Do They Tell You SVT is Benign?

[Cheers]

I have been told over and over again that this will not kill me...to stop worrying. And then I read this. http://www.ncbi.nlm.nih.gov/pubmed/9193013

WTH??!!

[ascott3]

I am 44 and I had my second ablation March 14,2013. I suffered a major stroke during the procedure. I have recovered ok but still have SVT and I am on 2.5 to 3 mg of Bystolic per day. I am way worse of then before the ablation since I took no medication before. Beta Blockers can be pretty tough. Dont think for a minute that an ablation is not risky. That said, my case was unfortunate and rare. I know multiple people who had multiple ablations but my advice would be to have only one.

[tom_h]

When I went back to my EP for my 1 month checkup, he ran an obligatory ECG, took a look at it, and said "Looks great".  I looked at him and said sort of hesitently, "That's it?  I'm done? Is it ok to drink caffeinated caffeinated stuff now?"  He replied, "There's a Starbucks across the street, go over and get yourself a double espresso." ...and I was on my way.  As littlegreenman1 said, SVT always keeps you looking over your shoulder.  You never know what you're going to do or eat, or drink that will come back to bite you in the butt.

I've had a number surgeries over the years; everything from having my toncils out at twenty-six, to 3 hernia surgeries, separated and broken shoulder from bicycle racing accidents, and an assortment of crazy deep cuts from skate blades, and hideous road rash. The EP procedure painwise was less than my hernia surgery, and about as complicated as a colonoscopy procedure from the patient point of view of course! Like I said to you last night, if it ever comes to that point, don't fear it.  If you've reach that point where ablation is recommended, it will give your life back to you, quite literally!

[MichelleP_3811]

Depending on the type of svt, accessory pathway svts can range in the 99% success rate with only around a 1% complication rate.  Appendicitis has a 15% complication rate.  I believe Afib is closer to 80%.  I am not sure the percentage on pacs because I am not sure I have heard anyone getting them ablated but pvcs have probably around the same success rate as Afib.  But accessory pathway svts have a very high success rate with low reoccurance or complications though you will want to ask your EP what his rates are if you are ever faced with an ablation.  I am not totally sure my stats are exact but they are close.  That said, success can only be achieved if they can induce the tachycardia otherwise everyone's time is being wasted.

[Cheers]

I think when I got the results this week I was surprised and regressed back to when everything first happened 8 years ago. Easily defeated, I suppose. But I am bouncing back and it is due in part to all here who have helped so much!!

This is a nice place to have because like I said before, I really have no one I can talk to about this stuff. I am sure I will come up with plenty of questions now that I know you are here. I apologize ahead of time :)

I exercise about 50 mins a day 5 days a week. But not hard. I have kind of a apprehension of getting my HR up even during exercise. That is why I go longer rather than harder. The "symptoms" I get from exercise are so much like an anxiety attack or tachy...so I dread it each day.

I do admit, reading the positive ablation stories I get a little jealous. You are right about it being a major pain...all the things to avoid, worry about and wait for. I would love to drink some coffee...or even get drunk just once LOL. I would love to go on all those water rides without being afraid that my heart will react (not that it ever has). And just the fear...how nice to have it gone. I cant imagine it.

But I also know it is a very invasive procedure and that much really can go wrong. And I would hate to go through that and end up with poor results. (Sorry for the TMI) I am the same way with breast reduction surgery. I am so jealous of all the ppl who have had it and say it is the best thing they have ever done. But I am far too chicken **** to go through with it. I realize this is much more serious....but kinda the same fear based hesitations.

I wonder what the actual stats are as far as ablations having a positive outcome vs. very bad outcomes (pacemaker, death, worse heart problems).

Anyway, thanks all!!

[littlegreenman1]

That's a 1997 study you have there.

The deal is: SVT proabaly will not kill you (but it ***might*** proabaly NOT though). But it's so disruptive! It makes high intensity exercise difficult. You have to limit potential trigger points: stress, lack of sleep, caffeine, decongestants, etc...  It keeps you looking over your shoulder.

