What's the fuss?

[medicmom911]

Hello everyone, I could use a second opinion....or multiple opinions.  5 years ago Dr took me to the Cath Lab for an EP Study because I was not tolerating the medications, and that I was persistant about something not being right with me.  Reluctantly she took me in, and found AVNRT with an atypical slow slow pathway.  She says that is why no one was ever able to "find it"....it wasn't noticeable enough.  Anyways, back in August of this year, I started feeling bad again.  Tired all the time, tachycardia, palpitations, a couple near syncopal episodes.  Luckily I am an EMT and most of these episodes were at work, so I was able to get myself on the heart monitor before it would completely disappate.  

I went in to see my cardiologist and showed her the strip.  She said that it was a proximal atrial tachycardia with macro-reentry.  I wore the trace monitor for a month, and the first week I had it, set it off 5 times, and was able to catch the extra beat sending me into PSVT.  I have an ablation scheduled for the end of this month, hopefully this will be the last one.

My dr has put me on light duty at work (the stairs are killing me lately!), and told me to take it "really easy".  She doesn't want me doing anything to exert myself and even put me on Digoxin.  Granted I stopped taking that last week because like the other meds, I just dont tolerate it well.  If this is a condition that is just bothersome and problematic, but not life threatening as she has stated, then why the strict restrictions on what I can and can't do?  

[kitcurious]

Doctors often tell you to stop doing things that produce symptoms. They figure if you complain of it, it bothers you. One way to make it not bother you is not to induce it.
Sometimes we say something as an observation to help lead to a diagnosis and not because it really bothers us all that much, but docs don't always realize that?
Just a theory.

[medicmom911]

Reading over my last posting, I just realized that I didn't put in there that I have had an ablation due to an accessory pathway.  AND that is why she has schedule another ablation at the end of the month.  Wow, I should really stop writing posts when I'm tired.  They come out all jumbled.  :o)

She is 99% sure that there is another pathway there this time, she just doesn't know if it is the same one that "grew back" or if I developed another one.  I'm in the medical field and this still is confusing me to no end.

[Michael J. McWilliams, M.D.]

Hello,
Sorry to hear about your symptoms.  I don't typically limit activities on people with AVNRT.  Based on what you have told me, I am not sure why she has restricted your activity, especially if you have had an EP study in the past and not been found to have an accessory pathway.  Your doctor may have done this because you were so symptomatic, but this is only speculation. That is about all I can say.

I hope this helps.  Good luck with your ablation.

[tickertock]

As you probably know the vast majority of SVTs are not life threatening, maybe your doctor just wants you to take it easy and not get your body stressed and run down before your upcoming ablation, this is just my guess. Up to this day even on a beta blocker my heart pounds when walking upstairs bending or stooping not really fast just pounds, yet I can pass a stress test without any problems whatsoever at least the last one I had over 5 years ago when I was plagued by PVCs. Can I ask what type of extra beat triggers your PSVT a PVC or PAC, why I ask is because a PVC always triggered my sinus tachycardia which the doctor could not rule out as a possible concealed accessory pathway.As I understand either a PVC or PAC can trigger AVNRT or AVRT, it is my understanding that a PVC the majority of time the will trigger PSVT in concealed accessory pathways , while PACs usually trigger the manifest pathways. Overall PVCs are  triggers about 30% of the time in PSVT.I'm just curious as to what might trigger yours. Good luck & best wishes with your upcoming ablation, may it be successful one.