What could be the cause of very infrequent SVT?

[ct4825]

Hello, I'm a 30 year old female who first experienced SVT when I was 22 years old.  The way it happened for me, I was playing ball outside with my 2 year old when I bent over to pick up the ball and got back up it started.  I didn't have another episode until this past February, 7 years later.  I was admitted over night and the only thing wrong in my bloodwork was low potassium.  My ekg, echo, were fine.  My question is what cause SVT in cases like mine where I don't get episodes but every few years or so (not even that)?

Thanks

[au2311]

Hi
My first time posting here. I'm a 53 yr female. Thinking back, I remember randomly, from my teens on, sometimes my heart seemed "out of sync". I would just hold my breath for a bit and it would be fine; I never thought much about it, it was so infrequent.Then out of the blue, I had my 1st SVT episode landing me in the ER 1.5 yrs ago.  I started on 25mg metoprolol 2X day after that (cycled in and out of the arythmia for about 4.5 hrs before getting to the ER, HR 190, then IV metoprolol). don't like the side effects at all... and tried to be more aware of my stress, caffeine intake, general health, hydration, etc. but with no further episodes, and with the meds, thought I was managing it. then I had  a mild episode this summer, which I attributed to my lack of attention to triggers. Then another, while alone down a long country road, with no cell reception that lasted about an hour.Alarmed me as I realized I had to be prepared, this could happen anywhere, anytime! No particular stressors ... fortunately someone else showed up so I wasn't alone.
Your comment about driving is what prompted me to write. Last month I was driving, alone, out of town as I often have to do, and often at night. I felt it coming on just as I was about to get on a busy highway, pulled off to the side and told the officer who checked on me that I would be ok, just had to wait it out, he continued to check on me and left his #. As he drove off again, I started passing out. Four or five times, in the city, windows open, on my own, trucks whizzing by. In between blackouts, I called him for help, and managed to call what friends I could reach in the area so someone would know where I was! Next thing I knew there was an ambulance, fire truck, and two police cars. And still I was thinking, this is probably over now, nothing to monitor unless its happening, right? Once I got to the ER (leaving my car on the side of the highway - the officer said he'd watch over it til friends came), I did have another episode, an IV dose of adenosine finished them off. I am now scheduling an ablation shortly (which I am nervous about, but trying not to stress about!)
My point is that what you are worrying about, did happen to me! I still have to drive, alone, before the procedure, but I cancel out if I don't feel 100%, not at night..etc, until then. And even so, I can't assume I can control them, and they are getting worse, which means I really can't anticipate what could happen...Before, when they were mild and infrequent, I could sort of forget how quickly incapacitating they are.
I would encourage you to follow up with an electrophysiologist. I know there is no quality of life to be wondering where and when it might happen! and if you are getting pvc's everyday, you should find out why and what your options are.
thanks to everyone for this great forum, glad you are here!
au

[jkfrench]

Mine started back in my late teens (around 17).  I am 47 now.  
They can consume you because you.  For me, I especially worry that they will act up if I am traveling or if I have to drive for long periods of time by myself.  You would think that after all these years the stress over them stops but everytime it happens I am shaken up for days. (even though it is only a few times a year).  I get pvc's every day.  Most of the time I can handle them.  (mentally)  :)
frenchie

[ct4825]

Yes I know what you mean, they scare you like crazy!  It's been 8 months now since my last episode and I feel like it has consumed my life.  I worry about the next time it may happen, if it does.  My last episode before that one was 7 years ago.  So I think to myself, it's going to be fine, you're not getting these frequently.  Twice a year is not so bad, I've encountered people who get them weekly.  How long ago did yours start?  

[Michael J. McWilliams, M.D.]

http://en.wikipedia.org/wiki/AV_nodal_reentrant_tachycardia

This is pretty thorough.

[jkfrench]

Hi
I have a similar situation to yours.  Although my svt's happen about twice a year.  I know for me it is the timing of the premature beat.  I feel a really long pause (longer than the normal pause of a pvc) and then that sets it off.  Fortunately it only lasts about 2 or 3 minutes. I think the longest episode was about 10 minutes.  I feel lucky that it only happens a couple of times a year but it really shakes me up when it does.  Along with the fast rate (around 220) there are pvc's with it.  Makes me crazy!
Frenchie

[ct4825]

Thank you for your response.  This does seem to help me understand SVT a little better.  Most forums that I have been to, describe this condition as an everyday occurence and I'm not in that catagory.  Can you tell me exactly what is AVNRT?  I do remember the day that my SVT occured, I was stressed, getting sick, and probably had premature heartbeats, and also caffeine earlier in the day (1 cup of tea).

[Michael J. McWilliams, M.D.]

There is a 70% chance it is AVNRT, 25% chance it is an accessory pathway and 5% chance it is an atrial tachycardia.  There are a lot of people out there like yourself.  The right conditions need to be present for the tachycardia to take affect.  Some people will out grow the tachycardia and others will having worsening symptoms as they get older.  The good news is the likelihood that it could be fixed with a relatively low risk procedure is over 95%.

The conditions that need to be present are probably some stress, fatigue, caffeine (etc) and have premature beats timed at exactly the right time.  The odds of being able to recreate it in a procedure or EP lab are much higher and actually necessary to cure it.

Does this answer your question?