SVT MVP and skipped beats... could ablation help?

[Karenshart]

I am so glad I found this place!!  Finally, I don't feel so alone.
History- 43F, history of tachycardia since my mid 20's.  Been to several cardiologists, everything normal,  but was told during an echo that I had some regurgitation...but nothing to worry about (that was 5 years ago).  I was on atenol 25 mg but stopped because it made my heart so slow... Was put on diltiazem 120 mg XR and started taking it Dec 24.  On Jan 10 at 1:30 am, I woke up suddenly to my dog barking. I was startled, got up to go to the bathroom and then laid back down and it felt like my heart was doing flips (but not beating fast yet), I then took a couple deep breaths and got up and then my heart was racing out of control.  Went to ER, they had to give me medicine in an IV to bring it down, I think it stopped my heart to reset it - such a weird feeling.  EKG said SVT and the one after that was sill abnormal.  After that, it became normal.  Doctor told me to continue my meds and see a cardio who referred me to see a specialist on Monday who does ablation treatments.  In the meantime, did some research and found a name for the fluttering I felt>>>PVC and found some info the medicine was taking causes them!  I stopped the medicine today and will ask about a different med on Monday when I see the doctor.  My question, would ablation help someone that has SVT along with MVP (that is supposedly nothing to worry about) and PVC's?  Thanks for any info. I want be as prepared as I could be for my appointment.  This was the first time I had to go the ER....usually, I would just sit quietly, drink herbal tea and it would go away on its own (some xanax helps too). I also just get PVS occasionally but the tachacardia is often.... at least a couple times a week,  but the beta blockers helped.

[MichelleP_3811]

My suspicion is you are triggering some pvcs or pacs when you lay on your side.  Changes in posture is a good way to trigger them.  And then when one goes off your heart pauses because the errant beat disrupts the normal beat cycle.   It is during this pause phase that you are vulnerable to falling into tachycardia.  Especially with avnrt because it is a tachycardia that is characterized by an extra pathway into the avnode.  When the signal has time to get into the avnode via this extra pathway because of a pvc pause it then goes out the main entry and then keeps looping on itself.   That said accessory pathway tachycardias generally start on a dime and stop on a dime.  I wouldn't think simply laying on your back would necessarily stop it though another pac or pvcs might.  It is kind of the same principle of the medicine they gave you.  By causing another disruption in the beat cycle you can get the stuck signal unstuck so to speak.  So I guess I would ask, this fast beat you feel does it start and stop suddenly or is it gradual?  And do you know how fast it is actually beating when you do have it?  I suspect you still have a classic svt or the er would not have recommended you see an EP cardiologist but maybe there is some sort of postural aspect to the way you position yourself that terminates the fast beat.  Since postural changes start it up I can't see why they can't stop them as well.  

Anyways, the feelings I felt before the ablation were feeling like my heart was jumping around or like there was popping corn in my chest.  I would then sometimes feel what I can only describe as a fizzle feeling and then immediately after wards my heart would take off.  I believe the first popcorn feeling was sinus tachycardia, the fizzle feeling was the pause after a pvcs and then the fast beat was obviously my svt.  After I had the ablation I continued to feel the popcorn jumping heart and pvc fizzles but I have not had any svt episodes.  Like I said, I did have a bad bout of the pvcs about 5 weeks past the ablation and it seemed anything and everything was triggering them.  Bending, laying on either side, talking breathing.  It was kind of crazy and the doctor isn't sure why they were going off so much but it only lasted a short while.  And now 4 months past the ablation the jumping heart is all but gone and the pvcs are minimal to maybe 100 a day.  Stress and certain foods that irritate my stomach set them off.  I can't say for certain how many pvcs/pacs I had before the ablation because I thought everything was related to the svt but the ones I do have now don't bother me much so I can deal.  And for the most part we generally have to because there isn't much they can do to fix those but at least the heart isn't getting worn out by them like it can with svt.  

As for feeling tired.  It could be your medicine that is making you tired or it could be that your episode that drove you to the ER was a bit taxing on the heart.  I had a couple of episodes like that where I let them go too long and paid for it for a bit after wards but your heart if very resilient, with a little time it will fix itself up.  Especially if you can resolve the svt episodes.  I had probably close to as many as you and my heart is still in tip top shape so if you decide to go ahead and get yours fixed I am sure you will feel much better for it even if you are still stuck with the pvcs.  Ridding yourself of the svt in my opinion is definitely worth it though you will be told it is only optional I think mainly because it is an expensive procedure.  But your insurance should cover it.  

[DeltaDawn23]

Hi -- I was able to tolerate my beta blocker better (Atenolol) by taking it (25 mg. tablet) in 1/4's throughout the day.  I check my bp and heart rate and if it is low, I delay the dose.  I worked this out with my family doctor and it helped a lot.  A whole tablet would knock me for a loop.  The tiredness may not be as bad as your body gets used to it and on the smaller dose.  Hope this is helpful.  Good luck.

