More than SVT?

[Moony37]

I'm 27, female, mother of two.  No maternal family history of cardiac problems, paternal history unknown.  Nine weeks into my second pregnancy (6 years ago) I began having episodes of SVT.  At ten weeks was put on Toprol (50mg, I believe), then topped out at "max dosage for adult" at 26 weeks and put on bedrest for the duration.  All EKGs normal except for SVT.  ECG at 25 weeks showed some MV regurg but otherwise normal.  I was told it would probably stop after I delivered but it didn't.  Stopped medication after delivery.  Twice since then the SVT episodes became so frequent and debilitating I've gone back on medication, Cardizem 100mg last time (2 1/2 years ago) and Toprol 50 mg this time (three weeks ago).  Up until the last few months the symptoms were always the same.  I'd usually start feeling nauseated, dizzy, and light-headed, then I'd feel my heart pounding and racing and it would slow to normal within 15 minutes to an hour.  My heart rate was 120 to 140 bpm during SVT, ER caught it at 160+ bpm at 26 weeks pregnant.  

In the last few months I've had quite a bit of left-sided chest pain, even outside of an SVT episode (upper abdominal x-ray and ultrasound normal).  My symptoms are more severe at lower HRs, there's more pounding, the episodes are lasting longer and are happening far more often.  I'm also feeling very loud, hard single beats at least once nearly every evening and this is also new.  Episode at work in July ended up in ER.  I took HR at 160+ at onset, EMT got it at 140+ 25 minutes later, 95 at ER 45 minutes after that.  Oxygen normal but hyperventilating (tingling arms, feet, and face even with controlled breathing).

115/65 BP, 60 bpm resting HR but irregular rhythm, normal EKG three weeks ago.  Meds x3 wks now, helped at first but now not as effective.  No stimulants except nicotine (half pack a day, moderated based on how my heart's acting that day).  Other triggers-exertion was raising it to 140+ bpm and even with med it still goes over 120 sometimes, anxiety-related SVT is usually just rapid HR.   Family doc ordered an ECG and a Holter, done 12/19, results on Thursday, with probable referral to cardio for follow-up.  He says it doesn't sound like 'classic SVT' and wanted to look further into this.  Mentioned ablation, says I'm too young to deal with this for the rest of my life.  Do you have any input into this?  I'm more or less wondering what he could mean by it not being "classic SVT".      

[strwblue]

To start I am currently 41 years old.  I have had two ablasions.  SVT does not trigger in vaccum.  Nicotine and caffine can aggrivate it but SVT is an electrical malfuction of the electrical pathways of the heart.  If you have a mitro-valve prolapse that could trigger the SVTas can WPW (more common in men).  As a general rule SVT is trigger by a PAC or a PVC.  You have probably had SVT long than you realize and dismissed it as panic attacks and such.  Those here who mentioned getting the Study done are correct.  But make no mistake they are NOT pleasant and normally they will have you sign to have the ablasion if they find something ablatable during the study.  The need for pacemake inplantation is also a risk of ablasion.  Although a low risk.  

I know have a second degree heart block with the PACs and can on occation feel my heart Attempting to move into SVT.  My heart rate alway went from normal to 190 than immediately to 240+ with a corresponding bottoming of my blood pressure.  Non responsive to Vagel Manuver alone, only temporarily responsive to Vagel with Card. massage. (excuse my spelling)  I tried all the beta blockers and they tend to have a only temporary effectiveness.  The trueth is that if this is SVT you will probably be dealing with it and/or the PVC/PACs the rest of your life (regaurdless of ablasion)  The faster you reconginze you are having an event the calmer you can remain and the better you can manage the event.  

I had my ablasion done at Mout Sinai in Manhattan and the Mayo Clinic in Rochester, MN.   I am currently on NO cardiac meds and only on occation feel my heart block.  

[Moony37]

I don't believe it's IST or POTS.  My heart rate is normally far too low for that and my HR doesn't change due to a change in position.    ddavey-We'll see what the results say on my rhythms but I'll probably ask someone about it soon.

[ddavey]

you may want to ask your dr about adding digoxin to your regimen.   my daughter's amount of svt decreased dramatically with the addition of digoxin and with that her ejection had improved (she has dilated cardiomyopathy) for the first time since diagnosis    just to give you some numbers,  in april of 07 48 hr holter showed 749 svt with max duration of 24 beats and max rate of 157 beats per minute and after adding digoxin it decreased to 166 svt with max duration of 5 beats      this is, what i believe, is what has increased her ejection fraction and has made her feel much better.   hope this helps          dawn

[whatayear]

IST has to do with you heart rate some people have high blood pressure with IST some have low I run a normal bp but I know some who have high and some who have low....IST has to do more with your heart rate being inapropriate.

[whatayear]

look up POTS and IST I have IST and run a higher then normal heart rate even on a beta blocker

[Moony37]

Thanks for your replies.  I guess I wasn't aware that SVT stopped as fast as it started.  Mine's always been like this and has never responded well to the vagal methods of stopping it.  When I was first seen during pregnancy I was diagnosed as having a "reactive heart" and wasn't diagnosed as PSVT until after the second bout of bad episodes.  Now after reading some responses on here I'm wondering if those beats I'm feeling at night are PACs/PVCs.  I also noticed one during the day today, so I might be having them more often than at night and just not noticing it.  Hopefully if that's true the Holter picked them up.  My HR doesn't always go up with exertion or anxiety and sometimes it happens just out of the blue.   That's part of the reason I haven't quit smoking yet-sometimes the nicotine bothers it, other times not.  One cup of coffee reliably sets it off and decongestants have put me in bed for an entire day.  I looked up IST last night and it doesn't sound right-my HR and BP have always run this low.

I'm just at the point that I wish they would find a cause for all of this so they could fix it, but I also hope they don't find something because I don't want anything to be wrong.  Medication is fine with me, but if it's not doing the job then I'd rather face surgery to (probably) fix it permanently.  

[maggiemag]

Classic SVT starts and stops abruptly.  The rate does not gradually come down, but suddenly.  Tach from anxiety would slow down gradually.  He also might mean that he suspects that you have IST, which is a fast rate from *inappropriate sinus tach*.  With that condition your rate can rise quite high just doing normal things around the house.  At any rate, you should see a cardiologist,  preferably an electrophysiologist, who would be the electrician of the heart.

[anacyde]

Classic SVT is unpredictable, but more predictable than what's going on with you.  I think an electrophysiology study would be a really good idea at this point.  The doctor is right, this isn't something you want to be dealing with forever.  An ablation might be curative for you, I understand they are highly successful for SVT (I have SVT too, so I've looked into all sorts of things).  

I'm sorry you've got all of this to deal with, and I hope they're able to get things controlled for you soon.