SVT/Medication or Ablation

[rosetoes]

I am a 51 year old female in overall good health.  In Nov of 2005, I experienced my first SVT episode in which I was taken by ambulance to the ER with a heart rate of 225.  I was given Adenosine in which it brought my heart rate back to normal, I stayed overnight.  The next day I had several test, ie echo, stress and several blood test...all was normal.  I was told that I had had a SVT episode and was released with no meds.   I was seen by my GP in which he prescribed Toprol XL 50mg.  I took them for a few months, weened myself off and I thought that I was fine.   In July  of this year, (20 months later), I experienced another SVT episode, my husband drove me to the ER and I again recieved adenosine and within a minute, my heart rate was in normal range.  I went to see a cardiologist who put me on Metoprolol 25mg (12.5 twice a day). I tolerate the beta blocker fine, no blood pressure issues,  (now my bp is 102/65).  Heart rate is now 64-72.  Im a pretty hyper person and my heart rate before beta blockers were 83-89 during the day.
(By the way, I was told I have an reentry problem, an extra circuit)

I have always experienced palpitations and PVC's since my early 20's and have learned to live with them.  Not too bad, but the SVT is a totally different feeling and the scariest experience of my life.  My questions are:

How effective are beta blockers to prevent SVT.... Is one more effective than another?  My sister takes Antenol for PVC's.  Also I am on a very low dosage (25mg per day), would increasing my dosage (under doctors supervision) recommended to prevent future SVT episodes?  

Given my age, is ablation as safe for me as other younger people with this problem. Since I my episodes were 20 months apart, what do you feel is the best approach.  I travel quite a bit with my family and I am just crazy with fear that I will have an episode while flying.

[myjeepbeepbeep]

thank for the info.  i am going to ask about it at my followup appointment.  the doctor said it was a
95% chance that my heart is fixed now after my ablation, however, it woud be nice to have a backup plan...just in case
S

[rosetoes]

I spoke to my cardio doctor about "A pill in the Pocket"  Information was in a brochure in his office about SVT.  My cardio doctor says there is a pill that you can take  when you are unable to get to a ER (for times like you are flying) but you have to see a electrophyiologist for that.  It will convert you back to a normal rhytm.  I'm going to explore that option when traveling.

[crgoalie16]

If u have Svt is it safe to take a drug like viagra?

[myjeepbeepbeep]

I always wondered about having an attack while flying myself.  If you are in the air and have attack, what do you do if you are not landing for 2 or 3 hours?  

[Michael J. McWilliams, M.D.]

Ms. Toes,
I didn't mean to imply that a beta blocker would not help -- it may help.  It depends on if you want to be on the medication and your tolerance for recurrent episodes.  There is an electrophysiologist in Chicago named Mohammed Khan (MD).   I have known him for over 8 years.  He has is very intelligent, has solid judgment and good technical skills -- we trained together at The Johns Hopkins Hospital and The Cleveland Clinic.  I emailed him and he sent me the following contact information for his practice:

Cardiovascular Associates (group of 19 cardiologists)
is 847-981-3680. I have offices in Elk Grove, Hoffman Estates and Barrington

There are many other great electrophyiologist is Chicago -- I know Mohammed and trust him.  If you decide to see him, please send him my best.

Good luck.

[Jillejam]

I live in the Chicagoland area and have recently become a new cardiac patient.  I am a 37 yo female who recently had an ICD implanted.  I am currently going to an electrophysiologist in Downers Grove, the practice is Midwest Heart Specialists at Good Sam Hospital.  I have been happy with the level of care I am receiving and would recommend them highly.  I hope you best of luck in your journey for better health.  

[rosetoes]

Thank you Dr. MJM;
I live in Chicago and would like to explore the possibility of ablation and would appreciate your recommendation of an electrophysiologist.  I have private insurance and it won't be a problem to see any doctor that you trust.  

Your post has been most helpful, and I'm sorry to hear that even with beta blockers., my odds are high that I will have enough episode.  Is it odd/rare that a person starts having these episodes at 49?  I have read alot about SVT and it appears that a person starts to experience them at a much younger age.

I will continue to post to assist others.....I believe in "Pay It Forward"   Thank you again.

[Michael J. McWilliams, M.D.]

Ms. Toes,

Thanks for the post.

How effective are beta blockers to prevent SVT.... Is one more effective than another?  My sister takes Antenol for PVC's.  Also I am on a very low dosage (25mg per day), would increasing my dosage (under doctors supervision) recommended to prevent future SVT episodes?  

It depends on the individual.  Your episodes are infrequent, so even if it cuts your events in half, it might be 4 years before your next event.  All beta blockers used to day are essentially the same -- atenolol is cheaper than metoprolol and can be taken once per day instead of twice per day.  your insurance company would love to see you on atenolol and to be honest, it is just as effective.  If you have no symptoms, you could increase the beta blocker.



Given my age, is ablation as safe for me as other younger people with this problem. Since I my episodes were 20 months apart, what do you feel is the best approach.  I travel quite a bit with my family and I am just crazy with fear that I will have an episode while flying.

The odds of you having more episodes is high.  SVTs are almost never dangerous but they are inconvenient.  The most common SVT for your age group is AVNRT.  AVNRT is a very safe arrhythmia to ablate.  So safe, in fact, that ablation is considered first line therapy as an alternative for people that do not want to take medications. It is worth seeing an electrophysiologist to discuss the options and talk about risk / benefits.

If you tell me where you are I might be able to recommend a center or someone that I know and trust.

I hope this helps.  Good luck and let us know what you decide to do.  It helps to give feed back to the forum because your experience will help the next person that comes along....kind of like the movie "Pay It Forward."