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Recent SVT diagnosis and questions
I was recently taken to the hospital with a racing heart beat. I was scared to death which I'm sure didn't help. I had no pain and no real warning that it was going to happen. I was standing in the living room watching a movie when I got lightheaded and felt my heart do a big stumble beat then it started racing. This has happened for close to thirteen years but I was told it was anxiety since every time I would go to hospital or Dr it would be back in normal beat. This time it seemed to get stuck in fast mode which was good because they finally got it documented but scary as can be. After a night in the hospital I had an ekg done and an echocardiogram done. I met with the cardiologist and explained everything to him and he said he believes it is SVT. I'm on a heart event monitor now that I'm to push record when I have an event and I'm on a new med to help control it. My question is this, is it possible to have the other symptoms of SVT with out your heart racing? Normally when I have a racing heart I get light headed, dizzy, and sick to my stomach. It really feels like an adrenalin rush that you are coming down from. Typically I will feel tired for the next day and my chest feels weak and sometimes I will have ringing in my ears. I had an SVT the other night and got the start and end recorded and sent in but a few days before that I had all the symptoms but no racing heart. The monitor I'm wearing shows my heart rate and it never went above 90ish. So I'm confused? I've also noticed I seem to be having a warm almost hot sensation in my lower chest that spreads sometimes before having the other symptoms. Almost like I've had a shot of whiskey.
Best Answer
Stop trying to figure it out and just start swimming laps every day at noon for 45 minutes stopping every 5 minutes to lower your heart rate and keep this up for one month and you should notice a bid difference in your heart strength and performance and after 2 months you should not have any more SVT or heart episodes.
I have had svt episodes my whole life. The episodes were infrequent until my 30s. They became very noticeable in my 40s. I thought I could fix myself with exercise so I started running everyday. Before I started exercising I needed to lay down during an episode so I didn't pass out but after I could walk around a little bit but I still felt very short of breath and light headed. Exercising did not change the number of episodes only how well I tolerated them. I actually got triggered into a few episodes while exercising. A big trigger for accessory pathway svts are ectopic beats and those are darn near impossible to completely get rid of.
My svt was cured with the first ablation within 2 hours of going in. I have not had an svt episode since the ablation though I still get ectopics. I have never taken beta blockers before or after the ablation. My EP did not see them as necessary. I have low bp to begin with so it would have likely caused more problems than good. For me I was starting to have daily symptoms with the svt before and after I started to exercise. Now that I have been free from the svt for a few years my heart is much calmer. I still have some ectopic activity but nothing like it was before the ablation.
After all I have read about afib I would be very cautious about having an ablation for afib but I definitely do not regret doing the ablation for my svt. Svts stress out the heart which causes more ectopics which causes more svt episodes. One of the factors needs to be eliminated to stop the cycle. For those with accessory pathway svt eliminating the pathway is usually a good bet because you would always be vulnerable to having an episode since you can't ever guarantee you will never get an ectopic again in your life. At least that is my view on the topic.
My svt was cured with the first ablation within 2 hours of going in. I have not had an svt episode since the ablation though I still get ectopics. I have never taken beta blockers before or after the ablation. My EP did not see them as necessary. I have low bp to begin with so it would have likely caused more problems than good. For me I was starting to have daily symptoms with the svt before and after I started to exercise. Now that I have been free from the svt for a few years my heart is much calmer. I still have some ectopic activity but nothing like it was before the ablation.
After all I have read about afib I would be very cautious about having an ablation for afib but I definitely do not regret doing the ablation for my svt. Svts stress out the heart which causes more ectopics which causes more svt episodes. One of the factors needs to be eliminated to stop the cycle. For those with accessory pathway svt eliminating the pathway is usually a good bet because you would always be vulnerable to having an episode since you can't ever guarantee you will never get an ectopic again in your life. At least that is my view on the topic.
I agree that exercise will probably help your overall cardiovascular condition. But, it did absolutely nothing to prevent my SVTs which I had since birth (59 now). I've had a resting HR of 48-50 since my teenage years and run 66 marathons, averaging 3:08 and cycled about 150,000 miles, holding several State records. In fact, my SVTs only occurred immediately following or during exercise. I had prolonged heart rates in the 140-145 range for hours following exercise as displayed on my HR monitor and eventually confirmed at my EP's office on an EKG while the SVT event was happening. It was only then that I was offered an ablation procedure as an option which I didn't hesitate to accept. That procedure was successful and I haven't experienced an SVT event since. That was 2 months ago. Prior to the ablation, my SVTs were recently occurring nearly everyday.
Here is an example of a world-class cyclist who was definitely fit (to say the least) that suffered from SVT, despite his fitness. He had an ablation and was cured of his SVT: ( quote from here: http://en.wikipedia.org/wiki/Bobby_Julich )
"...After a few "false" starts as a professional, he joined the Motorola team in 1995 alongside Italian rider Andrea Peron and fellow Americans Lance Armstrong and George Hincapie. In the 1996 season, Bobby Julich was diagnosed with re-entrant supraventricular tachycardia (RSVT),[6] a heart condition which meant his heart would beat much faster than normal. Julich was treated with radiofrequency ablation and was ready for the 1996 Vuelta a España late in the season, a race which showed the first glimpses of his potential in international professional cycling...."
Here is an example of a world-class cyclist who was definitely fit (to say the least) that suffered from SVT, despite his fitness. He had an ablation and was cured of his SVT: ( quote from here: http://en.wikipedia.org/wiki/Bobby_Julich )
"...After a few "false" starts as a professional, he joined the Motorola team in 1995 alongside Italian rider Andrea Peron and fellow Americans Lance Armstrong and George Hincapie. In the 1996 season, Bobby Julich was diagnosed with re-entrant supraventricular tachycardia (RSVT),[6] a heart condition which meant his heart would beat much faster than normal. Julich was treated with radiofrequency ablation and was ready for the 1996 Vuelta a España late in the season, a race which showed the first glimpses of his potential in international professional cycling...."
Definitely speak with your EP about all the particulars for your situation. As much as an ablation can be a wise choice it is important to realize if the episodes are rare the EP may have issues with being able to find the spot to ablate. I was having almost weekly episodes so the EP was able to induce an episode on the first try so I was in and out in 2 hours but if one is less active it can take a lot longer and be a bit more taxing on the patient. Some even come out without a cure so do discuss with your EP his confidence in being able to induce and map your svt for a successful cure. If you are only have a few episodes a year it may be a bit hard to locate, if you are more active you may find better success. So just know as much about your situation as you can and you will be able to make the decision that is best for you. Take care and let us know how it goes with the doctor.
I have to assume you are speaking of afib in particular because accessory pathway svts are usually cured with the first ablation and the scaring is very minimal. Afib ablations are a bit less successful and if the first fails there does seem to be indication that future ones may fail as well. I have heard of people going for numerous ablations and still having afib but not the same with accessory pathway svts. As well I am not sure how exercise effects afib patients but for my accessory pathway svt avnrt it only helped me tolerate my episodes better but did not lessen them in any way. I did not inquire about afib so I have no medical advice on afib and exercise but my EP told me exercise would not in any way fix my type of svt as well meds would not fix it either only slow the heart down when it was in svt. My EP actually didn't see a need for me to even try med therapy because it really does not stop the issue. He said my best bet was to either live with it or ablate. So though meds and exercise in particular are definitely helpful they are not a cure for accessory pathway issues and it sounds as though the OP was actually diagnosed with accessory pathway svt and not afib so I just want it to be clear that there is a marked difference in the conditions and the ablation risks and results between the 2 types of svts because it can be easy to become confused.
Before surgery did you do daily strenuous exercise to strengthen and condition your heart to determine if that reduced your SVT episodes? Was your ablation for simple avnrt or avrt, was it successful, and did you have more than one ablation? Do you still take meds like Beta Blockers or Calcium Channell Blockers to slow your heart-rate? Do you still have PSVT or are you SVT-free?
What was your heart-rate during your SVT episode- 140, 160, or 180 bpm? Ask your doctor for a copy of the EKG during the episode and he should give you one. Also ask him to explain to you what he sees in your P-waves. With your copy you can look online and determine yourself what is happening - whether it's uniform. If it's uniform you most likely have simple SVT, probably nodal re-entrant, but if it's erratic you probably have AFib.
Riding a stationary or outside bike needs to be done every day. Forget the walking as it generates constant pounding on your heart; cycling is much better.
You are being given meds to slow your heart-rate but if you bike every day your resting heart-rate should slow over one month so you don't need meds.
Read up on catheter ablation and you'll see how much it scars the inside of your heart and once you have the first scarring done you can have short-circuits start in other areas of the heart that will need to be ablated also. Some people go back for 6 or 7 ablations which adds scar-lines all over the inside of their heart.
You have to be pro-active and get information and copies of all your tests and EKG's so you can determine yourself how you want to proceed in the future.
I was scheduled for meds and surgery but my own program stopped my 2 hours SVT's every 3rd day and I've not been SVT-free for 3 months. You can do the same.
Riding a stationary or outside bike needs to be done every day. Forget the walking as it generates constant pounding on your heart; cycling is much better.
You are being given meds to slow your heart-rate but if you bike every day your resting heart-rate should slow over one month so you don't need meds.
Read up on catheter ablation and you'll see how much it scars the inside of your heart and once you have the first scarring done you can have short-circuits start in other areas of the heart that will need to be ablated also. Some people go back for 6 or 7 ablations which adds scar-lines all over the inside of their heart.
You have to be pro-active and get information and copies of all your tests and EKG's so you can determine yourself how you want to proceed in the future.
I was scheduled for meds and surgery but my own program stopped my 2 hours SVT's every 3rd day and I've not been SVT-free for 3 months. You can do the same.
Exercising, whatever form you choose is very good for your systemic health. However, exercise whatever type you choose is NOT going to cure you of whatever type of SVT you may have. Daily workouts are not going to do some kind of metamorphosis on your heart. If you believe that, you're watching too much sci-fi. There are or have been marathon runners, basketball players, cyclists, swimmers, and in my case speed skaters who have been on this forum with SVT. These people have superb cardiac condition but are still plagued with SVT. If "exercise" was ever going to cure SVT, it would be in these people.
So typical cure path is to first try drug therapy. In fact, insurance companies may require this path first before turning to ablation therapy. Yes, the procedure sounds frightening to just about everyone. But if you choose your electrophysiologist wisely, you can find one that will either twilight sedate you, or as was in my case full, general anesthesia. I remember nothing of what they did to me on the Cath Lab table. To lie still on your back for sometimes 4, 5, or 6 hours is too much to expect of anyone. Anesthesia relieves you of that and any discomfort associated with the procedure. The insertion site are merely needle punctures similar to what you see when donating blood. The following day when the dressing is removed, the only thing that you see is a red dot. During the procedure, everyone that you'd want to be there in case of an emergency is present in that room. That fact alone gave me comfort. There was some unsettling paperwork that I was required to read and sign. I filled out a living will, and had to elect a proxy (my wife). I had to read and sign the form stressing the possible need for a pacing device in the event of an emergency. This are standard procedure documentation and while in the realm of possibility, the likelihood of actually having that occur is extremely remote.
If you are getting frequent SVT events, at least several times a month, then ablation therapy is a good choice for you. Remember that an electrophysiology procedure carries no more risk than tinkering with different kinds and different strengths of drugs to control your SVT.
So typical cure path is to first try drug therapy. In fact, insurance companies may require this path first before turning to ablation therapy. Yes, the procedure sounds frightening to just about everyone. But if you choose your electrophysiologist wisely, you can find one that will either twilight sedate you, or as was in my case full, general anesthesia. I remember nothing of what they did to me on the Cath Lab table. To lie still on your back for sometimes 4, 5, or 6 hours is too much to expect of anyone. Anesthesia relieves you of that and any discomfort associated with the procedure. The insertion site are merely needle punctures similar to what you see when donating blood. The following day when the dressing is removed, the only thing that you see is a red dot. During the procedure, everyone that you'd want to be there in case of an emergency is present in that room. That fact alone gave me comfort. There was some unsettling paperwork that I was required to read and sign. I filled out a living will, and had to elect a proxy (my wife). I had to read and sign the form stressing the possible need for a pacing device in the event of an emergency. This are standard procedure documentation and while in the realm of possibility, the likelihood of actually having that occur is extremely remote.
If you are getting frequent SVT events, at least several times a month, then ablation therapy is a good choice for you. Remember that an electrophysiology procedure carries no more risk than tinkering with different kinds and different strengths of drugs to control your SVT.
Thank you for all the information. I did some looking into the ectopic heart beat and it sounds like what is going on. I'm adding that to my list of questions for the cardiologist when I go back on the 27th. I have looked in to the ablation since the Dr. mentioned it could be an option and it scares me but I am considering it. If this is going to keep getting more frequent with age which is what I seem to be learning then maybe I'm better doing it now while I'm still fairly young. It is something I will be talking more in depth with the Dr. about. In the ER they did first think it was afib but when they got looking at the ekg they decided it was rhythmic so it wasn't afib.
I don't know how to unselect this as the best answer because I didn't mean to click that. I am walking and riding my bike per the cardiologists instructions. I would love to swim but do not have a pool readily available and do not have the extra to pay for expensive gym memberships. But I do agree that exercise is going to help.
That hot sensation in your chest could be gerd, or something else. Be sure to familiarize yourself with the different types of chest pain and what they mean. If there's any question, see your doctor
Typically you will have symptoms like shortness of breath and dizziness or feeling like you may pass out with an svt but if you are well conditioned and exercise a lot your heart may be strong enough to not put out as many symptoms. When I first started getting my svt more often I had to lay down but after I started to work out, thinking it would cure the problem which it won't, but after I started working out there was a marked difference in how I tolerated the svt episodes. This said, I was always very short of breath and could not exert myself much while in an episode so it was noticeably affecting my ability to function. But I was not aware until after I got my svt ablated that generally we fall into svt due to what is called an ectopic beat. These are extra beats that can flare off at anytime anywhere in the heart but are not made by our normal pacemaker, the sa node. When these extra beats go off they disrupt our normal pace and give the svt a chance to jump in. But the timing has to be right or the svt can't complete the circuit it needs to cause the signal to loop and make the heart beat fast. Essentially an accessory pathway svt means a person has an extra piece of muscle that creates an opportunity for the electrical signal to get caught in a loop. Do some research online and you will see the anatomy of how svt is generated. Anyways, you can have ectopic beat activity and not actually fall into an svt episode. This may be what you experienced. It can feel odd, like pauses and flip flops or thumps and if you have some sort of pattern of them it can also feel like your heart is acting up and going fast. The doctor will be able to tell based on your recordings what it caught but if it never went above 90 then it is likely you weren't not having an svt episode but maybe something else. This is assuming your svt is accessory pathway svt and not afib which is a different type of svt that doesn't necessarily present with a fast rate. I suspect if you have had this for 13 years it is likely you have an accessory pathway svt but only the doctor can tell. Though I would think if you were in the er while having a racing heart they would have said it was afib. I had one called avnrt which is the most typical kind. Others are avrt or wpw. I had very rare episodes when I was young and they only started to become more noticeable in my 30s. I had the issue ablated in my 40s when I was starting to have weekly episodes. One thing you can try to get it to stop is to bear down like straining to go to the bathroom and hold your breath or drink a very cold glass of water. If you can do this and keep your episode to a minimum you may never need to go to the er for it though if it ever gets to a point where you are having many episodes and it starts to disrupt your life you may want to consider an ablation to correct the issue for good. It is a fairly simple procedure with high success for most and low complications. Anyways, you may be offered one if you are able to document an episode while on your monitor. If so then by all means come and ask all the questions you need. Take care and keep us posted on your results.
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