PSVT with pounding

[steve__0__0]

  I am a 29 year old male, played college Div I sports, extremely fit. About 9 months ago, I felt my heart having a significant decreased tolerance to any caffeinated food/drink...coffee, coke,etc..my heart would race and would feel shortness of breath.
  6 months ago, after playing ice hockey, I felt some irregular beats in my heart..thought nothing of it..Since then, after eating any meal, my heart would pound with a slight elevation in rate...the pounding was so bad, my entire chest and arms would shake and reverberate from my heart beating.. condition was torturous and unbearable...saw countless doctors...hematocrit was high but nothing else...recent tests show no polycythemia.
  4 months ago my heart starts beating in a regular irregeular pattern along with the constant pounding...eating food would compound the pounding affect about 2 hours after. Heart would go about 100 bpm for 15secs and the abruptly slow to 60bpm for 10 secs and then the pattern would restart.
  Saw a cardiologist and said I had paroxsysmal SVT.
  Arrythmia didn't really bother me, it was the pounding that was so unbearable...I could feel the pulse throughout my entire body but mostly on the left side of my body and at the extremities like the feet, hands, head, neck, tailbone area..
  Cardizem was ineffective but Atenolol worked like magic...it relieved my pounding as well as my arrythmia. But the atenolol gave me too many side effects like fatigue, drowsiness, insomnia, irritablity, etc..
  I'm only 29 and I can't take atenolol for more than a week at time so forget taking it for the rest of my life. Another cardiologist has recommended Tambocor but I'm very hesitant of taking that.
  Also, I had a 4 day bout of diahrrea in which the entire pounding sensation and arrythmia was entirely gone...once I became regular, the pounding sensation came right back..
  I have been to a endocrinologist and have tested negetive for diabetes and thyroid function was also negetive...
  I also recently developed premature ventricular beats...
  This condition, but mostly the pounding of my heart is driving me insane..
  I am seriously considering catheter ablation but every doctor seems hesitant about the procedure and warns against it...
  Any suggestions or ideas would be very helpful
  Steve

[CCF CARDIO MD APS]

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Dear Steve,
It is one thing to have PVCs or a few irregular beats, and it is a completely altogether different thing to have SVT.  PVCs and PACs are premature beats of the heart that are common, occur in all individuals, and only cause infrequently.  An SVT is a rhythm disturbance that often requires investigation with possible ablation, not definite.  You should consider an EP (electrophysiology) study very seriously as this could benefit you greatly, not only because it could quite easily take away the pounding of your heart (which sounds quite debilitating for you), but also because it could uncover any potential life-thratening arrythmias(abnormal heart rhythms.)  An electrophysiologist is a cardiologist that specializes in heart rhythm disturbances and in treating them with ablation.  If there is something to ablate in your heart, this procedure has a very high success rate (in the 95% range) and is very simple and with very little risk for you.  Another point for you to understand is that there are many, many beta blocker type medicines and others for treating your problems that could be tried on you as yet, but remember the drugs not only have potential side effects, they also have there own potential risks.   If you would like to be evaluated at the Cleveland Clinic just call 1-800-CCF-CARE and ask for an appointment with Dr. Kidwell or one of the electrophysiologist at desk F15.  Good Luck.  Information provided in the heart forum is intended for general medical information purposes only, actual diagnosis and treatment can only be made by your physician(s).