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Heart Disease  (Expert Forum)
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SVT and Exercise Induced Tachycardia
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SVT and Exercise Induced Tachycardia

by AED, May 11, 2007 12:00AM
I am a reasonably fit 40 year old woman.  I have had 4 episodes of SVT with a heart rate of 240 in the last 12 years.  The last two episodes were a year apart.  The first two episodes stopped without intervention, the last two required adenosine.  I feel somewhat weak, but can walk during the SVT (although I generally sit or lie down).

For the past 4 months I have been exercising with an elliptical for 30 minutes 5 days a week.  My heart rate has been going into the 180s or above when I exercise at a moderate level of intensity (I can still hold a conversation).  When I tried to jog a mile at a 10 min pace, my heart rate went up to 195 (at that point I stopped).  I had a stress test that they stopped after 7 minutes since I had reached my "max" heart rate of 184.  My heart rate seems disproportionate to my level of exercise.  I have had a normal echo.

My cardiologist has recommended an EP study and catheter ablation.  I intend to consult an electrophysiologist to pursue that.

I am trying to understand if (and how) the SVT and exercise induced tachycardia are related.  Symptom-wise they feel very different.  The SVT jumps to 240 and only goes down (to 120) when converted with adenosine.  The exercise induced tachycardia gradually goes up and then back down.

Is an EP study and catheter ablation appropriate for both problems?

by Forum-M.D.-MJM, May 11, 2007 12:00AM
Hello,
If they feel different, they probably are.  The tachycardia that jumps to 240 and stops with adenosine sounds like something that can be fixed with an EP study and ablation.  I would have to look at your exercise test to assess the other issue. It is probably just sinus tachycardia with a more aggressive increase in heart rate when compared to the level of exertion.  Again, I would need to see the EKGs, but this exercise induced tachycardia may not be a problem at all -- it might be just your response to exercise.  An electrophysiologist should be able to help you sort out these issues.  Bring your EKGs with you when you see him (the ones that required adenosine as well as the exercise test -- it will help them decide how to advise you).
Thanks for posting.
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