SVT & Lupus

[KforKaren]

Hello,

First of all, I would like to say, I like Dr. Micheal's "computer side manner" ...especially to the 70 year old woman who posted about one episode of SVT and ablation.

Now for my question -

I was diagnosed with SLE 2 years ago at 48. Started having tachycardia over a year ago. Could not "catch it" with EKG...Holter and every time i finally got in to Emerg it was gone. Few short episodes have grown into frequent 5 hour episodes (with me becoming complacent about it). Exhaustion finally incapacitated ...and motivated me to do something. Was brought in by ambulance a month ago with heart rate of 170 for 4 hours and then going up to 236 after paramedic instructed Valsalva Manuever. They shot me up with Adenosine 2 times that night. And had to do it again the next day. I have been told that they don't think the SVT is related to Lupus. I also have a Fibromyalgia overlap. There is some sort of symptom of Lupus  at all times....so I don't understand why Drs are quick to disassociate this SVT from the Lupus. I have found plenty of correlation on the internet.

What is your experience of SVT and Lupus/and/or fibro?

Anything you can tell me would be appreciated....

Kfor Karen

[tom_h]

Mine was a very positive experience possibly because was under general anesthesia for the entire process.  I had a hard time staying awake even until the put the mask over my face!  I chronicled my experience in my journals, and you can find them here: http://www.medhelp.org/user_journals/list/1423357?personal_page_id=1722358

I also recommend that you check the journals of Jannie411  She was awake for the entire process, and details her experience very completely.

I hope you can find a resolution to your SVT, and eliminate one factor that interrupts your daily life.  It was one of the best decisions I ever made.  I got it at 6 and got rid of it at 60.

[KforKaren]

Hi Tom,

Yes, I am on Metoprolo also. I am on a low dose as I weigh about 105-110 lbs and have low BP to begin with. They started me low to see what would happen. I still had breakthrough and went up to 75 MG.a day..which is more effective...but really diminishes my functioning. Rock and hard place. I have now dropped back to 50 MG and it seems to keep things in check more than before. I am getting the ablation in hopes that I won't have to be on the meds after the procedure - so I am a bit disappointed to hear that that is not always possible. I guess we'll see what happens. How was your ablation, if you don't mind sharing...

[marilee176]

Hi Linda,

How is everything with you?

I was reading your post and saw that you have been having svt's for years.
How do you convert it, please explain.  Does it always work.  I thought that feeling was afib but maybe not.

[tom_h]

Karen, somethat I wanted to mention to you with regards to your Toprol dosage. I'm almost positive that Toprol XL dosage is the same as Metoprolol.  Toprol XL is merely a time release version. (BTW, you could save a lot of p;rescription cost by taking Metoprolol) If your dosage is 25mg per day, this is a teeny weeny dose, the smallest available.  By contrast, 400mg. has been administered to other patients.  I was on 200mg. at one point, and at 200 pounds, I was a zombie at that level. I can fully function at 100mg, and am presently on 50mg. following my ablation and this works to keep the BP at really nice levels.

So what I'm trying to say is that you probably have a lot of wiggle room with regards to dosage.  Perhaps a higher dose would help you.

[KforKaren]

Hi Tom...I did reply to your post in depth...and some how it was lost...so now....just a short : Thanks for sharing your experience...keep well.

Karen

[KforKaren]

Hi Linda,

I believe that there has to be some association with Fibro and the heart...how can it not...the heart is a muscle. As I said to Tom below...sometimes my heart actually "aches"...it's not always painfull...just uncomfortable and achey...like I need to press on it to take a deep breath. I know with Lupus there can be pericarditus...I need to look into that more I think.

They hit me with 3 shots of BB in the ER...nothing brought the rate down...and even now on 25 mb each morning and evening...I still get breakthrough. Those episodes are tolerable...but the other side effects of the meds are not....so hopefully the ablation will work.

Keep well!

Karen

[tom_h]

Hello Karen.  Most everyone on this forum are fellow sufferers, and not physicians, so please take my input as just that.  That being said, I don't know much about Lupus.  With regard to the heart, I do know that  Lupus can cause inflammation of your heart muscle, the arteries or heart membrane. Having lupus also greatly increases your risk of cardiovascular disease and heart attacks.

SVT is a result of an electrical problem of the heart.  You can have a structurally sound, even robust heart and still suffer from electrical issues.  I believe the reason professionals don't want to link the two is because one is incapable of influencing the other.  That's not to say that your SVT cannot be influenced by a side effect of Lupus.  For instance, adrenaline is a trigger mechanism for SVT.  I've had instances where I've been really amped up for a sporting competition (speed skating), or flush with anger for whatever reason, and BAM!, off goes my heart.  So what I'm suggesting is perhaps Lupus trigger something that may set your heart into SVT, but not the Lupus itself.

I found Holters for be totally ineffective in catching events.  It wasn't until I wore a 30 day monitor that my SVT was revealed to the physicians, and I was on my way to a cure.  Coming up on 11 months not SVT free.  My particular SVT was self sustaining.  Once started, it wouldn't drop out on its own.  My cardiologist pleaded with me to go directly to the nearest ER when one started so it could be recorded, and there's no doubt it would have lasted until I got there.  But after 54 years of having it, I was extremely proficient at converting it with Valsalva.  So I'd convert it rather that having it last until they got an EKG of it.

Unlike Linda above me, Toprol (Metoprolol) had no effect on cutting down the number of events which had climbed to 3x-5x per month.  It did seem to make conversion easier though.

[LindaTX]

Hi and welcome to MH.  My tachycardia episodes are stopped usually after taking a beta-blocker, 25mg ToprolXL.  Sometimes for anxiety I then take a clonazapam.  I don't have episodes often oneor two a mo., my heart rate does go up to about 160...I just hate to run to the ER whenever I have an episode.  I can't tolerate adenosine.  If I didn't take the BB, I don't know how long it would take to resolve itself.  I don't have Lupus but I do have some fibromyalgia.  My tachycardia was a residual from years of a-fib that was treated successfully with a Pulmonary Vein Isolation Ablation.