SVT and the hormonal connection

I am a 26 year old female.  Since puberty, I have had SVT and other rhythm disturbances (ectopics, tachycardia and a generally "irritable" feeling heart) during the luteal phase of my cycle. My heart feels calm and steady pre-ovulation and completely different when I am premenstrual.  I understand that this is a recognized phenomenon in women.

My questions on that note:

1. Does anyone know what specific physiological change causes an increase in arrhythmias during the luteal phase?  If so, can anything be done about it?  Have you heard of any success in treating hormonally triggered SVT/arrhythmias with hormone therapy?

2. My SVT sometimes disappears for years at a time, only to suddenly return in clusters.  Is this common?  Any idea what would cause it to come and go like that?

3. Do you find that ablation is really as effective and safe in practice as it is quoted to be to patients?

Thanks a lot.  I'd also be interested in hearing from other patients with cyclical arrhythmias.

[Michael J. McWilliams, M.D.]

1. Does anyone know what specific physiological change causes an increase in arrhythmias during the luteal phase?  If so, can anything be done about it?  Have you heard of any success in treating hormonally triggered SVT/arrhythmias with hormone therapy?

I do not think you will find an explanation that is not speculation.  I have not heard of arrhythmias being treated with hormone therapy.

2. My SVT sometimes disappears for years at a time, only to suddenly return in clusters.  Is this common?  Any idea what would cause it to come and go like that?

This is common, but again, you will not find a good explanation as to why this happens.

3. Do you find that ablation is really as effective and safe in practice as it is quoted to be to patients?

It all depends on the type of arrhythmia and the location of the focus.  AVNRT is very effective ablated and is safe with minimal risks -- but there are risks.  There are so many types of arrhythmias, I cannot really quote the success rates/complication rates with out knowing the location of the rhythm.

I hope this helps.

[Cowgirl37]

Hi,
I'm 45 years old.  I've had this since I can remember (9 - 10 years old). My arrythymias are exactly like yours and I have suffered like you for years.  It does come in cycles!!!  I've always said that.  I'll go months or even years with the most perfect rhythm, then wham, it all starts again.  It'll go for months, day in and day out, even when I'm sleeping. I always try to figure out what I've done differently and nothing makes sense.

I just got out of the hospital because they were so bad and I was symptomatic.  I was seeing stars and almost passing out.  I have PVC's, Bigeminy, Trigeminy, all kinds of crazy stuff.....constantly.  I came out of the hospital with the same beats and still have it right now.  However, I did meet with an electrophysiologist in the hospital and I'm going to have an EP study done.  He says that "other people and regular cardiologists just don't get it."  He knows that "we feel every one of them and they make you miserable".  He gets it.  Maybe he can fix it...I'm going to let him try.  I've had it.  It drains you.  I had a couple of EP studies years ago, and I hear that they have come a long way since then.  My friend had it done last year (ablation) and he said it's a no brainer.  He would have done it sooner if he had known what a relief it would be.  He feels great to say the least.  

I have noticed that when I have a fever, or during my period I get a lot more.  When I had my daughter 16 years ago, I had a really bad run of them and was hospitalized then too.  The doctor at the time told me that when you are pregnant you gain alot of blood to support the baby, then when you deliver and you are losing it, your heart goes nuts.  It expands to pump all of that blood, then when it's shrinking back down and you are losing blood, it gets irritated.  Makes some sense to me.  

Anyway, I think you should ask around, maybe go to a large well known teaching hospital and find yourself an EP Studies expert and let them check it out.    

[JMonna]

A related discussion, Svt/Avnrt was started.