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Heart Disease (Expert Forum)
Re: PSVT
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Re: PSVT
by CCF CARDIO MD APS, Jan 01, 1995 12:00AM
Posted By CCF CARDIO MD-APS on December 27, 1998 at 18:35:09:
In Reply to: PSVT posted by bob on December 22, 1998 at 21:10:06:
I am a 25 year old male, very athletic, who when I was 14 started developing premature beats so was evaluated by a cardiologist. I would get these beats maybe 1X/hr, had a stress, echo, holter, the works and nothing was wrong (they found I had occasional PAC's and PVC's). Then when I was 17 I had an episode of PSVT while I was vigorously exercising. I was put on Inderal and had about 1 episode of PSVT every 6 months until I was 21. My senior year at college for a 3 week stint, i would get premature beats every other beat. Again, I was evaluated by my cardiologist but by the time he evaluated me, the premature beats vanished for no apparent reason. I continued to take Inderal (actually switched to inderal LA) for the next 3 years with no problem (60mg/d). Even the PSVT seemed to resolve. It would only happen about 1-2X/yr and would last for a max of 5 minutes, then I would convert back into a NSR. When I was 24, the premature beats that were every other beat came back and this time would not subside. Again I was evaluated and my cardiologist said that there's no real harm in PAC's every other beat and to just deal with it. I changed cardiologists to the University Hospital's (Newark, NJ) Cardiopulmonary Department where I was assessed by an electrophysiologist for an EP test but he said it wasn't indicated (by that time I had another full workup showing no structural abnormalities). He tried to wean me off Inderal to see if that's what was causing the arrythmia but it didn't change a thing. Next he prescribed me Tambocor (flecainide) and it did the trick. The inderal was DC'd I've been on this drug for 3 months. It just about nullifies the arrythmia except for when I go to sleep at night to an hour after I get up in the morning (I get premature beats every other beat then). Also in that hour in the morning, it seems like there's all kinds of weird beats going on with long pauses at times. After that, I go back into a NSR. Also, the other week, I had the first episode of PSVT in about a year and this time it lasted for 1.5 hrs!! I called my electrophysiologist when it happened and he told me to take my leftover inderal and finally I converted into NSR. I never really get a straight answer from my cardiologist. He says I'm fine but things don't seem perfect. What is you opinion of my status? I really want to avoid an EP study if possible. I very much appreciate your time.
Sincerely,
Bob (a very concerned 25 year old)
PS. I'm on Tambocor 100mg in am, 100mg in pm.
___
Dear Bob,
You are a very young person who even on potentially harmful medications (flecanide moreso than the inderal) still do not have control of the PSVT.
Although this is not a forum for "opinions" so to speak, I think that an EP study to try and stimulate and ablate the PSVT is the best bet. Now of course I do not know the rhythm at all and it is possible that your electrophysiologist knows he will not be able to ablate your PSVT. A holter or event monitor is maybe the first step, as it would be very educational if not beneficial to see what EXACT rhythm it was that you were in for that hour and a half while taking the tambacor. Discuss these options with your physician.
I hope this information is useful. Information provided in the heart forum is for
general purposes only. Only your physician can provided specific diagnoses and therapies.
Feel free to write back with further questions. Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please
call 1-800-CCF-CARE or inquire online by using the Heart Center website at
www.ccf.org/heartcenter. The Heart Center website contains a directory of the
cardiology staff that can be used to select the physician best suited to address your
cardiac problem.
In Reply to: PSVT posted by bob on December 22, 1998 at 21:10:06:
I am a 25 year old male, very athletic, who when I was 14 started developing premature beats so was evaluated by a cardiologist. I would get these beats maybe 1X/hr, had a stress, echo, holter, the works and nothing was wrong (they found I had occasional PAC's and PVC's). Then when I was 17 I had an episode of PSVT while I was vigorously exercising. I was put on Inderal and had about 1 episode of PSVT every 6 months until I was 21. My senior year at college for a 3 week stint, i would get premature beats every other beat. Again, I was evaluated by my cardiologist but by the time he evaluated me, the premature beats vanished for no apparent reason. I continued to take Inderal (actually switched to inderal LA) for the next 3 years with no problem (60mg/d). Even the PSVT seemed to resolve. It would only happen about 1-2X/yr and would last for a max of 5 minutes, then I would convert back into a NSR. When I was 24, the premature beats that were every other beat came back and this time would not subside. Again I was evaluated and my cardiologist said that there's no real harm in PAC's every other beat and to just deal with it. I changed cardiologists to the University Hospital's (Newark, NJ) Cardiopulmonary Department where I was assessed by an electrophysiologist for an EP test but he said it wasn't indicated (by that time I had another full workup showing no structural abnormalities). He tried to wean me off Inderal to see if that's what was causing the arrythmia but it didn't change a thing. Next he prescribed me Tambocor (flecainide) and it did the trick. The inderal was DC'd I've been on this drug for 3 months. It just about nullifies the arrythmia except for when I go to sleep at night to an hour after I get up in the morning (I get premature beats every other beat then). Also in that hour in the morning, it seems like there's all kinds of weird beats going on with long pauses at times. After that, I go back into a NSR. Also, the other week, I had the first episode of PSVT in about a year and this time it lasted for 1.5 hrs!! I called my electrophysiologist when it happened and he told me to take my leftover inderal and finally I converted into NSR. I never really get a straight answer from my cardiologist. He says I'm fine but things don't seem perfect. What is you opinion of my status? I really want to avoid an EP study if possible. I very much appreciate your time.
Sincerely,
Bob (a very concerned 25 year old)
PS. I'm on Tambocor 100mg in am, 100mg in pm.
___
Dear Bob,
You are a very young person who even on potentially harmful medications (flecanide moreso than the inderal) still do not have control of the PSVT.
Although this is not a forum for "opinions" so to speak, I think that an EP study to try and stimulate and ablate the PSVT is the best bet. Now of course I do not know the rhythm at all and it is possible that your electrophysiologist knows he will not be able to ablate your PSVT. A holter or event monitor is maybe the first step, as it would be very educational if not beneficial to see what EXACT rhythm it was that you were in for that hour and a half while taking the tambacor. Discuss these options with your physician.
I hope this information is useful. Information provided in the heart forum is for
general purposes only. Only your physician can provided specific diagnoses and therapies.
Feel free to write back with further questions. Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please
call 1-800-CCF-CARE or inquire online by using the Heart Center website at
www.ccf.org/heartcenter. The Heart Center website contains a directory of the
cardiology staff that can be used to select the physician best suited to address your
cardiac problem.
