PSVT, antiarrhthmics, ablation

[RikkiT]

I'm a 57 yr-old female with hx of PSVT, worsening in the last year, with 2 recent trips to the ER for Adenocard.  Sandwiched between them were two other episodes that I should have got treated but didn't - one 3-4 hrs and one 6 hrs.  I know...stupid, especially for an old CCU nurse.  I get fairly symptomatic with HR 165-180, with chest/neck/arm pain and SOB.
On the other hand, my EF is terrific, the Echo and Thallium stress tests look fine (after the 1st ER visit), BP’s fine, CXR's normal.  We're pretty sure I don't have any structural heart problems.

I already have an EPS/Ablation scheduled for next month.
I’ve tried antiarrhythmics in the meantime, but have stopped for the side effects.  Metoprolol felt awful, with chest heaviness, SOB, diarrhea; Diltiazem didn't prevent the 2nd ER trip; and Propafenone gave me blurred vision and headaches, and made me so SOB that eating was difficult – terrible!  Five days after stopping it things are much better, but I still get very tired and SOB with exertion.

Everybody has assured me that "all your symptoms are attributable to the PSVT episodes you've had" and  "fix your rhythm problems and your heart function will go back to normal."  I'm ready to believe them.  

The questions:
In your experience, are those two quotes true?  If so, how long does it take?
Could some of my wimpiness be leftovers of the cardiac drugs I've been taking?
Is there any other antiarrhythmic you’d try?
I've tried to keep walking for exercise; is this risky?  Should I chill out for a month?

Thank-you for your help!

[CCF-M.D.-MJM]

Hello,

It is difficult to answer any questions without knowing what the rhythm is.  PSVT is a broad category of arrhythmia's that include very treated things like AVNRT to those that are difficult to treat like IST (inappropriate sinus tachycardia).

In your experience, are those two quotes true? If so, how long does it take?

Again, it depends on what the rhythm is.  If it is AVNRT or AVRT, yes they are relatively easy to cure.  It all depends on what they find during the EP study -- that is unless they have enough information on EKG and holter already.


Could some of my wimpiness be leftovers of the cardiac drugs I've been taking?

They should be completely out of your system by 5 half lives of the drugs -- no more the 3-5 days for each drug.


Is there any other antiarrhythmic you’d try?

It depends on what type of arrhythmia it is.  there are too many options without being able to narrow down the options.


I've tried to keep walking for exercise; is this risky? Should I chill out for a month?

If you should cut back, I hope your doctors would have told you this already.  Again, PSVT is too broad of a category.  Without other risk factors or illnesses, PSVT rarely causes life threatening complications.  You should ask your doctor these questions though.

I know this isn 't very satisfying, but I can't say much more without knowing the diagnosis or the circumstances of initiation/termination of the arrhythmia.

Good luck

[bama jane]

I have psvt too.  As well as other rhythm problems.  I had an ablation attempt but they could not reproduce the arrhythmia.    That was 6 years ago and I am sure they have gotten much better at it. I think of doing it again but am not sure if it is worth it for me since I haveh other rhythm problems that are not ablatable.  Do you get lots of pvc's and pac's daily.   I do and they really interfere with my life because the disrupt my sleep, not to mention throw me into a fast heart rate at times. My tach usually resolves on it's own now whereas I use to have to go to the er a lot.  I just stopped going because after being hospitalized so many times with this or in the er I try to just ride it out at home.  They seem to think it won't kill me but as you know it is life altering.  Good luck and please post and let us know how your ablation turns out. I have been put on pretty much every heart med out there without great results. Do things like eating, bending over, reaching above your head, or digestive things trigger yours?  I can't sleep on my left side anymore. It triggers misbeats. Hopefully someone will come up with something that will help people that struggle with this. I hope they can help you out! Once again good luck!

[rhia]

Hi!

I seem to get very short and abrupt bouts of fast and pounding beats, that terminate suddenly. I really can't tell if its heart or muscular. Does this sound similar to your symptoms?

Any info would help.

[tara beth]

I just had a catheter ablation for AVNRT on March 22. It was successful, and I am feeling great, back at work already. I was very lucky (side note: Sacramento has a great EP lab, if you need to get "fixed").

It is different for everyone what triggers the arrythmia. For me, it wasn't (usually) exercise. Caffeine, alcohol or excessive chocolate sometimes did, but it was usually random (had attacks from age 13 to age 26, originally misdiagnosed as hypoglycemic). So, if walking or other exercise makes you feel good, and doesn't trigger the arrythmia, go for it. It will probably help keep down any stress you might be feeling about the whole process!

I was on Tenormin (generic: atenolol) for a couple of months, it sucked, I was very fatigued. I'm practically "peppy" now that I am off of it.

I am excited for you that you have the EP study/ablation next month. Best of luck. The technology really has improved - depending on where you are, they tell me these things are pretty routine.

Best of luck and quick healing!

Tara