What causes paroxysmal supraventricular tachycardia?
An arrhythmia that needs to be diagnosed
the palpitations you've felt in the past were probably paroxysmal supraventricular tachycardia (SVT) and that's why they were stopping with the Valsalva maneuver (holding your breath). This last arrhythmia seems like a different one. This time you had symptoms, which means that your heart could not pump the blood effectively. This is a medical emergency when it happens because a simple lightheadedness could evolve into a black-out or worse.
The 3 day heart monitor is a good test and it is supposed to provide the diagnosis if the arrhythmia occurs during monitoring.
The echocardiogram may provide information about the structural and functional status of your heart, which is important for treatment decisions. The echo might show findings related to your previous cardiac event (parts of the heart that are not moving because they were damaged).
I hope I've helped you understand your situation better.
You can contact me again if you'd like more information.
SVT can be stopped with the Valsalva maneuver due to its nature and the physiology of the cardiovascular system. Arrhythmias of different origin cannot be influenced by this (or other) maneuvers. The arrhythmia has to be identified (the 3 day monitoring should detect it) and treated accordingly. Treatment depends on the involved part of myocardium and diagnosis. The only thing you can do is to visit the emergency room every time you have symptoms...
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