Inappropriate Sinus Tachycardia?

[questionnone]

After speaking with the cardiologist several times and talking to a electrophysiologist once it seems that I may be diagnosed with IST. Does anyone else have this? Did you treat it or leave it alone? I wanted to leave it alone but without medicine or an ablation the electrophysiologist said my heart would fail. I heard sinuc ablations are unsuccessful in most cases or at least they return at a higher chance than other ablation procedures. I also do not want to be taking medicine for the rest of my life, I am only 20 and the fact that I have to work my schedule/life around medicine is depressing. I read in on article that "waiting" can be a choice of treatment however after being told that my heart could fail I would rather not go that route unless another doctor reassures that it would be okay. I usually don't notice the symptoms, originally I visited the cardiologist to ask about these psvt episodes I have been feeling but now it is more focused on how fast my heart rate is resting and with activity. what are your stories and what is your status right now?

[kathleen6364]

my cardiologist told me the same thing, that paticular area and or to many ablations, I have already had one, causes you to need a pacemaker.

[ocdish]

Hi, I am posting to this a few months after the last reply. Hopefully it will still be helpful.

I'm 39 and very healthy. No heart disease, and I've been through all of the heart tests 2 or 3 times! I have IST, SVT, and PAC's and PVC's.

I had an ablation done in February of 2010. My EP did the ablation for both my SVT and IST. He did not ablate my entire sinus node. I do not have a pace maker. I don't take medication and I am happy eating chocolate and having an occasional drink again.  

My EP ablated an a-v reentrance pathway for my SVT and was very "conservative" in the sinus node, make just a few ablations.

For a few months afterwards, I felt awful! I was always short of breath and I went into sinus taych everyday for a few weeks. It was very unpleasant.

Now I feel great! It's been 10 months. I've also started to exercise more (walking at least 2 miles a day, 5 times a week), drink a lot of fluids and gatorade (per my doctor) everyday.

I haven't had any SVT since the ablation. I still have some sinus taych episodes. At times my resting heart rate is in the high 60's and low 70's. This is pretty amazing considering how high it was before hand.

I'm not endorsing ablation for IST. I'm still undecided about if I would do it over again. (the ablation for the SVT, I would do again!) The recovery was long and there is a risk of pacemaker. I feel very lucky that I'm okay now, but I was really frightened for a long time.

If you can exercise, walk a few miles a day and hydrate. I truly believe that this is what is really helping me. My heart rate didn't come down until I started exercising and it slowly came down after that, a few beats a week.

There are things that you can do to control your heart rate. I don't take medication and I hope that I won't ever have to.

[SenseiRebel]

Did any of you also have PVCs when the IST started? I believe I could have IST since there's nothing showing up on EKGs or holter monitor. And I believe the PVCs is the IST trying to come out just from simple movements.

[msmusick]

I am 26 years old and have been on pretty much every medication for it since I was 18 years old. Recently they have decided to do the ablation surgery on me because my body builds up to the medications and it has to be increased often. My resting heart rate is on average 130 bpm. The last stress test that I had my heart rate went to 220 within 7 minutes on the treadmill. Having my surgery in the next few months and am very nervous being this young with the risk of having to get a pacemaker. With a 4 year old and a HUGE decrease in my livelyhood due to the rapid heartrate, I feel like this is the best long term solution for me. Just praying that it works.

[pharmtech1]

i have had ist since  i was 17 yrs. old. i am now 34. i have tried almost every med out there.beta blockers work for me, but they lower my blood pressure so i have to take the least dose possible. i also have raynaulds disease caused by the beta blockers. my doc has mentioned ablation and pace maker, but feels  i am too young for a pace maker right now. do  you or anyone you know have the problem with raynaulds from meds?

[questionnone]

when speaking to the EP it wasn't a detailed discussion. i simply asked if IST ablations are less successful than ablations for conditions like svt, most cases come back after IST ablation, and some say IST can deal with the autonomic system. his reply was short saying just "Correct , that is why we no longer do this procedure." i just wanted to share this information that's all. i did read the study and i am happy to hear that the procedures were successful. there was another post on here somewhere about someone posting about their daughter's only IST cure was to totally ablate the sinus node and there were chances (not for sure) that she may have to wear a pacemaker if her heart rate drops.

[itdood]

If I'm reading your follow-up correctly, the discussion with the EP centered around ablating the SA node?

Read the study again, they didn't ablate to the point of disabling the SA node.  None of the patients in the study required a pacemaker.  The SA node was left intact.

[questionnone]

thanks for the replies! :) well if this means anything I spoke with the doctor who was the first to perform a catheter ablation on humans. i explained and asked to him about sinus ablations and how people kept going back for more ablations and new studies have been saying that IST can deal with the autonomic system. his reply was very short and said "correct, this is why we no longer do this procedure". Maybe some EP doctors still support sinus node ablations after seeing success so they continue to do it. Still leaves mixed feelings about sinus node ablations.

[EMT23]

My EP wants to do an ablation on me...but my Cardiologist feels my problems are coming from the Sinus Node area which would be like an IST and does not want me to have this area ablated. He told me my risk of ending up with a pacemaker in the sinus node area would be very good. My Cardio then called my EP and told him if he does go ahead with the ablation to NOT ablate the sinus node area if that is where my problems are coming from and my EP agreed he would not do this area then. But from what I am reading there have been a lot of ablations done to this area for IST. Not sure why my Cardio is so against it. So now I'm waiting to be ablated and probably will have nothing changed when it's done. Not really sure if I should have it done now or not.

[itdood]

p.s., here's the study I referenced above.  Really good paper on IST and ablation.

http://content.onlinejacc.org/cgi/content/full/39/6/1046

[itdood]

I've read ablation has a high success rate for IST.  There was one study I read where the heart rate for IST patients in the study was 95-125.  All patients in the study benefited.  The mean resting rate dropped to 72 +/- 8 bpm.  21% required a follow up ablation.  No  one required a pacemaker afterwards.  Sounds like good odds to me.

If both your docs agree it's ablatable, I say go for that.  Much better than relying on the spray and pray approach (meds).