Symptoms Pre and Post SVT Ablation?

[mjb3223]

Hello Everyone,

Can anyone who has gone through an SVT ablation share some of their symptoms (aside from sustained SVT episodes) before the ablation and did the ablation get rid of these "other" symptoms?

I am a 29 year old male who experienced my first run of SVT about 17 years ago playing sports. I only had an episode once or twice a year so I just dealt with them and was able to get out of them by bearing down (1 time I needed an injection of adenosine). In college, I started to get a lot of palpitations and had a high resting heart rate (high 80's sometimes 90's) but no SVT runs so I started taking a beta blocker (atenolol). Over the past 10 years the beta blocker did a great job as I would only get occasional palpitations (a few a day) which never really bothered me and no SVT episodes. However, even on the beta blocker I have always been hesitant to push myself exercising and I avoid quick/jerky motions.

After 10 years on the beta blocker, I am now starting to experience heart symptoms that are greatly impacting my quality of life. It seems like many stimuli such as stress, lack of sleep, alcohol, certain foods, and even moderate exercise now lead to more than occassional PVCs/PACs. Sometimes when my heart gets really irritated I get runs of PVCs/PACs and it almost feels like it tries to go into SVT but doesn't sustain for more than a few seconds although the feeling is awful as it misfires for many beats in a row.

I am in a unique situation because I haven't technically had a sustained run of SVT in over 10 years and initially I had the mindset that these recent symptoms are palpitations that I would just need to deal with. However, after reading many of the posts on this iste, it seems like these symptoms may very well be attributable to this "bad circuit" that used to cause sustained SVT before I started with the beta blocker. Even though I don't get the sustained episodes of SVT right now, the symptoms I am experiencing greatly impact my quality of life as I don't feel comfortable exercising anymore and I am more hesitant to do things like travel on a plane for fear that my heart will go into a frenzy.

If I knew there was a strong chance that my "bad circuit" is causing these symptoms then I would strongly consider the ablation but the other side of me fears that I go through with the procedure and it doesn't correct my current symptoms or leads to new problems.

If anyone can share some insight I would greatly appreciate it, thank you!
-Matt

[AGWENSCARED]

My first Ablation was in nov 2012,

[AGWENSCARED]

I was having problems in my 30's, with palpitations, shortness of breath, but they kept telling me it was anxiety,  But in 2009, I had a Blood clot in right leg, but my pain was in my left side around my heart, But they kept assuring me it was not my heart, well fianally they did a blood test to find the clot,  but kept having these problems even after being diagnosied with the autoimmune disease, I was put on Blood thinner for life,  Fianally by the Grace oF God, they let me wear a heart monitor for 30 days and said I had PSVT'S, tried every medicine they could, I could not take any of them, then one night I went into full A-FIB, was in ICU for 4 days til they shipped me to Birmingham , where I went through ny First Heart ablation, It lasted about 9 months and the a-afib started again, had my second Ablation Jan of 14, and have been having problems ever since, I am currently wearing a monitor to see if a third surgery is needed.

[kcolly32]

I was awake for my entire ablation as well, i think due to nerves because they gave me alot of medication. I wasn't in pain but like Glori said it was uncomfortable. They restrain you during the procedure so that you don't move. I did feel them burn the area but again it didn't really hurt. Took a total 2hrs for mine but felt like 15mins. Goodluck!

[tom_h]

Sure.  There was a very slight delta wave, a slight slurred upstroke in the QRS complex which is indicative of Wolff-Parkinson-White.  It was very slight though, and a couple of the cardiologists that I saw had to talk themselves into seeing it.  Of course it wasn't until they went in that they confirmed that it was another type of AVRT.

[mjb3223]

Glori - Thanks for sharing your experience. Do you know why you were told you would be put out but then ended up kept awake?

I couldn't imagine being awake during the procedure as I get really anxious when my heart is out of sync and I would be afraid that I would move around.

[mjb3223]

Thank you all for your responses, it's great to hear about everyone's experience with the ablation. I'm wearing a 30 day event monitor now so I'm hoping to catch some of these runs of what I believe to be short bursts of SVT that are muted by the beta blocker I'm on.  It's just difficult for me to differentiate them from my full blown episodes that would last for a half hour or more before I started taking atenolol about 10 years ago.

I decided to go back and try to collect some of my past medical records associated with my SVT episodes to bring them to my appointment with the EP's physician assistant next month.  