[Karenshart]

Hi Michelle,  thanks for your response. Thanks for the great info, very helpful.  I also read about your procedure on your home page.  Definitely very informative and answered alot of questions I had about the procedure.  Before your procedure, have you had any problems with your heart while laying on your side?  See my last post on this.  It starts after about 15 minutes when I first lay down but I can usually stop to SVT by propping myself up and laying on my back.  This is a new symptom that started after I came back from the ER.  Thanks again for your time in sharing your experience.  Karen

[Karenshart]

Thank you for your post Jerry.    yes I am female, thanks for catching the error in my profile. Thanks for the info too.  I think what is scaring me the most is every time I go lie down on my side, I get this weird feeling in my chest like my heart is jumping around and after that,  it starts to beat fast.  Then I prop myself up with pillows and lie on my back and it seems to subside.  This has been happening since my ER visit on Tuesday morning. I also feel so tired. This is why I am thinking my MVP is causing problems.  I just started to take a beta blocker today.  

[Jerry_NJ]

First, good experience help from the previous post.

I read "41F" to stand for 41 Yo Female. You are listed as "male" in you profile.  You may want to edit that record.

I believe regurgitation of the Mitral Valve is common and mostly not treated.  I think it is something that deserves active monitoring.  I don't know what is needed, but think a echocardiogram or other physical examination of the heart size and efficiency every 5 years would "feel" right to me.  I have an echo myself every 3 years now.  I think that is set by an insurance (both medicare and my secondary) more than what my doctor might like to do.  In my case my regurgitation (leakage) over the years caused an enlargement of my left atrium.  This I lived with (undiagnosed) until age 67 when surgery was required.  I have not been told, but I believe an earlier repair of my Mitral valve may have prevented the atrial fibrillation I now suffer from.  But, Mitral Valve surgery is relatively new, I'd guess about 20 years old as a general procedure for the public.   I do not intend to worry you about the regurgitation, that is why I put the good news first.  The second part is my justification for suggesting you establish a regular (5 year?) check up on the state of the regurgitation and the size of you heat.

[MichelleP_3811]

The ablation will correct the svt but will not correct the pvcs.  They are two different conditions.  The svt is most likely an accessory pathway condition where you have some extra fibers in your heart that the electrical signal gets caught on and runs in a loop.  I had avnrt which involves the avnode and is the most common of the svts.  My heart rate would reach 230bpm which a 200 plus beat is common in avnrt.  There are a few others, avrt and wpw that more involve the wall of the heart and then some less common ones.  But if your heart beat is reaching the 200s then you may very well have avnrt though they will only know for sure once you go in for the ablation.  

As for the pvcs, I was told they weren't caused by my svt but I know I had the svt my whole life but have not felt the pvcs/pacs.  I really only noticed them probably the past couple of years though I really didn't know what they were until after I had the ablation and they became more noticeable.  Or at least it made it so I knew what I was feeling was no longer related to svt.  In any event, pacs/pvcs involve some cells in the heart becoming damaged or something, to be honest I am not sure how much the medical community totally understands them.  But essentially these cells cause the heart to miss fire or fire extra times.  The pac are extra beats arising from the atria and pvcs are ones that come from the ventricles.  The ventricle kind can be more dangerous if you get them in a row for a sustained amount of time meaning longer than 30 seconds.  This is Ventricular Tachycardia and could be life threatening because it could turn into Ventricular Fibrillation but I have been informed it is very rare for that to happen.  It is also very rare for your current pvcs to progress to this point.  Though like I said before, I didn't have these before, I would have felt them so I do think the svt had a hand in causing them but since I had the ablation they have calmed down a lot.  But in general, pvcs and pacs are benign in nature and will not affect the overall health of your heart in the long term so long as they are occasional or isolated.  My doctor quoted a concern after a person registers upwards of 20,000 a day.  But be prepared to continue to deal with them after the ablation.  

I was told it wasn't from the ablation but I had a bad bout of the pvcs/pacs about 5 weeks past the ablation.  I think my heart had just been through a lot and was a bit stressed but they have calmed down a lot.  But I also had some stomach issues that I am working on resolving so that may be a factor in the pvcs calming down as well.  But regardless, your heart may act a bit out of sorts for a good 3 months past the ablation but once you get some distance you will be amazed at how calm your heart feels.  My heart hasn't been this calm in a good 10 years.  

As for whether you should do the ablation only you can decide that, it is a heart procedure but it is one that is fairly simple.  You can read my journal entry if you want to know a little of what will occur.  Click my name and go to my profile.  That said, your svt will not go away on its own.  It will actually likely continue to progress and become more frequent.  Having episodes a couple of times a week is a lot on your heart.  Though svt doesn't generally cause sudden death it can lead to congestive heart failure if your heart gets worn out too much so though you may not be able to rid yourself of the pvcs eliminating the svt problem will be beneficial to the health of your heart in the long run.

Well I hope that helps.  If you have any questions moving forward let us know.  Good luck at the doctors and keeps us posted on how things are going.