NSVT and pregnancy

I am 35 years old and in early pregnancy. I have a history of sinus tachycardia, symptomatic pvcs and nsvt (not captured on holter but causes lightheadedness/dizziness) and take 40mg propranolol daily to alleviate symptoms. I would like to ask is it safe to continue to take BBs during pregnancy? as I have had mixed messages from doc. Also is the nsvt likely to be a problem if I quit taking BBs. I have had ecg, 24 hr holter and stress test (all fine).

[Cleveland Clinic]

kat,

Thanks for the post.

Im not sure how you know you have NSVT if it was never captured on a holter.

Just like any medicine beta blockers have positive and negative effects. Any time a medication is prescribed, one must weigh the risk and benefits of using or abstaining from the medication. The range of side effects of medications in pregnancy range from definite harm to a fetus to no harm and drugs are classified on this basis.

Since I dont know your full history it is impossible and inappropriate for me to make specific recommendations. Beta blockers have been used in pregancy, but should be used only with the supervision of your physicians.

good luck

[micangelab]

I have had a lot of irregular hear beats even before being PG. I am now 33 weeks along. Its been a really rough ride. I get those flutter feelings in my chest. It scares the heck out of me. I have been very tempeted many time to take a BB but have held off. Not sure how much longer I can deal with this. Its ruining my life. Its a hard call. Hang in there and do what you feel is best for you too. I know stress cannot be good for the baby either.

[kat13]

Many thanks for the posts.

I have noticed on the postings that in the US you seem to get a much wider range of tests and better follow up than we do here in the UK (on the NHS there is a very hands off approach and have a reluctance to do anything that costs money!) - my NSVT has never been captured on a holter because I have had one 24 holter done in 2001 (after baby no. 1) - of course I didn't have an episode that day (it only happens once every 3-6 months although I have PVCs and bouts of inappropriate sinus tachycardia every day (captured on holter) - it has not been deemed necessary to do another even although the cardiologist I saw thinks I probably have had episodes of NSVT. He believes that at 31 (at that time) I was unlikely to have CAD, therefore I should just ignore these episodes and has said that they will improve or disappear altogether with age (but thats not the impression I get from surfing the internet). Haven't seen a cardiologist since.

[fearfactor]

I am 20 weeks right now and I have taken 12.5 mg of Toprol XL throughout my whole pregnancy.  I know it may not be optimal, but my doctor says for me at least the benefits outweigh the risks.  I have severe anxiety related to palpitations and heart racing and I have already had to get off my anxiety meds so the danger of a huge anxiety relapse was too much to chance without at least a beta blocker.  I take a tiny dose, and my heart still beats fast after meals (I have only gained 5 lb. because I'm scared to eat too much) and I notice my resting heart rate is higher than before pregnancy.  But, the good news is I got an ultrasound on Friday and the baby is in perfect health - yes, she is small, but she is perfectly formed and has no birth defects or heart problems, thank God!  The doctors say not to worry about the lack of weight gain, it will happen in latter weeks of the pregnancy.  Good luck to you no matter what you decide to do with the BBs!

[andie3330]

From the posts in this thread, it seems that one is able to recognize NSVT if it happens. I know that I can feel PVCs, I'm not so sure if I've been able to feel PACs, although my holter moniter indicated that I have both PVCs and PACs. Could someone please tell me what NSVT feels like? Also, with a healthy heart, is NSVT considered benign?

My prayers go out to those of you who are experiencing challenging pregnancies. I was very stressed about my frequent heart palpitations during my pregnancy three years ago. I also have anxiety disorder and was having such a difficult time that my doctors agreed that it was better for me to stay on A low dose of Paxil throughout my pregnancy.  Then I went on a beta blocker soon after delivery, because my PVCs got so bad. It took almost a year before my heart seemed "back to normal". But the good news is that my daughter, now three, is healthy and perfect. She seems no worse for the wear of having an extremely anxious mom while she was in my belly. Being pregnant in order to have my daughter, as difficult as it was, was still the best thing I've ever done in my life. Hang in there, I know how hard it can be, but you'll get through it.  

Also, thank you in advance for anyone who knows what NSVT feels like.

[Momto3]

For me, when i have an episode of nsvt it is as if my heart is stuck in a persisten pvc mode.  Kind of like a tumbling or rolling feeling, one pvc after another...a string of them with no normal beats in between.


Enjoy your daughter....Kids are truly one of life's greatest gifts!

Have a great day!

