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Heart Disease (Expert Forum)
ST vs focal atrial tach
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ST vs focal atrial tach
by PVC, Oct 19, 1999 12:00AM
I posted a question last week regarding an atrial arrhythmia. I am currently considering a follow-up EP study to confirm the existence of an abnormal focus within the atria. I have suffered several bouts of afib that always follow a short burst of atrial tach. The atrial tach always occurs immediately upon swallowing. I have a few specific questions:
1. The atrial tach associated with swallowing happens every time. This can make eating quite a challenge at times. The problem is exacerbated with exercise and the effect becomes much less obvious when at rest or sleep. I have been on propafenone for about a week during which I have had no atrial tach, even after swallowing. Does this mean that the problem is likely focal atrial tach or could it still be sinus tachycardia? I am wondering if anti-arrhythmic meds have an effect on sinus tach.
The reason I ask is that I assume if it is focal atrial tach. that a possible ablation could be attempted if the area can be identified.
2. The action of swallowing seems to produce a sinus pause prior to the onset of atrial tach. The atrial tach usually only lasts for a few beats but during exercise can result in a run of several minutes. The fact that afib has occurred following the action of swallowing makes me wonder if the sinus pause creates the conditions necessary for atrial tach or afib. I assume the pause is due to the vagal response which is resulting from the action of swallowing on the vagus nerve. I suppose that would help explain why swallowing while exercising typically results in a much more dramatic effect (heart rates jump from 140 to 230 immediately after I swallow while on a run). If it turns out that my problem relates to the sinus pause (vagal effect) and not an abnormal focus, can anything be done about this (especially during an EP study)?
Thankyou for your comments
Peter
1. The atrial tach associated with swallowing happens every time. This can make eating quite a challenge at times. The problem is exacerbated with exercise and the effect becomes much less obvious when at rest or sleep. I have been on propafenone for about a week during which I have had no atrial tach, even after swallowing. Does this mean that the problem is likely focal atrial tach or could it still be sinus tachycardia? I am wondering if anti-arrhythmic meds have an effect on sinus tach.
The reason I ask is that I assume if it is focal atrial tach. that a possible ablation could be attempted if the area can be identified.
2. The action of swallowing seems to produce a sinus pause prior to the onset of atrial tach. The atrial tach usually only lasts for a few beats but during exercise can result in a run of several minutes. The fact that afib has occurred following the action of swallowing makes me wonder if the sinus pause creates the conditions necessary for atrial tach or afib. I assume the pause is due to the vagal response which is resulting from the action of swallowing on the vagus nerve. I suppose that would help explain why swallowing while exercising typically results in a much more dramatic effect (heart rates jump from 140 to 230 immediately after I swallow while on a run). If it turns out that my problem relates to the sinus pause (vagal effect) and not an abnormal focus, can anything be done about this (especially during an EP study)?
Thankyou for your comments
Peter
Doctor's Answer
by CCF CARDIO MD - DLB, Oct 19, 1999 12:00AM
1. I suspect the medicine is suppressing an atrial tachycardia.
2. Sometimes afib is dependent on a pause or a slow heart rate. In this situation, medications that slow the heart rate are to be avoided. If there are abnormally long pauses, a pacemaker may help.
2. Sometimes afib is dependent on a pause or a slow heart rate. In this situation, medications that slow the heart rate are to be avoided. If there are abnormally long pauses, a pacemaker may help.
Member Comments (3)
by Peter, Oct 20, 1999 12:00AM
What does it mean when the sinus pauses do not occur while on Propafenone? Also is it safe to take propafenone by itself? The last doctor told me they usually prescribe something such as digoxin in conjunction with the anti-arrhythmic
by CCF CARDIO MD - DLB, Oct 22, 1999 12:00AM
In addition to its other effects, propafenone can slow down the heart rate. It is sometimes used as a sole agent to treat afib.