Initially, I never thought my SVT got recorded on an ECG strip but when I picked up my medical records yesterday, I was pleasantly surprised to see that the EMS team who gave me an adenosine injection did record my heart activity (hopefully this recording is prior to the injection). I also received another report with a 12 strip ECG from the hospital (after the return to normal sinus rhythm) and was surprised to see some "findings" that never really got followed up on. The ER doctor made the following notes on my ECG report:

*Somewhat high voltage, likely secondary to young age and athletic conditioning
*Now has a T wave inversion in lead III and slurring of the T wave in lead aVF.
*J-point elevation
*Prominent R Waves in leads V1 and V2 are suspicious for "Right Ventricular Hypertrophy"    

I am somewhat surprised that none of my doctors who were made aware of this ER visit wanted to follow up on that report, especially the last note. However, I have had an echo/stress test done since that report and it came back normal so I'm confident I don't have "Right Venticular Hypertrophy" but I was researching other causes of "Prominent R Waves" on an ECG and WPW/AVRT is a common one.  

Tom - Do you remember what lead your EP to believe you had a form of WPW prior to the procedure?

Thank you!

[tom_h]

BY the way, it is very common to begin feeling ectopics of all varieties.  It's very common to experience skips, and short runs of SVT for months to follow.  Keep in mind that the accessory path (in AVRT) as well as the fast or slow path (in AVNRT) are still present but have merely been severed to prevent conduction.  It is very possible for fresh tissue to bridge the burn and begin conduction again.

I felt good after  week or so, although I had some heart ache for about 3 weeks because of the numerous burns I received.  I took a while for the limping to go away, and I had a large hematoma on the right side which drained into my thigh causing a huge purple bruise which extended down to my knee.  That took about 4 months for the color to fade.  But I was about 100% within 5 weeks of my procedure, and I was 60 at the time.

[tom_h]

Hi Glori19.  That a good account of your procedure.  Your comments regarding your personal SVT triggers are right on.  Body movement was a big one for me.  When I twisted my torso such as getting out of a car was a big one.  Sometimes a jarring step such as stepping flatfooted off a curb would start one.  Fortunately, mine responded well to Valsalva, holding a breath and squeezing it, so I never had to go to the ER.

I was under general anesthesia during my procedure, and partially intubated, so I remember absolutely nothing.  I was given a Vallium injection prior to being wheeled down the lab.  I was very nervous and I told the anesthesiologist that it wasn't working.  He joked with me, winked at my wife, and they pushed me away on the gurney.  Then I noticed that the overhead lights were blurring as I passed under each one.  When I got to the lab, I had to scoot onto the lab table.  I was able to do that and got settled.  They propped my arms into a comfortable position and I remember that.  I remember them placing a mask over my face and telling me it was just oxygen.  ....and that was it.

When I awoke, the electrophysiologist was peering into my eyes. In his dust dry humor he said, "Shoulda seen me sooner! .....that would be giving you any more problems."  So because of the use of general anesthesia, and the staff at UMass Memorial Hospital, the experience was very positive for me.  It's been over four years now, and I haven't experienced any episodes. This is after 54 years of SVT which increased in frequency to 3 to 5 times per month.  I can push myself to my personal physical limits without fear of an episode.  It's a wonderful feeling!

[Glori19]

May I ask if you were awake for your entire procedure? Thanks!

[Glori19]

Hi Matt, Wow your story sounds familiar. However, I am older than you and a woman. I am 53 and in the past 7 years I have had 3 SVT episodes where I have gone to the ER and received the adenosine injection. After the first one I went to a cardiologist and he put me on metoprolol. After having 3 SVT's during a 7 year period, I was able to determine some similar things that had been going on prior to setting off each SVT. I was dehydrated, constipated, had been experiencing a little stress .... & before each one started I turned around quickly. After my last SVT in Oct. I began to do a bit of research because the trip to the ER and the adenosine injection was frightening (even though I always tried to just brush it off). What I learned was that SVT situations deal with the electrical part in the heart and that the best specialist to see regarding this type of issue was a Cardiologist who specializes in electrophysiology. I met with a Dr. who specializes in this area. I brought all my records from each time I was in the ER & while looking at the EKG report from my 1st SVT, he said he knew what was going on & that I was born with an extra circuitry in my heart. He said it was quite common and that while only 3 SVT episodes in 7 years wasn't a lot, I could stop them all together by having an ablation. I decided to do this and had the ablation 5 days ago. The Dr. said he got it and that I would never experience this issue again. While still weak, I am excited about that. HOWEVER, I had been told I would be sedated for the procedure and not remember anything. BUT, I was awake for the entire procedure 1 1/2 hours & I felt everything. Being awake and unprepared to be awake was quite freaky (to say the least). I was not in major pain, but it was pretty uncomfortable at several points. They had to get the heart pumping quite fast in hopes of bringing me to the point of an SVT episode and then ablation to the parts of the circuitry that was causing an issue. I could feel the burning heat each time they did it & they did it 9 times.The Dr. said it was 100% successful and I hope he is right. You may wonder if I would do it again even though I was fully awake. I would if the SVT's never return. Currently, I feel a little weak, but I also stopped taking the metoprolol after the surgery. I am wondering If I may be feeling kind of weird from that since I had been off it for 7 years. Good luck to you in whatever you decide to do.

