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

Question Title: Had Ablation for psvt clocked at 234 bpm

Forum: The Heart Forum
Topic: Arrhythmia


Hi Im a 24 year old male with a 5 year history of "heart problems".
The first four years of fast heart beats and feeling faint i was told
it was panic attacks...During the time i went to er 7 times in 4 years
had about 4 holters, 3 stress test thallium,too many ekg's,3 echos...
ect.ect.....All "OK" until last november they finally caught one of my
"panic attacks on an ekg" it was really psvt with a 234 bpm rate..
after being told for 4 years it was all in my head i felt really
vendicated...anyway the next day I was transported to Another hospital
and had an ep study and a ablation all in one sitting.went home same
day.. That night felt real dizzy went back to hospital where i was told
that i had heart block.they said the heart muscle was probably bruised
during operation. I was in for 6 days until the heart block was at a safe
level.. I have been ok for a year now but within the last 2-3 months have
started to get dizzy and feel faint..and have a real bad funny heart
beat...I went and got a holter monitor 2 days ago and just got the
results.. After seeing my history please tell me your impression..

___
Holter results:

Frequent episodes of type 2 heart block consisting of
mobitz 1 Wenckebach periodicity occurred during this recording.

when I felt the funny heart beat it said there was mild sinus
tachycardia with a.v.nodal wenckebach fairly sustained for 12 min.

occasional episodes of mobitz 1 a.v. nodal wenckebach periodicity.

absent SVEA
absent VEA
absent high grade A.V. block
--------------------------------------------------------------------
I also have enlarged left ventical,slight thicking of heart wall
and High blood pressure.. Im on 50mg tenormin.,,,,.1 clonidine..

After so long im freaking out inside please give me some input i just
got married buying a house want to do a lot of stuff but i am starting
to be effected by all of this I"M ONLY 24 years old and I feel mad
sometimes about all of this...But I know there are people in a lot worse
situations and i keep reminding myself how lucky I am ..And how much
I have been blessed with family and friends...please help what are
the holter results to you????? Thank you very much..and this is the
best web site on heart problems I have found......

Thank you very very much,
Dave


________
Dear Dave,
Firstly, a holter monitor as you know does not always catch the pathology or problem so to speak, thus with the symptoms of dizziness/faintness that you have been experiencing, it probably would be smart to have an event monitor that would discern at the time of these said symptoms, what the rhythm is- is it the mild heart block or the tachycardia that is occurring? Also, in a patient without high degree heart block(which almost always requires a pacemaker) who has symptoms as you do, I would consider a drug for your high blood pressure that does not effect heart rate (as the tenormin does) just to see if I could prevent your symptoms- Heck why not consider these symptoms as a side effect of any of the drugs that you take ( for instance are the drugs lowering your blood pressure so much at certain times of the day that you are getting light headed and dizzi?) As you can see it would be very helpful to know what your blood pressure is during the symptoms.
For so young a person, it is quite unusual to have thickened heart walls, are you aware of all your echo findings (ultrasound of the heart?)
It is important that you discuss these issues with your physician, including the holter results, where to go from here/there, and any abnormal echo findings.
I hope this information is useful. Information provided in the heart forum is for
general purposes only. Only your physician can provided specific diagnoses and therapies.
Feel free to write back with further questions. Good luck!

If you would like to make an appointment at the Cleveland Clinic Heart Center, please
call 1-800-CCF-CARE or inquire online by using the Heart Center website at
www.ccf.org/heartcenter. The Heart Center website contains a directory of the
cardiology staff that can be used to select the physician best suited to address your
cardiac problem.





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