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IST diagnosed and confused...
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IST diagnosed and confused...

First let me start by saying, I'm 21, 5'8, 150 pounds and relatively active... due to my fast heart rate, it prevents me from exercising much so I'm not in the BEST shape. But let me start from the beginning.
For the past few years I've been in and out of doctors offices trying to find out what was wrong with me. My symptoms were simply palpitations and they were getting to be very bothersome. The first cardiologist did a number of tests including a nuclear stress test, a 48 hour halter monitor and a 30 day event monitor. The tests all came back normal and he told me that is was most likely in my head.

I recently started EMT school and will soon be starting Paramedic school. My instructor has been a paramedic for many years. While in class one night, we were learning how to take blood pressures and pulses. None of my classmates were able to get a blood pressure reading from me (the "old fashion" way) nor were they able to find a radial pulse (on the wrist). My instructor came over to me and hooked me up to a digital bp machine and a pulse ox. At that time, my resting heart rate was 180, my capillary refill was delayed, and I had a cold sweat. My instructor, being a paramedic, became extremely concerned and told me that my cardiologist was insane, that whatever was wrong with me was not in my head, and that I should seek a second opinion.

So I went through round two. Did another stress test and halter monitor. By describing my symptoms to this cardiologist, she was convinced I had SVT. She referred me to a specialist. After further testing, he concluded I have IST and suggested I start taking 20mg of Nadolol daily. We had discussed the ablation surgery before... but he told me that he didn't feel I needed the ablation now, and that I should be just fine with medication.

My quality of life hasn't been that great for the last year or so, and I've noticed a large change in how I feel. My resting heart rate (even while sleeping) is around 120... and my normal heart rate while up and being active during the day seems to run from 140 to 200. It's also very erratic... it will jump from 140 to 180 to 100 to 130 and so on. I've started to lose all of my energy and I'm always tired. I get nauseous constantly, or I get so dizzy that I have to sit or lay down for a few minutes. I have terrible nightmares every single night, where when I wake up from them, it feels like my heart is about to beat out of my chest.

Ok... he is where all my questions and concerns come into play.

I have a history of low blood pressure... I've done as much research as I could on Nadolol and it seems like it's generally used to treat HIGH blood pressure. Not only do I have a history of that, but asthma as well. My doctor knows these things... but it seems like lowering my blood pressure anymore could be dangerous. I've also read a lot of negative feedback from people who have taken this medicine. I'm worried that the quality of my life is going to go from bad to worse.
I'm also afraid that it's going to prevent me from being as alert and aware as I should be considering the kind of career I'm in. EMS is a highly stressful, high adrenalin job... and I'm afraid this is going to prevent me from performing like I should.

I really like my doctors attitude... but it seems like he has more of an attitude like "lets push all the drugs first and see what happens... then look at other options". I'm running out of time here. I'm cobra'd on my parents insurance for 4 months... and after that I will have no way to get insurance and I'll be a full time student and not working.

Although the ablation surgery is invasive... would it be the best rout for me to take?

All I'm concerned about is feeling better. It was the worst feeling in the world, to go to my doctor and be told I have a condition that they hardly know anything about, that drugs might not work for, and surgery only has a 80% success rate.

Should I seek another opinion and push the ablation? Or should I stick it out... and stick with the medications, even though the effects of them could be very serious for me?

Has anyone else as young as me had to go through this?? And what did they do for you? Does anyone have any success stories with this condition? Because so far, from everything I've read... nobody has gone through a successful treatment.

I just want to know if I should keep pushing for more answers, or just accept the doctor as being right? I'm really confused... and very nervous about all of this.
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I know this seems hard, but the first thing you want to do is relax! The more you stress out about all of this, the worse it will get. Ablations are never the first line of attack; drugs always are. Probably the only exception to that rule would be if you had arrhythmias origionating in the ventricles or had a severe form of muscle disease itself (such as a Hypertrophic Cardiomyopathy). Muscle diseases don't handle arrhythmias very well. I also have a history of SVT as well; it was far worse when I had it as a young person (18-26), now it hardly ever bothers me. I took Inderal and Digoxin, but had horrible side affects from those drugs (Hallucinated on them). Since I stopped the drugs and stopped worrying about the SVT, I really don't have that much of a problem. Ablations ONLY work if the electrical tract that the arrhythmia is running on that day is ACTIVE; if it's not, the ablation doesn't work and you are back at square one. You probably aren't ready for jumping into something like that. If you wake up with nightmares, your pulse will be through the roof, that's normal; 'the fight or flight response'. When your heart rate is high, does it run up and down or does it start and stop on a dime?  
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