Irregularly high heart rate.

[Characteristic]

For the last 12 years I have struggled with a (seemingly) uncontrollable heart rate. Being 31yrs old I am starting to notice the symptoms more than when I was a younger man.

Signs: High heart rate when exerting any energy (moving or performing any physical activity), or if I take a deep breath in and let it out very slowly, much like performing a PFT. My heart rate will jump from a resting rate of high 70s-low 80s to 160s-180s within seconds. When exercising it will approach the 280-300bpm in less then 25 seconds (according to my last stress test) with out PVCs. Concerned with this now that I am getting older I searched out more than the two local cardiologists I have been working with for years. Visiting a panel of electrophysiologists I began a battery of tests. Nuc Med Stress test, CBC, US, Holter Monitors, EP study and in the mean time I was placed on a beta blocker until they could make SOME sense of things. Other than the light headedness and ridiculously fast heart rate I am asymptomatic.  

After six months of tests they determined that my "extremely tachycardic heart rate was not SVT as the P wave was in perfect interval and without movement indicating no blockage in electronic activity, which is good. My Nuc Med test came back with some very nice numbers (EF of 66%). US proved that there are no murmurs or valvular pathologies. The beta blockers had no effect on me or my heart rate. WPW was rules out with an EP study and a confirmation of an "Extremely healthy heart" was granted.

At my last examination I was released from the cardiology group back to my health care provider with an unknown reason or diagnosis is to why this is happening. They know the signal is coming from the SA node, however they do not know why. One arrhythmia specialist suggested it may be musculoskeletal  related.

So I am at a loss here. I have been instructed to ween off of the beta blockers and consume more than a gallon of water a day (more than my subjectively informed gallon I already consume). I am an extremely active person who NEEDS to maintain a healthy lifestyle or I will go crazy.

Things I have discovered over the years. If I am exerting energy (grappling, working with my patients, carpentry and my heart rate gets uncomfortably high I can quickly lower it by walking at a quick pace. It will drop to the 60s and sustain. I can also lower it with 800mg of ibuprofen, however I love my gastric folds too much to maintain that remedy.

I am in need of any suggestions. Six Cardiologists and a lot of test with shrugged shoulders is getting depressing.

Thank you

[Characteristic]

michellepetkus- Thank you for the information. Although syncope has not been an issue I will admit the sensation of the heart rate this high is almost euphoric, much like a runners high. I will check into dysautonomia. I will find out how genetic it is or if there are any ties to my current test results. This is the first I have heard of the pathology so I assume it is relatively new. Thank you again!

den2094- Although the structure of the heart is normal would the SA activity also be normal with IST? I cannot seem to find a solid answer on-line. I will be pulling out some of my cardiology books here in a bit to see if they have that specific pathology.  Thank you very much for this information.

I will continue to play around with what seems to keep things mellow and under control as well as looking for a "top 10" electrophysiologist.

Jesse

[den2094]

maybe you have ist? innapropriate sinus tachycardia. usually the heart is structurally normal

[MichelleP_3811]

Though a classic symptom of it is passing out or near passing out but I would check into dysautonomia.  It sounds like some sort of automomic nervous system disorder maybe with a particular issue with the sympathetic nervous system over stimulating the heart.  There are cardiologist who specialize in the condition but you may have to travel to find one if you live in a small town.  Best of luck.  I can't imagine a heart rate that high.  I had avnrt and it would get in the 230s which felt very manic but it would start and stop on a dime so classic svt though my heart rate did look normal on the ekg just super fast.  But your issue does sound a bit different so check into dysautonomia and see if that give you any answers.  Good luck.  I do hope you can get to the bottom of this.