Aa
SVT - AF Confusion
Hi all
I have been suffering with random attacks of SVT since around the age of 16 (Now 29). My SVT always exceeds 250 bpm +. It was diagnosed as AVNRT.
Went for an Ablation 2 years back, but nothing could be found on the study, so was signed off and left to take 100mg Flecainide 2x a day. I have had 4 cardiologists examine my ecgs from the events, echo's etc, and all confirmed SVT.
Couple of months back, my usual weird rhythms were back (Not the fast rate) just the constant inconsistent rhythm during the day, if I feel my pulse, its almost like it finds it impossible to keep in time, some will skip, some a longer pause, some PACs, some double up. I took flec at my usual time and it eventually sorted the issue, I was advised to book another app with a cardiologist.
This time came, he took one look over my records and said he saw no evidence of SVT, and instead saw evidence of AF with a fast ventricular rate! All this time, and it looks like we have been looking in the wrong place. I have been referred for another ablation, but this time, he advises we will need to pierce through my heart wall, they will then "Separate" my vessels from the lung, stopping them interfering with my heart.
I'm no doc, but to me this is starting to make sense. My irregular rhythms always seems to match my breathing pattern, eg, if I breathe out, I get skipped beats etc. My first episode at 16 was caused when I took a draw from a cigarette, if I get a bad chest my heart skips for hours.
Questions:
- Any one had an ablation for AF, did it work? The risks seem higher than the SVT procedure
- Has anyone experienced a similar story?
- Does this mean I could have an underlying lung issue? My heart has been deemed healthy otherwise.
Cheers!
I have been suffering with random attacks of SVT since around the age of 16 (Now 29). My SVT always exceeds 250 bpm +. It was diagnosed as AVNRT.
Went for an Ablation 2 years back, but nothing could be found on the study, so was signed off and left to take 100mg Flecainide 2x a day. I have had 4 cardiologists examine my ecgs from the events, echo's etc, and all confirmed SVT.
Couple of months back, my usual weird rhythms were back (Not the fast rate) just the constant inconsistent rhythm during the day, if I feel my pulse, its almost like it finds it impossible to keep in time, some will skip, some a longer pause, some PACs, some double up. I took flec at my usual time and it eventually sorted the issue, I was advised to book another app with a cardiologist.
This time came, he took one look over my records and said he saw no evidence of SVT, and instead saw evidence of AF with a fast ventricular rate! All this time, and it looks like we have been looking in the wrong place. I have been referred for another ablation, but this time, he advises we will need to pierce through my heart wall, they will then "Separate" my vessels from the lung, stopping them interfering with my heart.
I'm no doc, but to me this is starting to make sense. My irregular rhythms always seems to match my breathing pattern, eg, if I breathe out, I get skipped beats etc. My first episode at 16 was caused when I took a draw from a cigarette, if I get a bad chest my heart skips for hours.
Questions:
- Any one had an ablation for AF, did it work? The risks seem higher than the SVT procedure
- Has anyone experienced a similar story?
- Does this mean I could have an underlying lung issue? My heart has been deemed healthy otherwise.
Cheers!
Not much to add except don't sweat the transseptal puncture. It's the standard way to get from the right atria to the left side of the heart. You may be prescribed anti-coagulants afterwards. ......and I'm sorry, but can't help myself...PLEASE stop smoking! This is akin to a diabetic eating candy bars. Hope they get it this time
Thanks! Yeah Afib. They originally diagnosed with AVNRT, but they could not figure out why when I was converted using Adenosine, I always ended up with Afib.
They believe I am having a fast ventricular response to Afib, and they is the cause of my episodes. I was told because the rate is so fast, it almost looks regular in the ECG, but he is convinced this is not the case.
They believe I am having a fast ventricular response to Afib, and they is the cause of my episodes. I was told because the rate is so fast, it almost looks regular in the ECG, but he is convinced this is not the case.
And to answer your lung issue, I don't believe it is a factor. Breathing just affects the heart in general because your rate can change a bit on breathing in and out and this can sometimes trigger ectopics but I don't think it is the source of arrhythmia issues especially accessory pathway issues which are caused by extra muscle tissue. Smoking does affect the heart though and may be why you had the reaction like you did but I really don't think the lungs are involved but you can ask the doctor and see what he has to say about it cause I am not a doctor and don't really know for sure.
Do you mean to say you were diagnosed with Afib? Not sure and want to be sure what AF means. Afib is a bit harder to fix than avnrt. A rate of 250 sounds like avnrt but you have to be pretty active (more frequent as opposed to rare episodes) for them to activate it and know where to ablate. Others have had unsuccessful ablations due to that. Mine didn't become really active until I reached my 30s. So your avnrt may not be very active and may never be very active depending on where the extra fiber is. And you could have a secondary problem with too much ectopic activity. the jumpiness and skipping. It isn't unheard of to have more than one issue. Ectopics actually leave one vulnerable to falling into svt so it stands to reason most people with svt also have ectopics. Ectopics can also be hard to ablate but if they know where they are then there is a good chance for success. If you stay active like you are then it should, I assume, go well. The type of procedure you mention though isn't one I am familiar with so I can't comment but I wish you the best of luck and much success. Keep us posted on how you are doing.
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Weigh your decisions, think about a second opinion (after all they ablated for SVT only later to tell you it's Afib, I'd want to have two doctors concur before progressing).
http://my.clevelandclinic.org/heart/atrial_fibrillation/pulmonaryvein_ablation.aspx
Breathing in increases your heart rate, breathing out decreases it. The phenomenon is known as Respiratory Sinus Arrhythmia, it is most noticeable in children and adolescents, but you're not too far from your teens after all. I guess there's a chance that the reduced heart rate while breathing out gives the cause of the fast rhythm a chance to discharge quicker than the heart's pacemaker.