supraventicular tachycardia questions????

[travis487]

.last Thursday...here is Chicago it was like 43 degrees and cold windy..I played outdoor tennis for 3 solid hours at medium/intensity... with only drinking around 30 ounces of water...I came home and I was cold and fatigued...I ate a healthy dinner and then showered...I showered with warm warm water....then I turned it to ice cold on my body for recovery on muscles... for a few minutes. I came out of shower and when I bent over to put lotion on my legs I came back up and my heart went crazy... I called 911 and emergency had my heart rate at 224 per minute. then gave me some iv medicine and slowed it down to normal..in the ER they said I had this and because of cold tennis/ warm house, and hot shower, then cold shower right away..I have to see a cardiologist this thurs. They said everything with my tests were great my entire heart and everything... I do workout a lot and eat very very well...throughout my life I get this racing heartbeat for around 5 to 8 seconds and then back to normal..a few times a year also..but this time was scary. Also, for the last 4 days since ER.. my heart rate is around 55 to 70...athletes heart rate right? I mean I am a huge biker, tennis player, and gym guy...thanks!! happy new year...

[MichelleP_3811]

You should be evaluated by a cardiologist but if this doesn't happen often then it might be hard to catch or correct at this time.  That said, though the doctor will give you the ultimate diagnosis it sounds like you have an svt titled avnrt.  You may have an accessory pathway leading into your avnode that sometimes allows the signal to get caught in a loop.  The beat rate for this type of svt is around 200-250.  Mine would be around 230.  A couple of things that trigger are having extra beats like pvcs or pac and also sinus arrhythmia.  A difference in your heart rate between inhalation and exhalation.  All of us have some difference but when there is a marked difference by say 20 or more beats then I think this leaves us vulnerable to falling into the tachycardia.  Holding your breath and bearing down may stop the episodes when they occur but they will not go away and will likely continue to get more frequent over time.  It is not something, in a structurally normal heart, that is anything to be concerned about but if it starts to disrupt your life you may consider doing an ablation to correct the problem.  It is a fairly easy procedure but the key to it working will be in the EPs ability to induce an episode.  They need to be able to induce an episode to know where to ablate.  That said, if you do indeed have avnrt it is one of the easiest svts to fix.  I was so active when I went in for mine that the EP was able to get it right away and I was in and out within 2 hours.  You can go to my profile to read my journal entry if you want to read more about an ablation.  In any event, since your heart sounds structurally fine you really don't have anything to be too concerned about but it is something you will need to pay attention to moving forward.  Take care and keep us posted on how you are doing an how your appointment went.

[travis487]

  Hello and thanks....yeah like the last time I had something was thanksgiving weekend.. I went out for a long walk and it was cold. I stopped and my heart raced like boom boom boom fast for 5 seconds and then back to normal. I usually get it when I bend down and come up to fast, the entire process is less than 10 seconds..when ti does happen like 3 to 5 times a year if that....

[MichelleP_3811]

Yeah, I am not sure why but likely because bending changes the dynamics of the heart but bending over is a big trigger.  Mine would go off mostly with changes in posture.  Having only 3-5 episodes a year and them lasting only 5 or so seconds you may not need to do anything about them right now but see the cardiologist.  Hopefully they can give you an event monitor and you can catch one on it so they can see what it going on.  If you get one do what you can do to actually trigger an episode.  Especially since they stop so quickly for you.  The sooner you can get one captured the sooner you will know what you are dealing with and what the next steps you should take.   I actually live in the northern chicagoland area.  My EP was really awesome if you wind up needing one but not sure what area of chicago you are.  In any event, I can pass his name along if you are interested.  Well good luck and let us know how your appointment went.

[travis487]

  Yes I am going to Dr.Yogesh Tejpal cardiologist here were I live Pronger and Smith Medical Center in Tinley Park,IL... One other thing... last Feb 2011 I went for my yearly physical, blood work,urine,etc.. everything was fine and I have always been getting good results on all blood work, etc.. This time though my TSI was high thyroid problem. They did a couple follow up tests and the tests came back normal. I heard this has maybe something to do with heart aspects as well. Whats your EP's name?  

[travis487]

you had the ablation for this right? so no more episodes your done now how you like it?

[tom_h]

Regardless of how conditioned you are, the truth is your heart is not suppose to go into SVT when you iced your body.  I suspect this was caused by some sort of vagal response.  But as Michelle suggested, this will probably be a hard one to catch.  You see, most SVT's are concealed.  Your typical EKG will show prefectly normal electrical activity and wave form.  The only time you'll be able to see it of course is when you're in SVT.  DId they happen to record it at the ER?  So from my amateur POV, you have some sort of electrical anomaly in your heart that reveals itself only once in a while, and when it does it's only for a short time (except for this event).  What you're experiencing is most likely non-life threatening.  A visit to the cardiologist will show that you most likely have a perfectly normal heart.  This is the way it usually plays out, becasue it's happpened to me along with dozens and dozens of other people here.  My cardiologist went so far as to tell me to let it race, and come to the ER so it could be recorded.  I eventually got a 30 day monitor, and there it was finally captured, and I was then on my way to proper treatment.  It would be prudent to see a cardiologist, and let him make the call.  Do not be surprised if your condition changes over the years.  It could go one way or the other.  This is often caused by a accessory pathway of conductive muscle tissue that loops back causing your heart to fire before it's suppose to.  Many of us here have it, or had it and been cured of it.  Best of health to you!