[vanillarose]

I am a 27 year old fe...this is my 2nd pregnancy...I am 31 weeks pregnant today...I was dia.with svt in Jan 2006...I was 3 months pregnat at the time.I have had a sudden rapid heart rate since I was in 4th grade off and on all my life...I wore a monitor and nothing.They just told me I had a heart mumor...well my heart would do this like maybe 3 times a year...I thought nothing of it and I thought it was normal and was a heart murmor....up until I was pregnant with my 2nd child it effected me alot.I finally went to a heart specialist because on dec 31...new years eve I went to bed and it happened...I called 911...My heart rate was up to 220 and lasted 30 minutes.I felt like I was going to vomit and couldn't breath and felt as if i was going to pass out.I have had about 20 attacks in the past 4 and ahalf months.Some lasting 3 min to 30 min...it is very scary.I was told to take digitek once dailey and propranolol 3 times dailey.When I was taking a full dose of the digitek I was geting alot of palp. and skipped beats...the propranolol makes me sick to my stomach.It doesn't seem to be helping the svt and i'm worried about the baby with taking these medications ...I did some research and it is a class d which scares me.will the svt get worse as my pregnancy progresses?It seems it has.And do these attacks harm the baby?I heard that the baby doesn't get enough oxygen....Will the svt go away or slow down after I deliver?Also I decided to have a c section to be on the safe side...it seems everytime I get a contraction my heart feels funny and my chest gets tight.

[vanillarose]

What are you doing when an episode starts?It seems to me when i bend over to pick something up on the ground or changing a position...but then again I have been on the computer 3 times out of the 25 I have had...I have had 8 attacks so far this month...it has been now every day or every ther day lately...and hasn't happened more than once a day and my rate is up to 220...I have had to call 911 3 x past week...bearing down seems to help sometimes...but it's scary because you don't know how long it is going to last this time...and i think about if it is effecting the baby.Why this pregnany and not the first?

[tickertock]

I'm not a doctor, but pregnancy from what I understand seems to trigger SVT in some persons, while from my understanding you'll probably do just fine, an extra plus is being at 31 weeks.

Try not panic, I'm a man so its hard for me understand what you're going through, chances are you'll be just fine. It's probably best for you to consult with an electrophysiologist and consider your options as radiofrequency ablation may well be option for you and "cure" you of the Svt episodes. Good luck , safe delivery, and enjoy the new addition.

[PikaPika88]

tickertock, could you tell me what is the different between radiofrequency ablation and electrical ablation?

I'll ask a 24 hour holter and see what I have.  Can you believe that I neither have any PAC nor PVC!  I definately know that I have "train" and "elephant"!  What are they respresent?  Everytime when I ask my cardio, he said whole lot is called "wpw".  What is whole lot consist of?  How many things are in the "whole lot"?  Any one has a clue?

Thanks for helping out.

Pika.

[PikaPika88]

Oh!  I've 2 daughters.  One year after the ablation, I started pregnant.  Last year the palps came back and my 2 daughters are 16 and 18 years old already.  My daughters' mum (me) was medication FREE during pregnancy.

Pika.

[andie3330]

My understanding is that wpw is one type of supraventricular tachycardia that results from an extra electrical pathway in the heart that allows "pre-excitation" of the ventricles. This extra curcuit, at times, causes a very fast heart rate - until the heart converts (spontaneously or with medical intervention)back to normal sinus rythem.  I think "wpw" is just the name of the condition and not really related to the frequency of episodes. Anyway, I'm not a doctor, I've only done a little reseach on my own.

I have another question for anyone who might know: In a healty, structurally normal heart, is there any relationship between the frequency of PVCs and the likelihood of having NSVT? It seems that people who are experiencing occasional NSVT also have more than a few thousand PVCs per day. Any thoughts?

[cristabelle]

Hello there.  I have taken beta blockers during two pregnancies under the care of my cardio and OB.  Once I took Inderal and once atenelol.  I was able to stay off of them in the first trimester, but after that they gave me the go ahead.  I havae two very wonderful and healthy children.  One was 8'3oz at birth and the other was 7'6oz.  No difficulties in labor or birth.  My NSVT was easily caught on a holter monitor.

Kind Regards,
cristabelle

[tickertock]

Pika I'm not really sure I have only heard of cyro and Rf ablations. I think others are in the experimental stages, unless they just referred to it as an electrical ablation becaused its used to solve electrical problems with the heart, speculation only on my part, I really don't know. Take care.

[upbeat63]

I don't know if there is a correlation between high frequency PVCs and a higher incidence of nsvt, but I can tell you that after a 22 year history of high frequency PVCs (450pvcs/hr for years) it wasn't until I got 1200+/hr last year that I started noticing the nsvt.