I'm glad that's OVER for me. I was only worried about dying from it once and that was early in the game.

[MichelleP_3811]

You don't ever have to shut up.  This is something you need to work through and if we can help you achieve that then keep talking.  I have had svt my whole life.  I remember having episodes when I was a kid and I actually simply thought everyone did it so I never said anything to anyone and maybe because of that I wasn't ever frightened by it.  As I got older and the episodes became more frequent I did start to think that maybe there is something that needed to be addressed.  Most of my episodes were very short so they didn't affect me much but I had a few longer ones.  The first long one was about 8 hours.  At that time I was not doing any exercising and so the episode made me feel very lightheaded and as though I would pass out.  In my 44 years with it though I never once passed out.  I believe for svt it is rare to pass out.  Anyways, after the long episode I researched what was going on and realized it was my heart.  At that point I decided to try to get healthy.  I started to exercise doing about 40 minutes of cardio a day and I have to say it had done wonders for my tolerance of the episodes.  So first thing I might suggest is to get in some cardio.  If you have more svt episodes you will be surprised at how well you can tolerate them compared to someone who is not exercising.

Second, and this you would need to do under the care of your physician but I never took medicine for the condition.  It is possible the bbs help your pacs but my cardiologist both believe that the medicine really doesn't do much for the conditions and it won't stop svt episodes.  It might help slow the beat down if you happen to have an episode but the mechanisms for accessirt pathway svt cannot be controlled by bbs though I am not sure how they work on IST.  Anyway, if you are interested in discontinuing your meds I might ask the cardiologist what he thought.  They may think it is a fine idea for you to go off them.  

Finally, my cardiologist only heard of one person ever dieing from svt so it is extremely rare for it to happen.  That said, a persistant high heart rate over time can wear the heart out so you would be more likely to develop congestive heart failure rather than experience sudden death.  That said, your few pacs and super isolated svt episodes, only having had one that had a somewhat high rate, does not lead one to believe you are in any danger of succumbing to this condition.  So just keep working through your anxiety over this.  It is a condition to pay attention to and get treated if it progresses but it isn't anything to worry about and you could go on and live a very long healthy life with very few issues.  Be strong.

[Cheers]

Oh - I should also add that my reaction to these results was probably exacerbated due to the mentioning of getting an ablation. That part really freaked me out. If she hadn't had said that, I probably would have reacted much differently. It made me feel as tho the problem was much worse than I thought.

Ok. I will shut up now.

[Cheers]

Thank you for that.

When she gave me the results she only said "you had a 7 beat run of SVT" so I had not idea it was the same as having PACs. Thank you for that explanation.

8 years ago I had an event which had me at a sustained rate of over 170-180 for over 4 hours. At one point my BP dropped to 50/30 and I thought I was certainly dying. It was a very traumatic experience which I think I never got over. HR finally went down after they gave me oral beta blocker. And I have been on them ever since.

The ekgs from that event never showed SVT, only fast sinus rhythm. But the cardio Dx me with SVT anyway. I had a 2nd opinion with an EP who said it was probably "just IST" and he saw nothing to be ablated (just from reading my chart). I had convinced myself that I was SVT free and could one day go off my BB. THEN (sorry, this is getting long) 5 years later my palps were increasing so I followed up with a new EP who DID say it was probably SVT but not to worry and had me do the monitor. So I guess I was disappointed that SVT was in fact found and that I probably will have to continue the BB (which I really hate having to take).

I know - believe me - that my story/problems are pebbles compared to what most here experience. And I feel like an arse complaining. But I just can't seem to rid myself of the fear. Yes, I am in therapy ;) But it just hasn't kicked in yet, I guess.

All in all, I do realize now that 7 beats in not a huge deal. I only worry what it could be the next time. Its all about the "what ifs" for me. I am sorry to be a pain in the butt :)

Thank you again.

[is_something_wrong]

I've read your initial post now (your event recording).

You're taking this too way too serious!

