Sinus tachychardia

My son, 22, otherwise in good health has been diagnosed with Sinus tachychardia ( 120-150 pulse); all med. exams have come back negative; he has been put on beta-blockers (25mg); is this forever? (I'm concerned about long-term side-effects...
I live in France, he in the US; his dad won't speak to me...I'm worried...
His symptoms besides his fast pulse: dizziness, migraines, getting easily out of breath...
Thank you for any info you might provide me...
Daniele

[CCF-M.D.-MJM]

Hi  Daniele,

This sounds like inappropriate sinus tachycardia, but here are a few other tachycardias that can masquerade as IST.  IST is notoriously difficult to treat with medications. It depends on how symptomatic he his.  There is an ablation procedure that can modify the sinus node, but the success rate is only 50-80%.  Ablations are last resort therapy.  There are a few other peole that follow the board with IST.  I am sure they will weigh in about options.

IST can rarely cause decreased heart function from sustained elevated rates.  This would be an indcation to attempt an ablation.
University medical centers are probably the best option, especially here in the US.

I hope this helps.

good luck and thanks for posting.

[CollegeGirl143]

what beta blocker was he perscribed?? sinus tachycardia isnt really an arrythmia.. its just a normal fast heart rate, like if u just got done running or something.. alot of times its caused by anxiety..is your son depressed or anxious? if so control that and he would likely be able to come off beta blockers

[mrbh]

Sinus tach is not considered a disease. As I'm sure the CCF Docs will point out, there are two kinds, appropriate (AST) and inappropriate (IST). Suggested causes and triggers can iclude fever, anxiety, dehydration and a number of others.

I'm curious as to what beta blocker he is on. Inderal would help with the tach, although 25mg per day seems like a low dose. A beta blocker might help reduce the frequency of his migraines, although it won't reduce any actual migraine pain.

In general, beta blockers are pretty safe meds when used as directed by a doctor.

There are lots of good posts in the archives here about sinus tachycardia. Check them out.

I'm not a medical professional, so your mileage may vary. Let his doctor take the lead on this, and try to calm down. Good Luck.

[Daniele]

Thank you for your quick responses, I'll try to find out what beta blocker he's on...However I'm not really reassured by the responses...I'll try to get more precise details if I can...
Thank you again!
Daniele

[jan]

I was told by my EP (electrophysiologist) that I would be on meds for life.  I have IST and NCS.  I take an incredibly sm. dose of atenolol (beta blocker), because of side effects, so I take verapamil (calcium channel blocker) in addition to help control the tachy.  I feel so much better since being treated!

[tickertock]

I too suffered with tachycardia as a young boy, teenager and man. Mine was diagnosed as sinus tachycardia, though anxiety , fright or a premature beat could trigger it like a switch, it always took a while to come back down. I used have heartrates in the 120s for days. My resting heartrate could vary bewteen 85-115bpm. I took inderal but had break throughs on inderal, atenolol completely controls my tachycardia with no break throughs . Some cardios debate whether I had IST, just anxiety tachycardia or maybe some PSVT. I have PVCs occasionally also, thats another plague though I rarely have them anymore. My grandmother had tachycardia all her life also, her resting heartrate was almost always over a 100 bpm. She died at 89 and her heart was still in good shape when she died, in fact the docs said her was very strong, she died of complications from a broken hip.I'm now 41 and my resting heartrate probably averages around 64 on atenolol. Wishing your son the best.

[momto3girls]

Hi,

I know exactly what you mean.  I too have been suffering from sinus tachycardia for years now.  (BTW, I'm only 33) My heart rate would go up to 180 bpm for no apparent reason,not to ,mention the pac's and pvc's.  Well after a slew of tests (echo's, stress-tests, holters, event monitors) the latest cardiologist says its SVT.  (My dad has SVT and right bundle branch blockage) I'm on atenolol,only 12.5 twice a day because taking 25 twice a day dropped my heart rate down to 40 while I was awake!  So far the atenolol works but my worst tachycardia happens when I'm asleep so I still get breakthrough tachycardia episodes with occassional night sweats.  They tell me structurally there's nothing wrong and to just ignore it but some days that's easier said then done.  Oh, I even get chest squeezing which now they tell me must be gerd because I'm too young to have blocked arteries!  Best of luck to your son though.  He's definitely not alone!  Stress really aggravates mine too so I try to keep the stress to minimum.  Hard to do with 3 kids under 7!  Take care (:

[Lyn2]

Hi Daniele,
I had a modified sinus node ablation in Boston at age 29. The fast rhythm came back quite quickly and I had a second and finally a third.  I ended up needing a pacemaker.  Since the pacemaker I have had terrible arrythmias all over the atrium.  The worst being a-fib.  I ended up shortly after the pacemaker and identification of the afib on coumadin, and eventually anti-arrythmics. After many years, and many drug trials, I had a complete AV node ablation, at age 37, 2 months ago.  This means I will no longer feel the arrythmias from the upper chambers, but I am also 100% dependant on my pacemaker.  
The bottom line:
Personally, if I were you I would do everything else before ablation.  It sounds like he is just starting trials with meds.  I went through several years of several meds. before I went forth with ablation.  I tend to hear more from the people that end up getting pacemakers due to the ablation, but I would love to know an actual statistic on how many ablations it takes to reach either a normal rate or getting a pacemaker.  
It sounds like it is a difficult situation for you, as communication is not great.  If he can get himself to a good EP who is conservative and willing to go through courses of meds. prior to an ablation decision, he's on a good path.  If you have more questions I would love to help.  Just keep replying.
Good luck!