I've been in pretty constant trigeminy for months and I didn't have any nsvt, but then I started having irregular PVCs, 3 beats, 4 beats and sometimes up to 10 regular beats in a row, which I thought would be heaven to have so many regular beats in a row, but I seem to have more symptoms with the irregular PVCs, more lightheadedness, a little SOB, and a couple of espisodes of nsvt.

I know it's nsvt because that's when my chest flutters and it feels like bubbles under my sternum, and sure enough, when I have listened to my heart with a steth it's a  pvc, pvc, pvc, pvc, pvc, pvc. Luckily I've only had a maximum of 10 pvcs in a row before it goes back to a regular beat.

Hope that description helps, it's only 100% certain nsvt if your doctor's catch it on an EKG, holter or they listen themselves.

[andie3330]

Thank you so much for your responces to my questions.

Upbeat - what does a pvc sound like with a stethoscope? I assume maybe it would not be the usual, sychonized "lub-dub" sound because the "lub" part comes from the atrium. So is a pvc just be a single sound from the ventricle?  Then what would NSVT sound like?  

I can't tell you all how helpful this site is for me. Thanks again!

[PikaPika88]

Why my GP said can't tell from listening to the heart?  So I thought the Dr listen to my chest is only for lungs!

My cardio said mine one was done under the electrical ablation.  It is in His bundle.  Is not a new thing, was done in 1985.  It may be out of fashion so no one will use it anymore.

Pika.

[Fran71]

That's a good question. I've asked it before and many on the forum have patiently tried to explain it to me but I still can't really understand what NSVT feels like; I guess we have to feel it to really know.

Bigeminy is 1 regular beat and 1 PVCs which feels like beat-pause-beat. NSVT is many ventricular beats in a row without the usual compensatory pause. I guess NSVT might feel like a very long PVC where the compensatory pause is longer than it is for just 1 isolated PVC.
I hope those who experience NSVT can clarify that better.

Fran

[andie3330]

Thank you Fran. Maybe I'll try to look back over previous threads to see how others have described what nsvt feels like.

[Fran71]

Kat,
I'm 35 and have been suffering from sinus tachy and PVCs for 6 years on and off. I too was told by my cardio that it may get better with age, though nobody can be sure. I too read in many places that PVCs usually get worse with age, so I was very pleased to hear that in his experience it is sometimes the opposite. About inappropriate sinus tachy, I've read that it often improves with age. At least, if our PVCs don't improve, the tachy might!

Andy, let me know if NSVT becomes clearer to you after reading the previous posts! :-)
Fran

[Momto3]

Hi Fran!!

Yep, I remember that thread...lol.  I'm gonna give it another shot. Maybe this time, I'll be able to better describe what I feel :)

Andie3330,

When you listen with a stethescope, a pvc sounds like lub-dub-dub. You can easily hear the extra beat.

With NSVT, the pvcs are strung together. So, for me, it is lub-dub-dub, lub-dub-dub, lub-dub-dub, etc.  I remember counting to 15 once, but I don't think I've ever crossed over 30 in a row.  That would constitute VT.  Whew!

Hope that helps : )

Connie

[upbeat63]

Connie, perfect!

I might only add that the extra beat sound (the pvc) might be a stronger or weaker sound sometimes and there maybe a longer or shorter pause as the heart resets itself. Hope that's not confusing.

Every once in awhile I get a lub-dub---DUBB pvc, which is likely the ones I "feel" like a really strong tap. For the most part it is lub-dub-soft dub (small case dub and one hyphen for a short pause)   :-)

The nsvt isn't any stronger a sensation (for me) just feels like rolling, or bubbles or soft flutters. That being said, some people feel their single or couplet pvcs as a flutter. It can get confusing!

[andie3330]

Thanks so much for your detailed explanations. Very helpful.
Best wishes, Andie

[andie3330]

Help! Now I'm scared because I just listened to my heart with a stethoscope and I hear a lot of the triple sounds "lub dub dub" or maybe - I'm hoping - "lub lub dub". In other words, I'm hoping that what I'm hearing is a lot of PACs rather than a lot of PVCs. I know that when I have a PVC while I'm taking my wrist pulse there is a definite pause between beats. But during the "triple sounds" or "lub lub dub" beats my wrist pulse feels steady and regular. Does this make sense? I don't think they could all be PVCs if my pulse is steady, right? Also, I can generally feel PVC's but I wouldn't know I was having these "lub lub dub" sounds (hopefully PACs)if I hadn't used the stethescope. Why did I feel compelled to listen with a stethescope? I almost wish I hadn't because until I know for sure these are PACs and not all PVCs I'm really scared. Please help if you can. Thank you!