PSVT Symptom?

[jolleyhearted]

Hi all,

For the last few months I have been experiencing very shout bouts of tachycardia (about 3-5 seconds in duration).  I have had a number of ECGs, a stress test and a 24 hour holter.  The holter is what caught the SVT.  I am currently waiting to see a cardiologist (which I see on the 20th of April).  Anyway, my doc told me that it is likely nothing to worry about (though refered me to a cardiologist just to be safe) and I was felling better.  But lately the bouts have increased in frequency... from on every 3-4 days to 1-2 per day, and wierd skipped beat feelings through the day (particularily after eating).  I have been under a lot of stress, which I am told aggrivates the condition, so the frequency increase is not really what is worrying me.  

ormally I fell the techy in my upper chest... just sort of aware of the faster heart beat (in fact, I usually get a wierd sensation right before it is about to hapen).  Yesterday however I felt a sort of pain (not really pain, but very uncomfortable sensation) in my lower throat with each beat during the tachy.  Is this a normal symptom?  Has anyone else felt something like this.  

I am really scared at the momentand would appreciate you feedback.  Oh, and as for history, I do not smoke (though liveed with second hand smke for half my life groeing up), rarely drink, eat a pretty healthy diet, not overweight and don't drink caffine.  Oh, and I have had panick attaks in the past (which feel completely different).

Thanks in advance

[ireneo]

I don't bother with vagal maneuvers for those tiny tachy bursts that last less than a minute. If it drags on for a couple of minutes, then I'll try it. Since my ablations I don't ever have those longer episodes lasting more than 30 minutes.

[is_something_wrong]

Hi,

Why do vagal maneuvers stop the tachycardia?
Because vagal maneuvers slows down the conduction in your AV node, allowing the next sinus beat to appear before the "loop" is complete. This cancels the tachycardia.

Why does it terminate on it's own?
Two reasons. Either your AV node is slowed without you actively use the vagal maneuvers, or another PAC hits and cancels the tachycardia.

If both fails, you can go to the ER and get a shot of adenosine (a drug blocking your AV node for a couple of seconds and wipes out the tachycardia). Other drugs, such as calcium channel blockers or beta blockers are also available for intravenous use at the ER.

[jolleyhearted]

Thanks for the feedback.  It is a little reassuring.  Can anyone tell me why the episodes last only a few moments and terminate all on their own?  I keep reading about the use of vagal manoeuvres... do these stop the episodes frequency, or are they intended to actually stop the tachycardia?  If so, how can I use them if the episodes only last mere seconds (like last night when it happened for about 3 seconds)?

Thanks in advance.

[ireneo]

Also known as a canon A wave.

[is_something_wrong]

If you feel this sensation in your throat, you have what is named AVNRT (Atrioventricular Nodal Reentry Tachycardia).

What happens is that a premature atrial contraction (PAC) fires so early that your point between atrias and ventricles are unable to conduct the impulse, hence, it's not creating a heart beat. However, sometimes this impulse finds another way through this point (the AV-node). When it has found a way around, the normal pathway is open again for conduction of impulses, and the same thing happens again and again, creating a quick heart rate.

You get this specific feeling in your throat because your upper chambers (atrias) are activated after your lower chambers (main chambers, ventricles). Picture a watch, ventricles are 6 and atrias 12, and activation happens clockwise. The result, when atrias contract a little after ventricles, is that your valves between the chambers are closed, making the blood backfire a little (not dangerous), thus creating this feeling.

[Darlingorla]

Sounds like PSVT - possibly AVNRT which I have, you have milder form.  Have it checked out with a cardiologist who may refer you to an EP specialist for meds or possible ablation down the line.  Has anyone shown you the vagal maneuvers in case the episodes get longer in duration?

[ireneo]

SVT is a rather general term referring to any tachy originating in the upper chambers of the heart. So I hope you can find out more information from your doctor as to the specific type.

I have PSVT - a form of tachy that starts suddenly, runs for a bit, then stops suddenly. It's harmless but can be a bit annoying. My rates run from 150 - 198 bpm, at least that's what's been caught on the monitors. I've had 3 ablations and my PSVT is greatly improved. Instead of being tachy for 30 or 45 minutes, now most of my times are less than a minute and only rarely up to 15 minutes.

As for the sensation: I can feel a light pitty-pat feeling in my chest, sometimes pressure in my throat like a finger is being pressed there, fatigue and a touch of lightheadedness. I remember getting an ache in my chest if it went on more than 10 minutes but not so much of that now.