[tickertock]

Unless clear a cut arrhythmia can be identified ie AVRT, AVNRT or in some cases RVOT or LVOT VT or PVI for a-fib, most doctors steer clear of ablation now from what I gather. Ablation have given some back their lives and is very successful such as in WPW , AVRT and AVNRT. One should seriously weigh the risk benefit ratio for arrhythmias that is known to have a very small % response to ablation, many are left with detrimental consequences, while I'm an advocate of ablation for certain arrhythmias it should not be taken lightly, I am not a doctor just my 2 cents worth of opinion.

[momto3girls]

Hi again Daniele,

I meant to let you know that my dad who has SVT (supra-ventricular tachycardia) had it for over 20 years and was on beta-blockers until they no longer worked.  He just this Christmas had an ablation which worked perfectly for him.  My point is that my dad had the tachycardia for a long time, it didn't damage his heart at all and he only had the ablation because it was too much of a nuisance to go to the ER and bring the fast heart rate down since his meds stopped working.  I hope this encourages you.  I'm sure your son will get a proper work-up and like the other people who posted already said, they'll try playing around with beta blockers to see how he feels.  I understand that it must be hard for your son to be only in his early 20's and facing long term medicine needs. Personally, I think atenolol (which has been around for a while and I've taken for a year now) works really well.  How frustrating for you though to be far away!  Best wishes to you and your son (:

[Heart3]

What is non sustained artial tachardia?

How do you know when to worry about these rythum disturbences?

[KAD]

Hi Daniele,

I also had IST with rapid rhythms in the 140-180's constantly.  They attempted 4 sinus node modifications.  The fast rhythm came back after the first 2 and then after the third I required a pacemaker.  I am also very young at 27.  I am glad they were so aggressive with treating me because I was developing an enlarged heart from the constantly fast rates.  My suggestion would be to go to a very large institution that has a lot of experience with IST, like the CCF doc said.  The best type of doctor for your son to see is an EP(electrophysiologist) because they deal specifically with electrical disturbances of the heart.  They would give options for various types of medications to more invasive treatment like ablations.  Good luck and I hope everything works out.

[CMP800]

I also have done a lot of research on sinus tachy, since I now have it due to stress/anxiety, and have found that if appropriate it is moreso uncomfortable than harmful.  I am no expert on this since my episode just began earlier this year, but I feel I can reassure you that your son will be fine.  He has to learn what his triggers are. For some people it can be caffine, chocolate or stress (conscious & unconcious) etc., even in small amounts.

If you read more of this forum, you will find people that have to deal w/ a lot worse and are still alive and kicking.  I know it's scary esp. since you are far away & it may feel like you can't help him, but this is a condition that could last for some years or could go away on it's own.  Tell him to stay positive, listen to calming music esp before bed and tell him to pray alot.  That has REALLY helped me.  I hope this helps ;)

[Emmaj]

KAD, I'm curious why they didn't try a pacer before the ablations? It seems like it would be the less extreme measure... although maybe it isn't generally as effective for ist? Thanks and good luck!

[KAD]

Hi Emma,

A pacer will not help IST.  A pacemaker is to help keep the heart rate up not to lower it.  For example, my own heart rate is 30 beats per minute without the pacemaker, but the pacer makes it beat at 80 beats per minute.  Pacemakers won't help to lower fast heart rates.  I wish they were able to do that(:  It would make life a lot easier for people with tachcardias.  A pacemaker is also pretty invasive.  It's actually more invasive than ablations, because it is a foreign body implanted into your body with electrodes attached to your heart.  So you run the risk of developing infections from it, and you have to go in for procedures to have it replaced every 5-10 yrs.  But I'm very grateful for it.  Life is better with it, than without it.  Take care!

[PikaPika88]

With the new technology, pacemaker uses for a lot of Sick Sinus Syndrome.  At the moment mine one is for brady, tachy and A-Fib as well.  (day time for tachy and night time for brady).

In 1982, there was one called "PASAR" was designed for tachy (SVT), Dr said was very effective but my beats overwrote so it wasn't effective for me.  That time I haven't had brady yet.

From my feeling, when I have exercise, the pacer keep continue to pace at 70 (doing its job).  My heart is doing its job and keep racing.  End up like a "WAR" in my chest, machine gun and dropping bombs.  My chest then become a battle field .....

Just let you all know, pacer also can use for control tachy as well.  Take care.

Pika

[Emmaj]

Thanks, KAD! Everything you say makes sense, but somehow I got this idea from somewhere that a pacer (or some kind of pacer) could keep a person's heart rate within a range... I don't know how I got that, because like you say, if it could do that, it would solve a lot of people's problems! Maybe that is what PikaPika is referring to though? I actually have had a pacer for somewhat over a year to keep my hr up, given I have to take a lot of arrhythmia meds, but I'm still fuzzy on how it works exactly. I never had an ablation for afib/aflutter -- I think that type of ablation wasn't very commonly done where I live when I was having trouble, and I needed a quick fix. Best of luck!

[PikaPika88]

This is NOT mine type of pacemaker.  It works on tachy, brady and Fib.

http://www.sjm.com/devices/device.aspx?name=Contour%26%23153%3b+MD+ICD&location=in&type=6

Pika.

[Emmaj]

Thanks, PikaPika -- I'm glad I caught this! I will check it out. Most of the pacer info I've found is pretty elementary stuff -- I admit I can't follow the highly technical, but I would like something with a bit more depth than the usual patient info on pacers. I'm looking forward to the reading -- thanks again.

Emma