Almost a week since hour long SVT(?) attack, feel horrible.

[nickifoxx]

I had a between 185-215 svt attack lasting an hour last Friday.  Since then, I have felt short of breath, fullness from the ribs under my arms and and back and just plain afraid. I have had lots of testing in the past year and besides the svt one or twice a year and a small ASD with ASA, there have been no significant findings.

Is this something I should worry about or is it just my body recovering or just plain anxiety?  I am 37 and I don't feel like it should still be an issue, although my last one was very taxing. It was 6 months ago and I was still afraid to exercise before this happened.   My HR and BP are normal for me, even a bit lower than usual.  I have not left the house since this has happened :(

Anyone else feel like this afterwards?  Thanks for any ideas, I feel trapped in a nightmare.

[nickifoxx]

It seems that ever since I had my first long run SVT in June that sent me to the ER (which they first tried to convert me with Adenosine with one injection that did not work, and I was fitted with paddles, they gave me Cardizem, which did work eventually) my heart has been wonky.  I find it hard to do housework because my HR rises quickly to 130ish while doing simple things like vacuuming or bending over and scrubbing or anything like that causes the same.  Could have been the same before, but I think that's where the anxiety rears its ugly head.

When I just did a maneuver, namely holding my nose and blowing while I am at 80 HR, it immediately went to 104 then dropped back.  Also made me weirdly uncomfortable.

I have been to 2 cardios and one EP since then.  FIrst one game me an extended release of Ditalizem and did testing (EKGs, echo, holter).  Went to the 2nd for another opinion, who sent me to the EP that took me off the extended release and gave me 30mg of Ditalizem for episodes.  I see him again soon.  I actually brought up to the EP that my heart is racing during housework and simple things and he told me I need to get my anxiety in check.  I feel like I can't do anything anymore without my heart racing and feeling woozy, but at least it comes down quickly.

Thanks again for lending the ears, not many I know can really understand. :)

[tom_h]

I didn't experience that.  If the maneuver didn't work, it would actually depress the rate slightly before it returned to my personal SVT rate.

Many people are being treated for panic attacks that are really SVT.  Knowing the difference is key to treatment!

[nickifoxx]

Thank you Tom, reading your replies always gives me hope that if it happens again I will be able to convert faster and relaxes me a little :)   I have a question though, when I do do the maneuvers, they tend to drive my HR up another 20 or more while I am doing them.  This in turn, scares me more because I am trying to get it to come down.  This happens to everyone right?  I try to remain as calm as possible in these attacks.  I would stand on my head in an attempt to make it work, but the thought of how much higher my heart rate would go scares the heck out of me.

I really like your description of sitting on a step, thank you for describing this to me.  I am also honestly wondering how many "panic" attacks I have had in the past were actually SVTs.

Thanks again!

[tom_h]

One thing is for certain, and that is you certainly not alone.  There are many of us here on the forum who have or have had SVT, and are always here to offer an answer.

Some people don't respond to the various methods used to convert an SVT episode.  Of course, consider the possibility that the method is being done incorrectly.  If you can't convert an episode, the first time, you have to keep trying.
Remember, to dip only your face in ice water, not your entire head.
To perform a vasovagal maneuver, try the following: sit on a step with your feet on the step below.  This brings the knees up into a semi crunch position. Take a shallow breath, hold it, and bear down hard.  People often liken it to trying to have a bowel movement when you're constipated.  I found it different than that.  I directed the pressure high by tensing my stomach muscles, and imagining that I was squeezing my heart with my lungs.  Impossible, I know, but imagining that kept the pressure high, and not into the bowels.  I held that shallow breath for 4 seconds or so.  If I wasn't successful, I'd try again and again.  Eventually I got it to convert.  Sometimes within seconds of it starting, other times it took perhaps an hour or so.
There was a user on here who would do a headstand against a wall to convert hers.  She reported that it was very effective.
The fact that I was able to control it. allowed me to live with it even before there were things like ablation, adenosine, electrical cardioversion, and the various beta blockers.  The only thing available to me was digitalis and digoxin.  But mastering it allowed me to live practically a normal life participating in sports and going about my life in a normal fashion.  There were things that I did not do.  I would not cruise.  I did not travel to a foreign country.  I would not do anything, or go anywhere that would put me out of reach of a US hospital even though in 54 years that I had it, I never set foot into one except for the first occasion that it happened.  When you have SVT for as long as I did, you observe patterns,and things that are triggers for an event.  I pushed my personal envelope, but I knew where my limits were, and avoided those limits as best as I could. For instance, I knew that sports that required long periods of medium exertion, spots like distance running, or road cycling were triggers for SVT.  I knew this because I tested those areas numerous times until I saw a pattern.  So I looked at sports that required high physical output, but for short durations.  I had much better success with this type of activity, so I gravitated towards them.
Observe and learn!  Spend some quiet time, and listen to your body, your heart.  Rather than panic, try and relax.  Panic releases adrenaline.  Physicians actually use adrenaline on the cath lab to coax your hear into SVT.  So stay calm.  I took the approach that I had countless episodes during my lifetime, thousands perhaps.  If none of them killed me, then this one wasn't going to either.

FInally, if you are experiencing two episodes per year, I think I'd wait a while.  There seems to be a correlation in the frequency of episodes, and the success in getting your heart to go into SVT in the lab.  Doing so is key in finding the location and destroying it.  Recently, there have been a couple of glum forum members who were recommended for an electrophysiology procedure after a couple of episodes, but whose procedures were failures because their hearts couldn't be coaxed into SVT.  In fact, my 50 year old cousin had one SVT episode recently and went to the local ER.  they converted her with adenosine and immediately recommended her for ablation.  Why? There's no evidence that she will ever have another one.  Ablation is a sure way to eliminate it hopefully forever.  But it's also very expensive.  If you're going to lay the money out for one, make sure then can find it on the first attempt.  The electrophysiologist gets paid regardless of the outcome.

[nickifoxx]

I tried dunking my head in ice water, coughing, bearing down, holding my nose and blowing.  I had to take 60mg of diltiazem within the first 30 minutes.

I do have an appointment scheduled with my EP.  I have a feeling he is going to want to do an ablation, but if I can't even handle an attack, would I have a horrible recovery?

I have felt a few runs of weird beats since, which pretty much immediately give me a panic attack now, but I am not sure it is any different than usual.  I guess I should get in with a pysch as well.

Thank you for your well wishes and reply.  It makes me just a little bit less crazy to know I am not alone :)

[MichelleP_3811]

They can be very taxing especially one that is an hour long.  What steps to you take to try and stop it?  Do you vasovagal maneuvers?   If not you should learn some like holding your breath and bearing down like straining to go to the bathroom or drinking a very cold glass of water.  Maybe even giving out a good strong cough or jumping up and down.  Just being in a bouncy car sometimes stopped mine.  Something to try and break the loop your heart rate is in.  My svt episodes were very rare most of my life and started to become more frequent in my 30s.  By my 40s they were frequent enough to be a candidate for a successful ablation.  It has been 3 years without an episode.  The thing is svt is usually accompanied by ectopic beats, pvc and pacs.  They kind of feed off each other and ectopic beats are more pronounced with an irritated heart.  If your heart was running fast for an hour it very well became quite irritated so part of your discomfort now could be ectopic activity.  Does it feel like your heart is a bit jumpy?  If so then that could be ectopic activity.  It should calm down but just take it easy until you feel better.  And if you are at all concerned just make an appointment to see your doctor for a check up.  Take care and feel better soon.