Atrial Tachycardia during exercise AVRT??

[a_fibphil]

I get heart skips when I exercise at about the time I get my heart rate to 140+ give or take 3 or so beats. I am going to attach a copy a few pages from my 48 hour heart monitor. Anyone know what this is? Maybe exercise induced AVRT? I mean when my heart slows down in between the "normal" heart beats is that a p wave right after the S wave? Perhaps I am getting some sort of ectopic beat right after my qrs that is causing a pause and then back to sinus tachycardia? I mean it should be sinus tachycardia in that I am only doing stairs to cause what you see on this strip. But the P wave appears to be hidden much of the time during the so called "Atrial Run". My heart rate should be around 140 during this monitor in that I am going up steep stairs to get my heart rate up to cause my symptoms. I am in sinus rhythm 99% during this 48 hour monitor. HELP Please. I am looking into an EP study at the Cleveland clinic now. Just scared to make it worse.

[The_beat_goes_on]

It sounds like your symptoms definitely warrant an EP study and possible ablation, but definitely do your research and find a doctor that you are 100% confident in.  Good luck!  keep us updated!

[a_fibphil]

I have had a bruce protocol stress test. They said I had atrial fib, flutter... actually they seemed confused by my stress test and referred me to an EP doc. She said I had afib, but said it wasn't really afib per say but that bacause my of my atrial runs they could call it afib, though it stops just as soon as my heart rate comes down below 100 (stop whatever I was doing to get my heart rate up). The EP doc says she saw some emerging P waves and thinks it could be atrial tachycardia. she wanted to do an EP study with intent to ablate and possibly do an PVAI if it was atrial fib. I decided she might not have enough experience and that I would prefer a higher volume center like Cleveland. I just want to be able to have a cold and not have my heart skip all over just taking out the trash. Or dig a whole for a plant in my yard without my heart beginning to skip all over the place. IT usually starts with a skipped beat every fourth beat, then three, then it just beats really slow and steady, but I get very fatigued. Guess it's pretty much in bigimeny or atrial fib at this point not sure. But my heart goes from 140 to about 90 pretty quick and I can push through, but it's hard. When I quit and sit down it starts to skip here and there as the atrial kick starts to work again and then it jumps back up to 100 or wherever I should be and beats normally at that point. Very odd... guess I am just having ectopic beats every other heart beat and that results in my slower pretty much regular rhythm or I am in a junctional beat or something at that time. No clue

[The_beat_goes_on]

Have you had a stress test? I think if you were able to replicate this with stairs, you could easily have it evaluated further with a cardiologist / stress test.  Or have stress test results sent to the electrophysiologist of your choice. What are your symptoms during exercise?

[tom_h]

Just as successive PVC's can be considered ventricular tachycardia, so too can successive PAC's be considered atrial tachycardia. AT is defined as an SVT, but it does not require the atrioventricular junction or accessory pathways.  So it's not like AVNRT or AVRT types.  So this is what might be occuring.  I think you might be experiencing atrial ectopics.

[a_fibphil]

Sorry, thought my heart monitor was attached. Here is the link to it. https://drive.google.com/file/d/0B4Z5JlCy0CFcQjNJOE03czRYczQ/edit?usp=sharing