SVT Ablation Candidate but concerned I'm jumping the gun

[tekNO]

I've been experiencing mild tachycardia for 13 years. It started when I was playing collegiate basketball and would only occur during a strenuous workout. My heart would race at a pace that I couldn't count my bpm and I would feel light headed. I would immediately walk off the court and wait for it to pass, which was about a minute or so. The tachycardia was very sporadic. When I was 20 I wore a 24 hour holter monitor, but was unable to trigger my symptoms so they diagnosed me with mild tachycardia and told me not to worry as I won't be drop dead. That was comforting. Over the next 10 years I continued to have tachycardia continued to be unpredictable and mainly occurred when I was exercising or dancing, but again never lasting more than a minute. The past few years my symptoms have worsen. I now experience skipped heart beats (gushing sensation) any where from once a week to a couple times a day, which only last a second or two tops. I had an episode on a plane where I almost passed out because my heart skipped several times and I wasn't getting enough oxygen. I have worn a 30 day heart monitor and my Cardiologist saw the skipped heart beats (PVCs) on my results and could see when I would go into tachycardia as well. He again said he is not concerned with my symptoms as they are not life threatening, but explained to me my options if I chose to pursue treatment.

Now let me get to my point and question. Last week I rode my bike to the hospital for a thyroid ultrasound (I have thyroid nodules, but all my thyroid tests have come back normal so it's unrelated) and when I walked into the hospital I felt my heart skip, but it didn't skip just once, but 4 or 5 times consecutively, which then triggered my worst case of tachycardia to date. My heart was racing out of control, I was getting light headed and wasn't sure what to do as I've never experienced an episode quite like this one. My tachycardia lasted 3-5 minutes and abruptly stopped. Because of what happened and since I was already in a hospital I was sent to the ER. Of course my EKG came back normal as I was no longer in a tachycardia state. I was extremely scared during the episode, but here is my question. I met with my Cardiologist/EP Tuesday, explained what had happened with me last week and told him now I'm in a state of mind where I'm feeling scared and wondering when I'm going to have another attack. That I'm afraid of working out because I don't know if it will trigger another attack. He of course assured me that my symptoms are not life threatening, but if it's limiting my life than I should consider ablation. We spoke about beta blockers and calcium blockers as an option. He doesn't recommend the beta blocker because of my active lifestyle and told me the calcium blockers have a 30% chance of working for me. I'm not a big fan of taking medication so the ablation sounds like the best bet. Going straight to the source and fixing the problem. BUT, I've read several other posts and it sounds like most other patients have had far more severe symptoms than I. I'm mainly concerned that I'm jumping into ablation too early and maybe my symptoms are not severe enough to warrant ablation. What if my tachycardia is so minimal in comparison to most patients that he won't be able to trigger it and I end up going through the procedure for no reason.

Do you think it's wise for me to go through with the ablation before the symptoms worsen over the years? Or am I jumping the gun?  

[tom_h]

Not "crusts" but PVC "clusters".  Darn spell checker second guessing me!

[tom_h]

i hit "post" too soon.  I'm glad that you're on the road to recovery.  Experiencing some jumpiness is normal.  Mine has finally started to settle down nearly a year and a half later.  I haven't had PVC crusts in months.  Enjoy life!

[tom_h]

The term SVT is an all-around term that encompasses several forms.  AVNRT is one of them.  My SVT was AVRT.

[tekNO]

Hey everyone, I wanted to provide you all with an update. I had my SVT ablation last Thursday, 28 June and it was a complete success. Originally I was diagnosed with having SVT, but once they mapped my heart they found that I had AVNRT (extra pathway). I feel great. I'm experiencing some mild symptoms like burning sensation and skipped heartbeats but they are tapering off with each passing day. I worked out yesterday. Went on an hour and half walk followed by plank pose, sit ups, push ups and some yoga poses. I couldn't get my heart rate up beyond 108. I'm going to keep pushing myself to see if I can trigger any symptoms, but according to my EP I am cured. The procedure was a piece of cake. Worst part is lying still for 5+ hours after the procedure and the pain from the incisions, but it was not unbearable. I took Tylenol when needed. I highly recommend this procedure to anyone considering it.