The PACs, the PAC couplet and the seven beat event, they are PACs! When you did mention SVT, I thought you had those disrupting runs that last for several minutes or hours (AVNRT or AVRT). A seven beat run of PACs is exactly that - PACs. They may occur in singles, couplets, triplets or longer, and it doesn't matter. I have those too. Most of us does, actually. Stress and anxiety can make them worse.

Though 3 or more PACs is named "SVT" or more precise "atrial tachycardia", it's usually a meaningless event. How was your symptoms, by the way?

Similar, people with a PVC triplet believe they are dying because they have ventricular tachycardia. There is a difference here. Sustained ventricular tachycardia caused by scar tissue from a heart attack is serious. PVCs are usually not.

A seven beat run of PACs is no cardiac diagnosis. If this was all, I don't think you've been misinformed the last decade :-)

[Cheers]

I have been told to stop reading the internet about this by a number of people. And here is a great example LOL. One person says to have an ablation ASAP and one says to wait. :) I realize no one here or anywhere outside my Dr office can really say for sure. I am just trying to arm myself best I can with information.

For over a decade I was told this is in my head, take a xanax and see a shrink. After Dx, they told me not to worry, this would never kill or harm me and just ignore it. As you can see, it is so hard to trust the medical professionals sometimes. Which leaves me trying to make medical decisions based on so much conflicting information. It is just super discouraging.

I really appreciate your responses, however. Please know that.

[tom_h]

While I heartily agree with the 2 posts, please note that I had 54 years of AVRT with frequencies ranging from 4x per year to 4x to 6x per month.  I'm nearly 61 years of age.  These weren't short runs of SVT.  THis was self sustaining SVT that wouldn't self convert.  As I mentioned to you in a previous post. With the symptoms you described, an EP study and ablation is far down the road.  In fact, I run from an EP who would want to do a procedure based on your reported symptoms.  Simply put, they're just not enough to warrant one.

I read the link, and I just don't see where your concern lies.
"SVT can have potentially lethal consequences, and is more disruptive than previously thought."

The "lethal consequences" are overblown. "More disruptive than previously thought", hah!  I could have told them that!

[is_something_wrong]

Maybe you should stop reading those articles? :)

Where some supraventricular arrhythmias are completely benign, some are not. For example, atrial fibrillation is not necessarily benign. Atrial flutter is considered worse than atrial fibrillation. Atrial fibrillation and flutter in combination with WPW is dangerous and in some cases as malignant as their ventricular counterparts (if the extra pathway is conducting very rapidly).

The danger with supraventricular arrhythmias is if they get so rapid that cardiac output is low. That will cause your blood pressure to drop dangerously low, which in combination with a high cardiac oxygen demand and low supply (the coronary arteries are blocked when the heart beats) can cause ischemia and ventricular arrhythmias.

If you faint from a supraventricular tachycardia, it can be dangerous and must be treated. The same if you experience chest pain.

With most supraventricular tachycardias, the AV node prevents your heart from beating dangerously fast, so most supraventricular tachycardias are benign, but annoying. Young hearts also have the ability to beat rapidly for a long time without taking damage.

However, if you experience serious chest pain or fainting with your SVT, see a doctor immediately. As mentioned above, no rhythm is as safe as sinus rhythm.

[RVVq]

There's an abundance of clinical research out there that indicates that any form of arrhythmia, with a notable exceptions of sinus arrhythmia, physiological tachycardia and bradycardia, are potentially dangerous. There is recent research which indicates that frequent PVCs and even frequent PACs are not completely benign (as their presence can indicate sublincal heart diseases or dysfunction of the central nervous system). I think what doctor's mean when they say SVT is benign is that most healthy young hearts can handle this rhythm for several hours without any major cardiac damage or risk of death. However, as you age and acquire atherosclerosis (most people will have some degree of CAD by the age of 50), your chances of keeling over from prolonged SVT increase. One can say that SVT is 'benign' compared to stable VT. But its definitely not as benign as good old sinus rhythm. Therefore, I highly recommend you consider ablation early in the game, rather than late.

Good luck and good health!