[tom_h]

Hey Matt.  I had 54 years of SVT until I had my ablation 4 years ago.  The ablation eliminated the SVT, but it did nothing for the occasional PVC's and PAC's which I occasionally experience.  The procedure targeted only the SVT.  My electrophysiologist reported that on my 30 day monitor each of the three SVT events that were recorded were initiated by a single PVC.  From the EKG traces, the electrophysiologist was confident this was as "accessory pathway" and not AVNRT.  It did indeed turn out to be AVRT and was located in the left atria near the valve to the ventricle.  17 burns were required to sever the pathway.  In the 4 years since my ablation, I have not experience any sustained runs of SVT.  I occasionally get brief runs of something.  I don't know if it's NSVT or SVT, but it's something that lasts for about 8 to 12 beats before dropping out.  As mentioned, I still get occasionally clusters of PVC which hang around, then disappear for weeks.

I lived a lifetime with frequent episodes of sustained SVT. I suppose I would have gone after it before I did, but it responded well to Valsalva, and I was always able to convert it, without ever stepping foot into an ER.  I was hospitalized as a child when it first occurred, but that was it.  I just lived with it without any medication.  I participated at a high level in couple of sports which I alternated between.  I didn't want to use any medications that would hinder my performance, or that could be called into question, so I just didn't use anything.  It wasn't until I was around 10 years ago that I started the beta blocker Metoprolol for a reason unrelated to my SVT.  I was experiencing elevated and pounding heart rates nearly every evening during my sleep.  This turned out to be the result of severe sleep apnea which was corrected through CPAP.  But I discovered that while the Metoprolol did nothing for my SVT, it did help to convert them, and I could often halt an episode within seconds of its commencement.

My opinion of cardiac ablation is that if the SVT episodes are significantly impacting your quality of life, if you're seriously involved in a sport or occupation that would be adversely affected by an episode, or if you've reached an age where high heart rates become a problem with the heart, then ablation is the way to go.  Experimenting with different anti-arrhythmics at various levels carries risks that are as significant as the ablation procedure itself.  That said, if you're experiencing perhaps a few SVT episodes in a year, I'd hold off.  From my experience here on the forum, there seems to be a correlation between frequency of episodes and the success rate in finding it during the procedure and ablating it.  Finally, as I experienced, the frequency of episodes increased as I aged.  During my procedure, finding it was extremely easy as it started up merely by touching the area with the catheter.

[kcolly32]

Hi Matt, sounds like you're in the same boat I was prior to my ablation back in October. I first started getting SVT when I was around 20 y/o. I didn't know then what it was and thought it was just some weird quirk I had and seemed to only happen a couple times a year so I ignored it. Then it seemed like it was gone for about 4yrs or so. I didn't have any symptoms and trained and ran a half marathon. Turned 28, and everything came back with vengeance it seemed. Not only did I start have SVT pretty much anytime I tried to have a good workout but I would constantly have PACs too, occasionally PVCs as well. I tried to ignore it and thought maybe it was anxiety. I was always able to get out of my SVT by bearing down so I didn't think it was really an issue. But it came to a point where I was scared to workout or even bend over quickly because that would cause it. Finally got a 30 day heart monitor on and had the sort SVT episode while on it, HR jumped up to 260bpm. That got me to a electrophysiologist which recommend an ablation. I was definitely scared of getting it done and asked for a beta blocker but his response made sense, the beta blocker wouldn't get rid of my SVT and i would have to be on it the rest of my life. So I got the ablation and 3 months out I feel great! I've had zero SVT episodes and my PACs are pretty much gone as well. I run and workout without any issues. I had a high HR for a little afterwards and my groin was sore for a few weeks but it was all definitely worth it. My SVT was caused by an extra pathway in the atrium, which is where the PACs were coming from im assuming since that extra pathway has been burned away both my ectopic beats and SVT have vanished. I would recommend an ablation, it's one of the best things I've done.