Please feel free to ask me any questions. Good luck!

[MollieRose]

I had an ablation for my AVNRT (in 2010) but it wasn't successful. My cardiologist/EP was unable to get my heart to go into AVNRT but he said he was able to get it to go into some type of arrhythmia. The AVNRT did come back last year but through taking 50mg of Metoprolol twice a day it seems to have gone away (I have a device called a Loop recorder implanted that records like an EKG whenever my heart rate goes above 176 or below 60 so they can download off of it and see if the SVT is happening). Unfortunately the Loop recorder is considered a diagnostic device so once I have this one removed(They only last about 4 years before they stop working and I had it put in Jan 2009) I probably will not get insurance coverage for another one to be put in. I would still say(despite my experience) to go ahead with the ablation. I personally think that the reason mine did not work is because I had a difficult case to treat (I was going into SVT about 6 times a month and dealing with recurrent tachycardia). After the ablation (as in the moment I came out) I developed high blood pressure and it hasn't gone away, I did not have high blood pressure before the ablation. Kinda strange, I'm not sure how that happened.

[ireneo]

Has anyone explained vagal maneuvers to you? I've had PSVT (sudden onset of tachy lasting for awhile and then stopping suddenly) all my life. I dealt with it for the first 20+ years not knowing what it was. Then a doctor told me and taught me the valsalva maneuver (just one of the vagal maneuvers). It's simple: take a breath, hold it and bear down as if you're having a BM. Takes about 10 seconds and the heart flip flops a bit and will drop back to normal rhythm. I used that for over 30 years before I finally went in for my ablations (more than one because my heart is stubborn and I have more than one type of arrhythmia). It was quite helpful in stopping my tachy times.

[tekNO]

thank you for your feedback barbie. i'm sorry to hear it didn't work fully for you. i'm scheduled for my surgery on the 14th of june, but have another appointment with my EP next week to go over some of my concerns. i think i'm going to go through with it because i don't want to sit around wondering "what if?" the thought of never having another episode again is motivation enough even if it doesn't work.

[barbie1999]

hi
I know exactly how you feel. I had a similar dilema to you a couple of months ago. I have AVNRT but I only get 1 or 2 episodes a year which are terminated when I take Verapami,l a calcium blocker. I too wondered whether I should have an ablation or not as my symptoms were not frequent at all. But in the end I decided to go for it as it was affecting me physcologically...I would panic thinking I would have an episode in a remote place, on a plane, bascically it was affecting my quality of life.

I had an ablation in about 8 weeks ago but unfortunately the EP could not abalate all the points as my heartrate increased and he thought it would be best to stop. Which is fine, he was playing it safe and i'm glad about that. Unfortunately the following day after surgery I has an SVT episode which lasted about 30 min and was terminated ny verapamil.
I don't regret the ablation, the procedure was a lot less scary than I had anticipated. I was back to feeling myself after a week, but it was a tough week, I was tired, breathless,lost my appetite and had a 'jumpy' heart for a few days which is very unpleasant.

Glad I did it but it looks like I might have to do it again, that's what my EP recommends. At the end of the day I just want to lead a normal life and not worry about having an episode. You'll just have to weigh up the pros and cons, think about whether you want to go through with it or whether you'd rather wait and see how you feel .

[tom_h]

Must be short as I'm on a pbone.  I was up to 3-5x per month when I decided that 54 yrs. of this was enough.  Beta blockers did not help whatsoever. Ablation was the best thing I could have done. Lot's on here have had it done.   Very easy. More later if you wish.

[tekNO]

you have had three already??? why have you had to have so many?

[annie37]

Hi tek I understand wat u feel to well I had ablation done I would tell u have it done...everything will be fine at least it will help it to slow down...hope you decide to go thru with it So u  can try n live with tachycardia good luck I have had 3 already...