ep study?

[hockey_player04]

I am a 34 year old male.  Former division 1 athlete.  I have had episodes of tachycardia since my junior year of college.  It only happens during activity.  It does not necessarily have to be intense exercise to make them happen.  I have been through just about every test (echo, several ekgs, 2 treadmill tests and one with a dye injected, 48 hr monitor, 2 event monitors, and a trip to the ER where it quit right before they got me back).  It is a situation that I feel has extremely limited my life.  I cannot do anything physical without concern that my heart will take off on me.  I also have skipped beats and did capture a moment on an event monitor where I had PVCs every other beat for a few minutes.  I still have tacky events multiple times a year but have not been lucky enough to record it.  Since I have not been able to capture the tacky event over years of trying my EP cardiologist has suggested EP study.  I guess I would like to know if anyone has experienced this and can help me out with some wisdom/encouragement.  I'm worried that they won't be able to identify the problem during the EP study and I will be back to trying to record this by rushing to the ER.  I am tired of having my life limited by this problem but also have anxiety about the EP study.  Also, can they cured the PVCs with ablation?  I appreciate any advice as I just don't know what to do.  Thanks

[Iva_87]

Hey there,

I´ve been there too! you can check my full story in www.livingwithsvt.blogspot.com but to put it here, too, my episodes happened while swimming, so I didnt capture them and was offered the EP study to find diagnose and eventually fix the problem.

I was one of the very rare cases who had little problems after; my ablation wasnt a success and I also have some other SVT arrytmie then AVRNT as they foudn during the EP study. But he said its less then 1% of all patients.

Still, dear hockey player, Im so glad I went. To read the words "absolutely benin" does help a lot. I think a diagnose is very important, to know for sure, to have a name and to know its not something which puts you into danger (even if it can destroy your life.. if you let it) ..is extremelty important to me.

And furthermore, they are pretty good in fixing it. Im sure you will be the lucky one. Go for it!!!

[tom_h]

"Evidence" I think is what they need before going in and trying to get rid of it.  At a cost approaching $100k and over, they want to make pretty sure that you have what you suspect you do.  With all the other tests you've done, I would recommend that you get a 30 day monitor to try and capture an event.  The recorder is a simple two lead device with electrode pads that the user replaces daily.  You can wear it for everything going except bathing.  Catching an SVT event on the recorder will be proof to get the wheels turning towards your personal cure.

[hockey_player04]

Thanks tom.  I guess we have a few things in common. It happens most when I play hockey which is the most upsetting b/c it has replaced my love of the game with fear.  I still play but am anxious about it each time and avoid pushing myself.  I am from WI by way of northern Ontario.   My racing heart just seems to quit on its own.  usually within a 10-15 min time frame.  I don't know if you can answer this but since I have never caught it on a monitor do you think they will be able to find it during the EP study.  My fear is that it will be all for naught.  

[hockey_player04]

I want to thank you all for your responses.  I will definitely take these into consideration.  I guess I'm just nervous that b/c whatever this tachycardia is has been difficult to catch.  I worry that even the EP will not lead me anywhere.  On the other hand I am quite tired of this nonsense.  

[littlegreenman1]

I also had SVT which was exascerbated by physical activity.
The EP study, will also likely include ablation to destroy the accessory pathways which are causing your onset of SVT.

In general, they are very successful at locating and fixing SVT in the first try. My guess (worth every penny I paid in Med School tuition, which is zero).... is they have a 90% chance of getting it fixed the first time.

Note, the procedure, while not terribly invasive is terribly expensive. Be prepared to pay your health plan's "Maximum out of pocket" expense. Not deductible. Out of pocket. Typically, that's a few to several thousand dollars.

That being said, it worked for me. I have run several marathons on that ablated heart and am qualified to run the Boston Marathon.

Good luck with your ticker. Oh, regarding the HRM results... my EP didn't care jack about my Garmin graphs. He did like 12 lead EKG sheets though! ;)

[Chip8]

Also, I forgot to mention above, that I was only able to observe my SVT events on a Polar heart rate monitor.  My Garmin HRM only displayed blanks and very erratic readings during PVCs and SVT; but worked normally at other times.

[Chip8]

My first recorded SVT event (first induced during running and an exercise-induced PVC), was for four hours on a 12-lead EKG, in an ER, still didn't result in a diagnosis of anything.  In the ER that night they didn't even call in a Cardiologist to look at the EKG.  It was nearly a year later that a Cardiologist, to whom I referred myself to, at a different hospital, made the SVT diagnosis.  When I first started going to this new Cardiologist and described my symptoms, he instructed me to come in asap for an EKG, when I observed the prolonged, high heart rate on my own heart rate monitor.  I did so and it was then that this EP Cardiologist captured the SVT on EKG and he recommended an ablation procedure.  

Just make certain, if you go to the ER, that they will call in a Cardiologist that is a EP specialist.  Good luck to you.

[tom_h]

Welcome to the forum.  Your post could have been written by me years ago.  You have come to the right place as there are many people on the forum who experience the same thing as you.  my first SVT episode was when I was six and lasted until sixty when I got it fixed by and electrophysiology procedure with ablation.  Most adults experience an increase in the frequency of their episodes as they age.  Mine increased dramatically when I hit my early 50 to a maximum of 5 per month.

Have they been able to get an EKG when you're in tachycardia?
Have you tried a 30 day monitor yet?
Do you know the methods to force your heart to convert back to normal rhythm?

Apparently, PVC's are often the triggering mechanism for SVT.  I caught 3 events on my long term monitor which indicated a PCV at each initiation of SVT.

Most instances of PVC are benign, and physicians usually do nothing until they reach over 10,000 per day.  Electrophysiology procedures for PVC only usually meet with mixed success, so unless your condition is very serious, they will most like only go after the SVT.  What part of the world/country are you from?

The procedure can last from a couple hours to six or more hours long.  Mine was around five hours.  My electrophysiologist sedates his patients, and I had general anesthesia and remember nothing.  Consequently, it was a very positive experience for me.  You usually in and out in one day if they get you in early.  I believe I was home by 6:30.  I had it done on a Thursday and was back to work on Tuesday.  Walked with a limp for a couple of weeks, but no biggie.

Rather than repeating myself, if you click on my user name, then find my posts, you'll see my numerous recent posts about dealing with SVT and sports, in my case sprint cycling and short track speed skating.

We're always around if you have any specific questions.  Good luck!