. Medicines and other treatments can help you control your symptoms. You may need to wear a Holter monitor or do electrophysiology testing to see how well your medicine is working.

How long tachycardia lasts

Tachycardia that puts you in danger doesn’t go away on its own. You’ll need to live a healthier lifestyle and take medicines to control it. You may also need to have a procedure, such as an ablation, to help you manage it.

Outlook for tachycardia

Although medications can’t cure tachycardia, they can help you control it. Ablation may be a long-term solution to certain types of tachycardia. Ventricular fibrillation can be fatal without immediate treatment.

Keep taking the medicines your healthcare provider prescribed and be sure to go to all follow-up appointments.

When should I see my healthcare provider?

Contact your provider if your medicine isn’t helping you as much anymore or if you start having new symptoms.

When should I go to the ER?

Get help right away if you feel your heart pounding, have chest pain or if you’re fainting or getting dizzy. You should also get help immediately for someone who collapses or is unconscious from ventricular fibrillation. They’ll need CPR to survive until paramedics arrive.

What questions should I ask my doctor?

• Do I have a dangerous type of tachycardia?
• What kind of treatment do you recommend for me?
• What are your success rates with cardiac ablation?

Yes, tachycardia is a kind of arrhythmia in which your heart rate is much faster than normal. Bradycardia is another kind of arrhythmia in which your heart rate is not fast enough.

Is tachycardia dangerous?

Yes, some types of tachycardia are dangerous, especially ventricular fibrillation. Some tachycardias are mild, and others cause problems that are moderately dangerous.

Can tachycardia go away?

If you have sinus tachycardia, your symptoms will go away once the fear, anxiety or emotion that caused it ends. For most other types of tachycardia, you’ll need medication or even a procedure to keep your symptoms from coming back.

A note from Cleveland Clinic

Tachycardia symptoms can range from mild to severe, depending on which type of tachycardia you have. For peace of mind, talk to your healthcare provider if you’re having symptoms. They can tell you if you have a reason to be concerned. Keep taking the medicines your provider prescribed for you, especially heart medicines. Don’t stop taking them without your provider’s approval. And be sure to keep going to all of your follow-up appointments.

Last reviewed by a Cleveland Clinic medical professional on 11/23/2021.

References

• American College of Cardiology. Supraventricular Tachycardia: What Increases Your Risk? (https://www.cardiosmart.org/topics/supraventricular-tachycardia/what-increases-your-risk) Accessed 11/23/2021.
• American Heart Association. Multiple pages. Accessed 11/23/2021.
• Heart Rhythm Society. Early Warning Signs. (https://upbeat.org/early-warning-signs) Accessed 11/23/2021.
• MedlinePlus. Ventricular tachycardia. (https://medlineplus.gov/ency/article/000187.htm) Accessed 11/23/2021.
• National Heart, Lung, and Blood Institute. Arrhythmia. (https://www.nhlbi.nih.gov/health-topics/arrhythmia) Accessed 11/23/2021.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy