Exercise Induced Supraventricular tachycardia

[janetkathryn]

I am a woman and am 58 years old.  For the past two years, I have been experiencing exercise-induced palpitations.  They were recently confirmed via heart monitoring to be supraventricular tachycardia.  I only get SVT when I am rowing.  Other aerobic exercises do not produce is, such as bicycling, etc.  My heart rate gets up to 223 bpm during these episodes.  My doctor wants to do an ablation.  My question is, shouldn't more conservative measures be done first?  I also have moderate mitral regurgitation.  Thanks!!

[RNRita]

Lunges and squats can do this to me.  I don't know where I read it, but a long time ago, it said somewhere that a person with heart arrhythmias shouldn't do them.  Oh well, I do.  Also, I am not so sure that after a month of exercise my endurance has increase much.

[Wisconsin2007]

Hi Janet -

Hey, I saw your visit elsewhere.  As for your resting heart rate - if it was really low, trying a beta blocker might be out of the question, as it could lower your resting rate even further, which could result in your organs not getting as much oxygen-rich blood as they need.  You also don't want your BP to get too low, another thing a beta blocker does.

But I would think that if your BP isn't too low, you might ask your doctor about trying a course of beta blockers.

Something else of note - Ohio State is currently putting together a study on the use of beta blockers to treat mitral regurgitation:  http://clinicaltrials.gov/ct2/show/NCT00700947

[janetkathryn]

Hi Jeff,
Thank you so much for the information.  I forgot to answer your question about my heart rate.  My resting hr is from 60 to 65 bpm.  Why do you ask?  Does that mean anything regarding SVTs?  And, your're right.  My heart rate after I row is usually around 160.   I have been riding the stationary bike instead of rowing, keeping my hr around 150, and riding for a longer time, and I don't get svt. So, why not just stop rowing, instead of ablations, medications, etc. But, like you, I still have a lot left in the tank!!

Thanks again,
Janet

[Wisconsin2007]

What's your resting heart rate?  Is it pretty low?  

Also - you might consider buying a Polar heart monitor (or something similar).  Get the kind with a chest strap that transmits to a wrist unit.  You can set alarms on it, so that it's easy to know when your heart rate hits a certain "mile marker" without having to constantly look at it.  

According to the American Heart Association, your theoretical maximum heart rate is supposed to be 220 minus your age.  They use that as a guide to determine what a good target heart rate is for aerobic exercise, and that range is supposed to be 50-85% of your maximum.  I'm 40, and for me that would mean my target range is 90-153bpm.  But honestly, just warming up I'm over 90, and even when I was in good shape, I'd be at 170-180 bpm and feel like there was still a lot left in the tank.

For you, the target would be 81 - 140.  You probably couldn't row for more than 2 minutes before you topped 140.  So I'm dubious about the theoretical max and target heart rates, and suspect they have been developed with the generally out-of-shape American population in mind.

[janetkathryn]

Thank you so much for you response.  I rode the stationary bike the past few days, and if I keep my heart rate around 150 bpm or so, I don't get the SVTs. If I row, I get them within about 15 minutes.  It's hard to take my heart rate when rowing, but when I stop to do it, the bpm are around 160-165.  Interesting.  Anyway, Thanks again and it is comforting to have such a knowledge support group.
Best Regards,
Janet

[Wisconsin2007]

Ablation has become so mainstream that it is often the first line of defense.  And just knowing how my organs get squashed up riding a recumbent bike (which has occasionally set off a short burst of SVT), I would imagine rowing has a similar, if not more pronounced effect.

There are other things to consider for this situation, such as your resting heart rate and blood pressure, as the common class of drugs to treat that condition (beta blockers) lower both of those.  For some people that's fine, for others it isn't.  And if you are very physically active it might put a crimp in your activities, as some people feel that beta blockers make them more tired.  But I would think it would be reasonable to discuss that option with your doctor.