Pre-Existing Tachycardia Issues- 18 weeks pregnant

For about 10 years I have had issues with random onset tachycardia, basically diagnosed as PSVT.
I have nothing structurally wrong with my heart (been through all the Echos, etc.) but the episodes have increased in the past year or so.  No real triggers have been established.  The only thing that stops it on it’s own is throwing up, which can sometimes take an hour to occur (Gagging myself doesn’t work easily for some reason).
I checked with all of my Doctors prior to getting pregnant and was told my pregnancy could either make it worse, or it would go away for the 9 months but was told it was fine to get pregnant.  I had a great first 16 weeks or so, but with my increasing blood volume it seems to be getting worse for me.  I had to go to the ER last week for a heart rate of 260 bpm.
I am not on any medication- I planned on starting a beta blocker once the baby is born in April, and am really hoping I can make it through this pregnancy without having to be on anything- or at least wait as long as humanly possible.  I know many of the beta blockers are safe during pregnancy, but obviously I would rather not be medicated if possible.  
Has anyone else had issues like this?  I’m curious as to how you dealt with it during pregnancy and what happened during labor?  I’d like to avoid having a C-Section if possible, but am definitely worried about labor and the stress that alone will place on my heart.  Has anyone had an attack of tachycardia during labor?  My cardiologist informed me they would be able to treat me right away if it happens, but that doesn’t really make me feel better.
Also, has anyone made it through pregnancy without the beta blocker despite what Dr’s recommended to you?  I’m very torn.  I want to avoid the attacks as much as possible, but also want to do what’s best for the baby.
Any tips on anything related to what’s here?  I’ve made my next OB appointment with my Dr and not a midwife so I will inquire about labor options, etc. but I would love some advice from people who have been there.
Thanks in advance!

[scaredtodeath1]

I had my Tachycardia started when I was 8 weeks pregnant and the next 4 weeks my doctors all told me it was part of being pregnant (I knew better).  I did the holters, EKG, Echo and all was good, but when I was on the table for the Echo my rate was well over 200, just as you were.  I was seen my an arrethmia specialist here where I live and they put me on Flecanide (50 mg 2x per day).  I delivered normal, with the exception that I was induced and hooked up to the heart monitors during labor and delivery.  I made it through delivery just fine and without drugs.  My doctor scheduled the induction only to make sure that I was going to deliver at the hospital and with the best staff there at the time. The meds had no effect on my sone, he came out a very healthly 8 lb baby.

[meredith_jrsj]

Hi,
I'm 34 mom of 3 and I am just starting down this road with PVCs and my heart rate was fast this morning on my EKG.  I would love to exchange emails with women who may have experience with these PVCs and PVST.  My email is ***@****

[salidamommy]

Hi, I have had tachycardia since I was fourteen.  I am now 28 and have one two year old son, and am ten weeks into my next pregnancy.  Pregnancy increases the incidences of tachycardia for me.  However, it is easier for me to stop it by lying down and doing deep breathing than it is when I am not pregnant.  My heart has been up to 250 and I have had to go to the ER after two hours of prolonged tachycardia (when I was not pregnant).  My first son was breech, so I was forced to do a C Section.  My heart rate got up to 150...but other than that, I was fine.  I am planning on a VBAC this time and hoping that the labor and delivery do not trigger an attack.  I do think that you can take beta blockers before you deliver, at the onset of labor?  You may want to ask your cardiologist about that possiblity.  Everything will be fine...enjoy your pregnancy!

[liz27]

I too was diagnosed with tachychardia during my 20th week of pregn.  I have already had one c-section and am trying for a VBAC this time.  Although when I was prescribed the metoprolol for the tachychardia I remember my cardiologist mentioning being on this drug (although safe for the baby) can complicate delivery...something about diminished contractions.  I'm looking into it now, but you should ask your cardio. about this as well.  Good luck - looks like we are not alone!

Liz

[billyqureshi]

hey
PSVT is a condition where the atria of the heart fire too quickly and results in a fast ventricular response. it has numerous causes and triggers, including recreational drugs,alcohol, hyperthyroidism, stress etc etc
any acute episode obviously needs treating, typically with vagal manoevres, adenosine or other anti arrythymics. as im sure you are aware the vomiting you describe is a form of performing a valsalva or vagal maneovre. other more bearable options are to take a big breath and try to blow out through a closed mouth and nose, or to blow into the tip of a depressed syringe, or to bear down as if you were passing stools, or to massage the carotid body in the neck. if you do this last one make sure you do it on the same side as your dominant hand ie if you were right handed you would massage the right carotid body. this is becaue there is a theoretical risk of dislodging a small thrombus or clot into the brain, but this is spectacularly rare. just make sure you dont massage both carotids at the same time or you will faint!
in terms of the pregnany, its not a beta blocker that they use to prevent you from getting these attacks. indeed, beta blockers may be used in acute attacks if adenosine fails. the drugs you may be recommened are the antiarrhythmic such as fliecanide or digoxin. i have not looked up their safety in pregnancy, but the fact is that there is a limited amount of informatino available on the safety and long term outcomes of drugs in pregnancy because of the unethical task of testing drugs on pregnant women.
medicine is all about balancing risks and if your doctor believes that the risk of taking prophylactic (preventative) medication outweight that of the risk of the medication to the baby, then that is what they will recommend.
hope this helps
billy
2 weeks from graduating from med school