SNRT

[gdeniseg]

Can Sinus Node Reentry Tachycardia be diagnosed on the mere presence of p waves or is there something else you have to look for?  Also, in some of the reading I have done on SNRT, it said that organic heart disease is frequently present, is that true? I have been diagnosed with SNRT by my cardiologist (when she interpreted my EKG's & rhythm strips), however I had an echo which was normal, a Holter which was basically benign with the exception of some short runs of SVT and frequent episodes of sinus tachycardia - my heart rate got up to over 120 almost every hour of the day.  
Also, she placed me on 50 mg. Lopressor bid and I want to know if I can expect that medication to control my SVT/SNRT?  It has worked well in the 3 months I have been on it, but I was unsure about the long term benefit.  
Is it important for me to find out for sure which tachycardia I have (SNRT or another form of SVT) or does the exact diagnosis not really important since I am on beta-blockers anyway?

And one last question - on one EKG I had, the EKG machine intrepreted mine as Long QT, with a QTc of 462/rate 135.
Follow up EKG showed QTc of 449 rate 123.  My cardiologist said that I did not have long QT.  My concern is that I have read that those numbers are borderline long QT and even though my cardiologist said I didn't have long QT, I can't seem to accept that because everything I read said those numbers are borderline.  What are your thoughts on that?

[WPWGuy]

Some folks here have gone to cleveland, and some to other outstanding medical facilities.  After a recent visit to cleveland, I found I was able to get very personalized treatment and follow up, both from my doctor, and from his support staff.  The cleveland doc (and I must say my local EP)have always been more than happy to personally return calls, and reply to concerns I express via email.  Support staff at CCF was exceptional --- probably 90% of the reason for the success of the clinic. The doctors assistants primed me before my visit with the doctor, thoroughly assessed all aspects of my state of affairs, helped me sort through a huge pile of dumb questions I had, and followed up on my pain in the neck requests for medical data to be sent all over the country...

I am sure other people here have found other good doctors and nurses and can relate similar experiences. But let's face it, good doctors/nurses dont go on trees, and the ones that are out there are really in demand!!  Unfortunately, this forum has only a limited capability to answer all questions. It is really too bad we cant figure out some way to grow the capacity of this thing...

[gdeniseg]

My heart has been fast for about a year now, but since I ended up in the ER with the SVT/SNRT, they put me on Beta Blockers (Lopressor actually) and it has worked beautifully. My heart stays about 50-60 most of the time on Lopressor unless I get anxious or am exercising.  So, hopefully that will keep mine under control.  
My cardiologist did in passing mention the possibility of an EP study, but as long as the Lopressor is keeping things under control, I hope to avoid that.  Thanks for your post.

[Jeff67]

Just curious, for those who have had SVT captured on a trace, do many of you feel the SVT beats as being quite different to normal sinus beats (for example SVT beats being much more vigorous, strange feeling contractions, violent, pack a real punch, etc).  I ask because you would think that unless the SVT is aberrantly conducted the beats should feel similar to sinus tach.  Maybe what I am feeling is VT.

[gdeniseg]

Yes, my captured SVT beats do feel differently from normal beats.  They are not as 'strong' as PVC's but you can definitely tell that it is different, it feels more like a sudden burst of sinus tachycardia, then it just goes back to normal (if it was a short run).

[Neener44]

I had a similar thing for years. My heartrate was 120 or higher for hours at a time day after day. They did an echo on me and my rate while laying down for about 45 minutes during the echo never went lower than 120 bpm. The echo also showed my heart was enlarged from the constant tachycardia.I've had two ep studies with ablations and still have tachycardia (though not as bad as before) and I take Betapace (sotalol) every 12 hours to keep my rate in a more normal range. You need to see an electrophysiologist if you haven't already. They specialize in heart rhythm problems. Before the first ep study they thought I had AVNRT. After the second study when the tachycardia returned again I was told that I had IST most likely caused by a dysfunctional sinus node. The most important thing is to find a specialist who can really determine what's going on and give you the treatment that will work best. Many heart rhythm disorders can now be cured with ablation. Good luck and take care.

[pms_barbie]

Im not sure rather you know this ot not.  However there is a 2 question limit in a 6 month period of time.  It ruffles a lot of feathers when you post 2 questions in two days.

[gdeniseg]

Neener, I forgot to ask - has your enlarged heart went back down to normal size?  I have always wondered if once your heart was enlarged if it was even possible to go back to normal size...

[mika_k]

hi!  When I have pvc's they feel like a big thud, or a butterfly in the stomach kind of feeling.  When I have svt I feel more shakey.  Kind of like my insides are shakey but my hands are still steady.  Does that make sense?  So, it feels a little different to me, but not the same as a pvc.

[WPWGuy]

Hi. I read a posting from the cardio here recently that said that SVT refers to a whole class of arrythmias that originate above the ventricals.  The AVRT (an SVT) that I used to have packed a bit of a punch.  I am guessing how much you feel has to do with the particular way blood flow and muscle contraction are affected by any given arrythmia.  Also, maybe that any wide complex tachy might be felt more strongly than narrow complex.  This is a complete guess.

[jobob52 ford]

When I had VT it was like all of a sudden a switch came on and my pulse was at 250. If I could get it to terminate it would end the same way. If I couldn't get it to terminate on my own, a trip to ER and 12cc of adenosin followed. Hope this helps.

[Cleveland Clinic]

denise,

thanks for the post.

SVTs are classified by the location of the P waves and their morphology.  The actual specific type of SVT is sometimes difficult to diagnose off a surface ECG and better elucidated from the internal recording of electric potentials during and EP study.

All arrythmias are more common with strutural heart disease.  

The only way you will know if the lopressor is working is if it works.  B-blockers and other anti-arhytmics work exquisitely well for some and not at all for others.  However, some people need no other therapy.  If your heart rate is reaching 120 every hour, it suggest your therapy isnt working well.

The EKG interpretation of QT intervals are often times wrong.  If your cardiologist looked at it I would trust his or her opinion over the machine.

good luck