POTS of central origin

[JCappiello]

So after a lot of trial and error with my electrophysiologist - he believes I do not have POTS of a peripheral origin, but from a central origin... which is much less common and a lot harder to treat... Anyone else diagnosed with POTS with a central origin?

[Heiferly]

Any word from the doc?

As for pots of a central origin, this is not a standardized diagnosis, and indeed sounds more descriptive than diagnostic in nature. Pots can be secondary to another diagnosis, and a few of those diagnoses might be considered central I suppose? I would need to double-check with a neuroscientist to find out if a preganglionic lesion would be considered central or how far "upstream" you'd need to be. At any rate, it takes a QSART and a TST to sort out preganglionic and postganglionic, so I'm having difficulty understanding how the doctor would know it was central. I don't think an EP cardiologist would have done sophisticated autonomic testing? So maybe he's just postulating on a clinical diagnosis??

[LivingInHope]

Hi- I think your question was actually meant for me.  I apologize I didn't see this before today.  He did point out a specific part of the wave that was different than it would be in a sinus tachycardia.  I have a picture of the earlier SVT uploaded on my picture section of my profile, if you'd care to see that one.

[0Freaked0]

My understanding was that svt is often only differentiated in ekg from normal rhythm by sudden onset. Was he able to tell a specific region creating the rhythm or a certain sort of svt, or did he just assume it was svt due to the extremely sudden onset?

[LivingInHope]

See PM for some info I found on the ANS.  

Please, do let me know the July 8th EP doctor's opinion.

Well, on this latest holter monitor, SVT was demonstrated for a second time when I stood after having been asleep and I believe he said it lasted for about ten minutes.  I mentioned how I'd read ablation is a no no with people with P.O.T.S. and I think he told me about how someone who was desperate had gotten ablation and a pacemaker or something.

He gave me some Bystolic samples, but I haven't tried them yet.  

[JCappiello]

That is interesting.. I am confused about what the Dr. said also, but as he explained the autonomic nervous system is central and peripherally involved.  In my cases the cause of POTS is peripheral.. i.e. blood pooling in the legs, but he seems to think mine is totally central in origin.  I am seeing a different electrophysiologist July 8th for another opinion of what he thinks and treatment options.. I'll def let you guys know what he has to say..

Hmm what did he say about the SVT?  I had a few heart monitors and although my HR almost hit 180 and I have IST along with POTS my heart was in normal sinus tach

[LivingInHope]

I'd not even heard of 'central origin' before.  My understanding was that P.O.T.S. was symptomology of dysfunction of the autonomic nervous system, which I believe is controlled by your brain and spinal cord.  I think study has been done where the kidneys may have something to do with things also.  

When I think central and peripheral origin in context of electrophysiology, I would think it would be in regards to whether the tachycardia was sinus in nature, which would mean the electrical firing to cause the heart to beat was originating in the appropriate node or whether the tachycardia was originating where the electrical firing was coming from an inappropriate spot, such as happens with supraventricular tachycardia.

Interesting thing I learned with my new cardiologist.  When I stand up from sleeping in bed, my heart is actually going into supraventricular tachycardia.  Other places he noticed sinus tachycardia.