How/when to treat SVT

[IlovePSU]

have an implantable loop recorder and it has been picking up episodes of SVT. THey happen a few times a week last between 10-30 seconds. During the episodes, I am highly symptomatic. I experience shortness of breath, near passing out and it takes me a long time to relax after these episodes happen. I haven't met with the EP yet but will next week. What are your thoughts on how to treat this? What would you do if it were you? I had an EP in December that they couldn't induce the SVT or anything else. Should I request another one? I haven't had an echo since 2006, should I ask for another one?

[CCF HeartMD-1]

It really depends on what type of SVT you are having and there are a few types.  Your EP should be able to tell this from your loop recorder or even better on an EP study.  Sounds like you had one in December which didn't show anything however if you are now having SVT on a loop recorder there must be something going on.   You can always see another EP to get a second opinion also.  I do think it would be wise to have another echo since you haven't had one since 2006 and are having arrhythmias.   Overall though we usually try to get patients on medications that slow the heart rate such as beta-blockers or calcium-channel blockers, however in your case since you feel so poorly with your SVT, you may be a person who we would consider ablation of the SVT (which is a procedure to essentially cauterize/burn the spot in the heart where the arrhythmia is coming from). However, in order to see if you were a candidate for this we would need to no what type of SVT you were having.  

Hope this helps.  Good Luck!

[IlovePSU]

Thank you for your quick response. I see the EP on Tuesday but am really trying to know what to expect from him with these recent events. I had passed out in November and have two very near pass outs in the past six months. That is the reason I had the first EP study and the ILR placed. The other thing the ILR is recording is during two times of dizziness that I activated the device, I  was in normal sinus rhythm but at HR of 44/45 at those times. I had tried to take beta blockers before because I was having lots of PVC's but that caused a severe reaction of a  constant low heart rate and a bp that was too low.
Is it possible another EP may catch the SVT? I don't know what the exact SVT is as it has taken me a long time for my EP to respond to me and finally I pushed for an earlier appointment which is Tuesday. I had a stress test two years that was very normal.