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Can you have PSVT without fast heart rate?

I been having pac's a lot of them. past month has been ok but before that horrible. I would get extremely tired with them it felt like my heart was struggling to beat almost like a fist straining to close like thuump thuuuump thuuuuuuump then a hard thump the about 2 or3 fast thumps few normal then a restart. My heart rate normally stays in the 60's sometimes in the high 50's during normal activity usually in the 80s. Wore a holter and that day I didn't seem to feel like i had bad episodes but doctor said it showed 2000 pac's said it was likely stress but stress meds didn't help. He sent me to a cardio, who today did a ekg and talked with me. He said my heart rate was 59 seen a small hiccup on ekg and then said i PSVT (Heart rate at 59 when he said this) with the pac's but my heart rate rarely ever reaches into the 90+ range at rest. A few times maybe once in a year and it was just at 100. So how could it be PSVT? I thought that was a fast heart rate disorder?
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1807132 tn?1318743597
If your insurance doesn't require a referral then contact another cardiologist and let them know you are interested in getting your issue checked out.  I am sure they will fit you in.
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Avatar universal
He said my heart rate was to slow for a beta blocker. Which confuses me to the psvt he said i had. Would probably make me feel worse due to slowing my heart rate more. Said flecinide wouldnt slow it any.. how do I go about getting a second opinion just call up another cardio? Ir referal from pcp? My plan doesnt require one but do the cardio docs?
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187666 tn?1331173345
I agree with michelle: get a second opinion. I understand you don't yet have all the information you need to make the decision concerning an ablation. But typically doctors don't rush into an ablation for PSVT unless it's really interfering with your life. I was having it quite often, many times a week with rates up close to 200. Even then, the cardio said I could try medication for awhile if I wanted or go for an ablation. There was no pressure and no rush. Then again, I'd been living with PSVT for over 40 years by that point.

See what you can find out first. And as for the flecainide, I thought that was one of the stronger heart meds. Wonder why the doctor chose that?
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1807132 tn?1318743597
It is possible you have classic svt and don't feel it.  I think that would be odd but not impossible. I would think during it your rate was faster than 59 but I have also heard that afib can present with a slower rate because not all the beats reach the ventricles or something like that.  Afib can also just be an irregular beat so not classic svt like you think with a fast beat.  If I were you I would in the minimum question your doctor about what type of svt he thinks you have and how successful he thinks an ablation will be for you.  And if you are still unsure then seek a second opinion because if you are in the states it is a very expensive procedure so you will be required to pay your full out of pocket.  Not that that should keep you from doing one if needed but I wouldn't go into it lightly.  
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Avatar universal
Stress doesnt overtly seem to be a factor ive had very stressful days with non at all. The doctor put me on flecinide but after reading up on it. It scares the hell out of me. He also suggested ablation. Does his approach seem radical then for my symptoms?
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1807132 tn?1318743597
In general supraventricular tachycardia is a heart rate faster than normal so over 100bpm but it can be considered in as few as 3 beats.  I surmise you may have had a very short lived run of pacs that he is defining as psvt.  PSVT is a general term for a number of conditions a run of pacs I believe being PAT.  That said, I would call the doctor and ask him to clarify.  But in either case if you are functioning fine, not passing out, having low oxygen levels or severe chest pain I don't know that there is much they do for the issue beyond beta blockers. Especially with issues with the atria.  So do your best to reduce and learn to cope with the stress in your life and I am sure you will feel better but if things get worse make sure you follow up with the doctor.  Hang in there.  I know heart stuff can be uncomfortable and distracting but usually it is more of a nuisance than anything else.  Stay strong.
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