[littlegreenman1]

I had the same type of SVT.
There's a bazillion things to kick off a run of SVT.
Follow you EP's advice.
Understand your insurance if you go for an abalation as the bill (after discounts) will be $60-80,000.

[littlegreenman1]

Oh. Read and re-read Tom's response. Then read it again. He is correct.

[MichelleP_3811]

Thyroid problems can cause heart rhythm problems of a fast heart rate and more likely afib.  It sounds more like you have what I have but it could possibly be afib but the doctor is the only one who can officially diagnose what you have.  Are you sure they checked your TSI because from what I understand that is a test to find out if you have Graves which means your hormones would already be off and they want to verify if you have Graves as the cause of hyperthyroidism.  My TSH is on the low side and my doctor checked my T4 levels to see if those were off and when they weren't so it was deemed my high heart rate isn't caused by my thyroid.  Regardless it sounds like your hormone levels are fine so no worries there.

My EP is actually in the Glenview area so quite a trek from where you are down south of the city but if you are faced with needing an ablation and would like to go to one someone recommends then I will pass his name along but you would have to travel to Highland Park to have it done.  

I had the ablation done in September.  I had episodes all my life mostly lasting a minute tops but had a few episodes that lasted for hours that I probably should have went to the ER for those but I actually always thought I was hyperventilating and I always figured they would stop and they did.  Anyways over the past 10 years the episodes started to get more frequent and this past year I was getting them probably biweekly and sometimes more than 1 a week so they were starting to disrupt my life.   But since I was so active the ablation was a piece of cake.  The EP was able to induce an episode on the first try so a procedure that normally takes 3 hours minimum only took 2 hours for me.  But that is why I say you may not be offered one at this time if they are too infrequent.  If they can't get an episode going then they won't know where to ablate but the procedure itself is really no big deal.  The stress of worrying about having your heart messed with was harder on me than the procedure.   It has only been almost 4 months but I haven't had any more svt episodes.  I do, however have some pacs and pvcs.  That is a whole other condition where you get some extra beats.  I was not aware I actually had them until after the ablation because before I thought it was all related to the svt.  I kind of wish someone had alerted me because they did take me by surprise but I guess some people don't notice them at all so they don't say anything unless you complain.   They got pretty bad for a week or so in October but have settled down now so I am feeling pretty heart healthy at the moment and hopefully things will stay that way.  If you want to read more about the ablation click on my name and check out my journal entry.  It should give you a pretty good idea of what to expect.  Ok, talk to you later.

[travis487]

  ok well I go tomorrow to see cardiologist. I am going to tell him about my thyroid possible problems...overactive. Also, I am a big tennis player that plays intense matches, I work out 3 times a week, bike ride, walk, you name it.. I mean even in the summer for years I play tennis outdoors in 95 heat and full humidity and stay hydrated and never nothing like this.. The Dr. said at the Er it triggered because cold outdoor tennis, no hydrated to much, then warm house...then hot shower and ice cold water on shower for muscles..and BOOM.... all this combined.... it this precise situation. I mean whenever I get that rapid beat for 5 seconds and then back to normal it is never during sports or gym..always when Im not doing too much or in a store walking.

[MichelleP_3811]

The accessory pathway svts generally start randomly for no reason.  The cause isn't due to adrenaline it is simply due to having some extra fibers in your heart that can conduct electricity that gets caught in a circle.  They are not dangerous in the short term especially since yours convert back so quickly but it is good you are getting checked out to make sure that your type is one of the less severe kinds.  Good luck at the doctors.  

[travis487]

I went to the Dr. last Thurs... He said it was svt..and is having an ultrasound done of my heart....what is the ultrasound for though? to look in detail of the heart? thought it was svt why this now?  Also, he said I do not have to do nothing about it and if it happens do maneuvers , or take medicine, which I do not... or have the ablation done...to fix permanently he told me. I want to have the ablation because I am a big time traveler outside the US and do not want this to happen and it will not go back down to normal rhythm outside country.  Just for peace of mind also, this has been nagging me now for almost 2 weeks. At the hospital they did not see in detail of my heart? these are the tests they did..
EKG 12 Lead tracing only...
Resp 02 Delivery Appliance Rec
Chest PA
Hemagram, with Platelets
Prothrombin time profile pt
Partial thrombonplastin time
ED Chest pain Troponin I
Ed Chest pain Metabolic Panel
POC bedside urinalysis..

