Skipped beats with Supraventricular tachycardia

[Will1977]

Hello everyone.  I have recently acquired a 30 event monitor from the cleveland clinic and sent in a transmission where the doctor's nurse told me I had skipped beats followed by a run of an 11 beat supraventricular tachycardia. The problem is for me that I have been having skipped beats for 7 years now but only been having these fast runs of beats off and on for about 13 months, so they are new. For the past two weeks they seem to be more frequent once a day sometimes for 2-4 days in a row then sometimes they disappear for a week. I am concerned about the increased frequency of them and think that this might develop into VT in the future. I had all the tests done EKG, holter, 30 day dopudamine stress test blood work all fine. No blockages or evidence of a heart attack but I beg to differ. I know back in 2004 I had a few times where I had very bad chest pains and went to the walk in clinic where they did an ekg and the printout said Lateral infarction. I have showed this to 4 cardiologists who have dismissed the readout including my EP doctor. Well I my heart was fine before the chest pains and I am now suffering from arrhythmias I think I did some damage, but they do not agree and suggest it has always been there but just now decided to show up. Does anyone here experience the skipped beats followed by runs of SVT? I seem to only get the SVT when my heart seems to skip beats?

[tom_h]

Yes, I was told to expect brief runs along with PVCs.  I've experienced both.  The SVT runs are weak, and last only a 5-10 beats before dropping out.  They have diminished to almost nothing over the past couple of days.  The PVCs remain but are tolerable.

The EP study is usually performed together with ablation therapy.  They map the heart, then ablate if necessary.  This is why these procedure can last for hours.  My EP and ablation was performed at UMass Hospital in Worcester, MA by Dr. Lawrence Rosenthal.  I was very pleased with the way he "operates" ;) and would highly recommend his services to anyone.

[Will1977]

You have a very pleasurable experience. Glad after all this time in dealing with it you have a very gracious exit from the world of arrhythmias. Did the doctor tell you that you would have little runs of SVT for awhile then they would abate? Or is this a new norm for you? Also where did you go if I might ask. I know before ablation they have to do an ep study too. How was your experience there?

[tom_h]

Hi Will. Well.....I was out for the entire procedure, so I have no idea what was going on.  I was under general anesthesia, and intubated.  I don't think I would have been as courageous if I had been awake!

I had been on medication for about 5 years.  It did little to halt the SVT episodes.  My cardiologist actually didn't want to experiment with drugs, but rather encouraged me to look into ablation.

Everything you heard and saw on YouTube can happen.  I can also win the MegaMillion lottery tomorrow too!  The risks are very minute.  I questioned my EP regarding his "wins and losses".  He reported to me that he had personally done over 2000 ablations, and had one death, and that patient had a very poor prognosis going into the procedure.  What you and I have is cake for the average EP, and the success rate is very high.  It's when you add in the ablations for complicated procedures like afib or procedures close to the AV node that the overall success rate drops a bit.

So in summation, for me, it was a minute of dizziness, then it was the afternoon, and somebody was trying to wake me from a really nice sleep!

[Will1977]

Hi Tom. Thanks for your responses. I find it incredible that you were able to deal with this for such a long time! I have had this a year and cannot take it anymore. Your a brave soul. Did your doctors when you initially wanted to have this ablated tell you that they wanted you to take medications first? That's what mine are telling me, but I would rather do the surgery and be done with it if I can. It must have been pretty frightening to undergo the surgery knowing they were going to put you into an arrhythmia? I saw a women on youtube who said she had the ablation for SVT and said the risks were stroke, heart attack, and your heart could possibly stop that is why they put the defibrillator patches on her chest during the procedure. How was your experience during the surgery?

[ireneo]

If I'm reading this correctly you had very brief runs of supraventricular tachy, supra referring to above the ventricles. That means it's an atrial tachy which is generally not all that dangerous. I'm not sure there's a huge connection between the random PVC's and atrial tachy.

I have PVC's and PAC's and atrial tachy bursts (sometimes 5 times a day) but I'm considered to be in good health.

As for the ECG printout, the computer programs for those give possibilities but it still has to be read by a cardiologist to get a final diagnosis. I do hope you get some solid results soon so you don't have to live with the constant worry.

[tom_h]

,,,,oh...one other thing.  I would get clusters of PVCs, then my heart would become quiet for a period of time, perhaps a week when it would start over again.  I always regarded the PVCs as a precursor to an SVT event.  Now I understand why.  I never felt the PVC with the onset of tachycardia, Probably becasue of the initial startle that goes thru your body (at least mine). But it was very evident on my 30 day recorder when I had three SVT events.  A PVC was visible on each of the traces that were recorded.

[tom_h]

Mine first appeared at the age of 6......I'm turning 60 shortly.  It stared during an illness.  I would get these raging, high fevers and it started during one of those, and I had it ever since.  I use to get perhaps 4 or 5 per year up into my 40's when it started to increase in frequency.  I've kept a log for the past 3 years, and I've averaged 3-5 per month.  Mine have always hit hard, and do not convert on their own.  I was taught Valsalva after the firt occasion, and I've used it ever since, avoiding hospitalization.  This no doubt contributed to the duration that I've put up with it.  It became a way of life, but each one always felt like "THe BIG One!".  But, I'd slow it after a couple of minute, and life would move on.    Funny you should mention coffee.  I visited the EP yesterday for a 1 month checkup and asked him about caffeine, and antihistimes from which I completely avoid.  He told me to go to the coffee shop and celebrate with a double cappacino.  As far as he's concerned, I'm cured, and he released me.  I've said this before on another post so forgive me if you've heard it before.  My cardiologist said that abaltion technology has progressed to a point where the procedure is safer than the meds they must sequence through to find the one the MAY...MAY work for you.....and that one can have it's own little nasty side effects.  That said, my PCP would like me to continue on the Metoprolol which I take daily.  I tolerate it very well, and it keeps my BP low.  He feels that if the average person could be trusted with this medication, he'd like to see it blended with a statin (which I also take), and sold over the counter; and that almost every adult should be taking it like a daily supplement.  Talk about "better living through chemistry"!

Please feel free to ask any question you wish.  For me, it serves to pay it forward, as I too had questions as I was comtemplating the procedure. There were a lot of nice people here for me and to allay my fears.  I hope I can do the same for you.

[Will1977]

Thanks for your feedback. This makes sense because my SVT seems to come on after a skipped beat or so. How long have you had your problem. Did you acquire it later in life after never having it? Mine started with premature beats and recently had progressed to SVT within the last year, but is now more frequent. Are you able to drink coffee once more and have glass of wine or a beer? Have you had many attacks of your AVRT since your ablation? I have so many questions, I am sorry.LOL. I am just leaning the way of ablation as I do not believe meds help but rather irritate the situation further down the road. My doctor prescribed Cardizem, but I refused to take it out of fear of side effects.

[tom_h]

My EP described my SVT as the result of a PVC occuring at precisely the right moment which initiated a looping or circular feedback within the heart's electrical.sysyem. In my case in diagnosed as AVRT. Yours could be different, but I wanted to point out that a PVCvan be the initiater of an event.