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Avatar universal

Shall I or not

Hi

I am 38 and male.  I am fairly fit exceeding three to four times a week.  About three years ago I started doing triathlons and got extremely fit, at the same time I was going through a divorce and at this time I noticed my heart beating faster than normal.  I went for some test and was diagnosed with SVT. My options were to take tablets, have operation or do nothing as they were quite infrequent.

I made the decision to do nothing based on my heart raving occasionally and usually brought on by pushing my body too much during exercise. So the past two years I have managed it this way quite successfully.

Recently I have to say it feels as though it is happening more, I am still exercising and have a very stressful job.

Ok so here is where I need advice or pointing in the right direction.  I am really nervous of having the operation. If I could be knocked out I wouldn't mind but being awake I can't seem to get out of my head.

Anyone had the same or able to offer advice on how they overcome.
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1807132 tn?1318743597
No one can make the decision for you but I will say I have had anvrt my whole life but the episodes were so infrequent I was really cognizant of it being an issue until my 30s when it started to act up a lot. Sometimes we just reach a point where the connection becomes active.  Odds are though it will get worse not better.  The episodes will become more frequent and last longer as you age.  So if you don't do the procedure just be very mindful of managing your episodes when they happen manually (vagal maneuvers like bearing down and holding your breath or drinking a cold glass of water) stopping them as best you can as soon as you can and your heart should tolerate it well.  Exercising is likely also helping your heart remain strong though do stop if you get an episode while you are in the middle of a workout.  

I was absolutely terrified to do the ablation but when it was all said and done it was such a piece of cake I wondered why I fretted so much.  You can read my ablation story by clicking my name and reading my journal entry.  I will say my heart was very jumpy for a good year afterwards.  In general we fall into accessory pathway svt (extra muscle fibers in the heart that create a loop) because of another issue called ectopic beats,  These are localized cells in the heart that trigger an extra beat.  After that extra beat happens our heart pauses to reset itself.  It is during this pause that the signal has time to make the full circuit of the loop.  After my ablation these extra beats flared up pretty bad.  I did not know I had them and was taken totally off guard when they went crazy on me.  They do eventually settle down and now after the svt has been cleared I am aware I was having them prior I just wasn't aware it was a different condition.  I mention this so you are not taken by surprise if you do go for the ablation and come out with a jumpy heart.  It takes time but your heart will settle and for the long term health of my heart to avoid the risk of failure an ablation was right for me.  My episodes were disrupting my life.  It is a fairly safe procedure and they do know enough now how to avoid needing a pacemaker but I know it is a tough decision so we are here to support you whatever you decide to do.  Take care and best of luck moving forward.
Helpful - 0
1423357 tn?1511085442
.... I wanted to add that determination as to what kind of SVT you may have is often not made until they begin to map your heart as was the case with mine.  By the way, I had a less common type of AVRT referred to as Circus Motion Tachycardia which was an accessory path between the left atria and ventricle.  It required 17 individual burns to bridge a wide path of conductive tissue.
Helpful - 0
1423357 tn?1511085442
"Because of my fitness it was mention that the more likely the strand is going to be near my node (forgive the completely  incorrect terminology) therefore increase the risk of passing current through this and needing a pace maker"

I believe that determining which type of SVT you have, AVNRT or AVRT is rather difficult unless you may have WPW (a type of AVRT) which may leave a marker.  You couldn't get any more superbly conditioned than I once was while training for short trach speed skating, and track cycling.  I had left side AVRT well away from the AV node.  It is true that (I believe) 75% of the SVT's are the AVNRT type and while perhaps close, or even considered part of the AV node many parients are fixed every single day.  It's very possible that littlegreenman above who now does marathons had the AVNRT type of SVT.  A good electrophysiologist won't go where there's a chance of messign things up.  Also today there is cryoablation where the suspect path can be deactivated my chilling it first without permanent damage.   I think most of us would say that it was worth the small risk involved and most definitely gave our lives back to us.
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Avatar universal
Thank you so much for you comments they really do help.  I'm in the UK and have private med cover with my job so I am luck that I get to see one of the best specialists in the UK.  I am going to book another appointment and talk things through with him as it was about 12 months ago we last meet and discussed my options.  With so much happening in my life at that time I decided to push to the side for a while.

I suppose I'm a 6ft 2 built to match big ***** cat. It's just getting my head around the procedure and the risks that was quote. Because of my fitness it was mention that the more likely the strand is going to be near my node (forgive the completely  incorrect terminology) therefore increase the risk of passing current through this and needing a pace maker.

Ps apologies for spelling just about to go in meeting and speed typing in phone.
Helpful - 0
1398166 tn?1358870523
You really have to weigh your symptoms vs procedure vs meds vs nothing for yourself.

The procedure is not bad, but it's expensive. If you are USA, you will pay your maximum out of pocket expense. Not deductible: Deductible +10% until it maxes out. It runs about $75,000 give or take (after discounts). Often deductible + copay plans, that's about $3-5,000 - be prepared to write checks or negotiate payments because that's split amongst the facility, surgeon and anethesiologist.

How bad is the problem? It probably isn't fatal... otherwise they would have acted a little more aggressively in the past. That's my guess and is worth every dollar I spent on med school - hint: $0.

I had "generic" SVT for... well forever and I lived with it until I was 40. Until then I was fairly sedentary and only had episodes every so often and I could stop them using vagals. (google if you don't know).  I was undiagnosed and just dealt with it. And TRULY, it was/is not that big a deal. At 40, I started running again and had episodes every other run or maybe 4 times a week. After a week long cold and a box of Psuedafed I had an episode that landed me in the ER. Completely uncontrollable and persistent. So, I opted for fixing. (I had an additional ER visit interim to the procedure.)

So... measure for yourself. At age 36, I'd not be inclined to start a lifetime chemical dependency problem (beta blockers). But, I'd also not be inclined to spend $75,000 if it's manageable.

If you get the procedure... you owe it to society to take care of that heart. It would be a shame to die young of fat, smoking, alcohol and arteriosclerosis. Exercise. Work it.
Helpful - 0
Avatar universal
It depends on what type of SVT do you have. Do you remember the specific name? Does AV nodal re-entry sounds familiar? The procedure recommended to you is not truly considered an "operation." You can consider it to be more like going to the dentist where you are numbed up with lidocaine and awake but feel no pain. Many of my patients who went through the "ablation" told me that it was no big deal. The anticipation is worse than the actual procedure.
Helpful - 0
1423357 tn?1511085442
Lots of us here on the forum have or have had SVT.  I had it for 54 years.  Lots of us here have gotten in fixed by cardiac ablation. Don't think of it as an "operation" but more of a "procedure".  It has about as much to do with an operation as donating blood does.  Access to your heart is thru a blood vessel where your leg meets your groin.  They don't cut it, but puncture it with a rather large diameter needle.  Afterwards the puncture heals very rapidly.  Overall recovery takes about 2 to 3 weeks, but post-ablation symptoms can last for over a year.

I had general anesthesia so remember almost nothing.  There is a very good write-up in the journals of forum member Jannie411.  If you do a search for her name, she will give you a very good recollection of her procedure as she was awake for the entire thing.

I had mine done almost 3 years ago, and today feel great.  Like you, I was very active and involved in sports that challenged my SVT.  Now 62, I only skate competitively in an old man's division, and coach.  If I could have had it done in my 30's, it would have been a different story.  Remember that it's not a structural problem, but an electrical problem with your heart.  We're always here if you have questions.
Helpful - 0
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1807132 tn?1318743597
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