Questions posted in the Heart Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: difficult arrythmia

Forum: The Heart Forum
Topic: Arrhythmia


I previously posted a mesage and was asked for a follow up. Since then my message was archived with no response. Here's my question: I am a twenty nine year old woman who has experienced tachycardia for more than 10 years. I was diagnosed with PSVT three years ago. I had an ablation done in 1995 & 1996. Both failed, the source of my arrythmia is too close to the A-V node. I have tried atenolol alone, covera alone, and both combined.The tachycardia continues to occur. I am wondering if there is any treatment short of a pacemaker that I may not be aware of either surgical, drug, or unconventional. I have tried bearing down, ice water, etc, to stop the tachycardia when it starts, but the only thing that has worked for me is a type of funky deep breathing. Are there any other techniques or treatment??

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Dear Heidi, thank you for your question. I'm sorry about the mix up with your prior question. From the information you have provided, it appears to me that you have PSVT from an accessory electrical pathway that is located very close to the AV node. Prior attempts at radiofrequency ablation failed and commonly used medications (beta blockers and calcium channel blockers - atenolol and covera) have not adequately controlled the arrhythmia. The only definitive way to terminate your PSVT would be to do an aggressive ablation which would probably also ablate your nearby AV node. If that were to happen, you would need a permanent pacemaker to keep your baseline heart rate at an adequate level. There are other medications that primarily treat the arrhythmia that could be used, but those medications have numerous side effects and are not good long term solutions for the course of many years. The decision now rests with how severe and debilitating your episodes of PSVT are and how far you are willing to go to eliminate the PSVT. To make that decision (i.e.- whether you would be willing to have a pacemaker), you would need to have a long discussion with the cardiologist who performed your ablation procedures. Good luck!

I hope you find this information useful. Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back with additional questions.

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