[tom_h]

Ultrasound or Echocardiogram  of the heart is just another tool in diagnosing your situation.  Most of us at one time or another had a stress echo (ultrasound) done on the path towards eventual ablation.  Echo's can be used to examine the structure of the heart and can access blood flow though Doppler technology.  ....pretty standard procedure.

[travis487]

    I called the secretary of my cardiologist and she said they do it to look at the heart and see if its nerves or possible valve... "Valve??!! The cardiologist told me its SVT already..hmmm

[tom_h]

Don't read too much into it.  Like I said, it's pretty much standard procedure for everyone, especially those leaning toward an EP study.

[MichelleP_3811]

It is just a test to make sure your heart is structurally OK.  Whenever there are heart issues this is a test that is performed to make sure your heart is normal despite the arryhthmia to determine if the arryhthmia is dangerous or not.  In a healthy heart arrrhythmias are of no conseqence which is why they tell you that you can choose whether or not you want to have the ablation.  If your EP is satisfied he can induce an episode and cure your svt then it is definitely worth doing because it really will likely only become more frequent as you get older.  In all likelihood your heart is healthy with the exception of having a few extra fibers that not everyone has but chances are real good that all your other heart tests will come back fine.  

[travis487]

There a difference between these two?       ventricular tachycardia & SVT ?

[MichelleP_3811]

Yes there is a difference.  SVT stands for Supraventricular Tachycardia which means Supra (over) the ventricles so a tachycardia that originates in the atria.  Ventricular Tachycardia is just that a tachycardia that originates from the ventricles.  It is a more dangerous tachycardia because it can deteriorate into Ventricular Fibrillation which is deadly in minutes if not treated but it is also rare for that to happen in a healthy heart even with VT.  

[travis487]

Wolff-Parkinson-White syndrome this the same as svt? thank you for all your answers..

[travis487]

I just read this by someone who had ablation.... is it true the nerves can grow back, both cardiologist and Er Dr. didnt say so..

I have SVT…Has anyone had a heart ablation or know of it?SVT (supraventricular tachycardia)….is a congenital heart disease that consists of a swift heartbeat originating in the atria, which is located in the upper chambers of the heart. An option to cure it is a heart ablation and it basically eases the symptoms for 2-3 yrs until the nerve grows back. The first time I had it done I was 15, now I’m 23 and I’m scheduled for my 2nd ablation

[MichelleP_3811]

There are a number of different svts Wolff Parkinsons being one of them.  I had one called AVNRT Avnodal Reentrant Tachycardia.  The extra fiber was near the AV node and when the signal got going it would circle the AV node.  With your fast heart beat at 224 it is likely you also have this kind.  WPW rate is more around 150ish because the loop is around the whole heart and not just the avnode.  There is another AVRT which involves the atria but is more in the wall like WPW but WPW involves a connection between the Atria and Ventricles.  The type you likely have, AVNRT, they won't know for sure until they ablate, is one of the easiest to fix because it is generally easiest to trigger though the only downside is if the extra fiber is too close to the av node they won't ablate or you would loose the use of the AV node and need a pacemaker.  This is rare though from what I understand.  As for it coming back, from what I understand that happens more often in younger people because their bodies are still maturing.  I don't know how old you are but the younger you are when you ablate the more chances if it coming back but that is not necessarily the case with all people.  Everyone is different.  But there is a chance for it to come back with everyone though a second ablation generally fixes the problem for good.

[littlegreenman1]

They do the Echo to make sure the heart is structurally sound.
WPW is a type of SVT. As Ford is a type of car, as is Volvo... but there are GENERIC SVT's also.

I am athletic also, and it makes no difference. Actually - physical exertion exascerbates the condition. In the last year - prior to ablation - 95% of my episodes occured while training for marathons. Qnd they'd occur -usually- at the BEGINNING of the run.  I'd get it... knock it down and go run 15 miles.

Ablation: UNDERSTAND your insurance. It's expensive - $60,000+ (POST discount). You will pay your Max Out of Pocket expense.  Know that number and be ready to write a check for that amount. (Typical 90/10 insurance is about $3,500)

Procedure wise - it's not bad.  I was training again @ +14 days.

[travis487]

I am 29 will be 30 in March... I am going to see Mohammed Khan.cardiologist specializes in EP. He is rated one of the best in chicago..

http://www.toptiermd.com/find-a-doc/cardiology---electrophysiology/chicago---all/364375280-doctor-dr.-mohammed-n.-khan-md

[tom_h]

There's another cause for the restoration of the accessory path; an insufficient burn which eventually bridges over.  This is one of the reasons RF is preferred to cryogenics; it burns deeper.  An Electrophysiologost will find the trouble spot, burn it,then attempt provoke conduction of the path.  The talent of the physician lies in his ability to judge the depth and width of the burn to insure complete and permanent disconnection of the path, with minimal injury to the tissue.

I had a form of AVRT called Circus Motion Tachycardia.  It originated in the wall of left atria just above the valve.  The short, wide path resulted in extremely hight rates.  At six years of age, it was measured at 312 BPM.  That slowed to the mid 200's as I aged.