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Living with SVT Without Worries
Very important: When you are diagnosed with SVT, follow your doctor's orders, but be informed.
I have been diagnosed with SVT and I am living a totally happy life with no worries and I am given a "keep-it-up" clean bill of health at each of my annual Medicare wellness check ups.
It bothers me that it appears that many, many people in this world have SVT and are worried sick about it. Therefore, I wanted to tell my story here. It may not apply to you or someone reading it but it is my story.
Background:
I only recently discovered this Mayo Clinic forum on heart rhythm. Very interesting! Thank you, Mayo Clinic for hosting it.
I was searching for information on a wearable bpm recording device. I then posted a question in a new topic here.
Then, I spent time over the past two days reading dozens of SVT discussions here dating from recent ones and all the way back to 2013.
I have had SVT for 30 years. (randomly occuring , or "Paroxysmal")
Back at the beginning I went to my physician (GP) and he diagnosed it as "skipped beats" or "extra beats" and told me that my condition was benign if my symptoms remained occasional, and if I could control it without tachycardia going on for long periods of time. To control it, he introduced me to the Valsalva maneuver. I was able to perform the maneuver and so for all these many years, I have had few problems in starting the Valsalva maneuver when my rapid heart rate, or tachycardia, began, thereby eliminating the symptoms.
After a few years, my physician referred me to a cardiologist to be sure.
The cardiologist did all his tests and officially diagnosed me with PSVT. He also recommended that same Valsalva maneuver and also pronounced my condition was benign if controlled.
(Note: he said that if Valsalva didn't work or if I could not do Valsalva then oral medication would be needed. If that didn't work then surgery via ablation would be necessary.)
After 15 years in that city we moved across the state for retirement.
My new physician there (GP) did his EKG test on me and said the same thing as my previous doctor in that my SVT was benign if it could be controlled.
So, fully understanding what was happening and being able to stop the SVT almost at will, I have had no worries and lead a carefree, happy life. I realize that my particular condition may be unique. My procedures may not apply to everyone especially if they have heart abnormalities like AFIB or PVC. But if my story applies to even just one other person out there, who is now very worried and distraught over their SVT condition then I will have accomplished some good.
Again, my cardiologist and my regular doctor say my annual checkups are great. While the SVT diagnosis remains in my medical record, I perceive it as no more important than if it was hayfever or an allergy. It certainly doesn’t interfere with my lifestyle and I have no worries when I go to sleep at night or doing normal activities.
I have great sympathy for anyone who has to spend hours looking at the ceiling while their heart races.
That concludes my speech.
Now, I would like to add a couple more things.
When I turned 65 years old, 11 years ago, I was given a free membership in gyms through the Silver Sneakers program with my Medicare advantage health insurance. I embraced going to the gym for the first time in my life. My wife and I still go at least five days a week. I have never been in better shape since high school. Thank goodness that Medicare advantage programs provide Silver Sneakers. My insurance provider is certainly investing in my health (and reducing their costs) by reducing payouts for medical procedures that I might not have to have because I am physically fit. My SVT records don’t perfectly match my exercise programs, but I do feel there is an indication that vigorous cardio exercise reduces my SVT symptoms.
As an engineer, I have kept good records of almost every occurrence over those years. I did this, so I could share the records with my doctor at my annual physical. I recorded the time, the duration, the bpm rate, and my physical symptoms.
At each physical my doctor continued to say my SVT was benign. and he said that was because my EKG annual tests showed that my heart rate was strong and proper, and these extra beats were just interfering a little bit and causing the tachycardia, but my normal heart rate firing mechanism was there all the time and was proper. Plus I had no heart valve or heart abnormalities whatsoever.
If your physician can't say this about you then my story may not apply to you.
Finally,
I have three pictures to attach to this memo. The first one shows when I, in December 2022, had a SPT episode at my gym. I did not have my heart rate monitor chest strap on. So, knowing the onset of my SVT symptoms, the rapid heart rate, etc, I took time putting the Polar H9 strap on, then waited a minute or two to record something for my doctor and then performed the Valsalva maneuver and my BPM dropped immediately. The whole procedure took maybe five minutes.
The second picture is of just this morning at 4:25 am. Of hundreds of my recorded SVT eliminations via my Valsalva maneuver, this graph may be the gold standard and the best I’ve ever done. At 4:25 am you can see my heart rate race over 130 bpm. My heart rate strap through my smart phone triggered a gentle alarm that woke me up from a deep REM sleep, and I, without even getting out of bed, compressed my chest and eliminated the SVT almost immediately as can be seen in the graph. Within 2 minutes I was back asleep. My wife beside of me in bed never even woke up.
The third picture is of my Garmin wrist device for recording of the same event over last night's sleep. However, the Garmin Vivosmart 4 averages bmp readings over a two minute period so it can miss the second-by-second bpm that Polar H9 records. But Garmin tries to measure REM (accurate?), deep sleep and light sleep.
So, during the day I can easily tell when SVT starts. But at night I need a monitor.
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4 ReactionsCongratulations on a methodical and reasoned approach to controlling your SVT. I know of one other person on another forum who has managed his AF, also paroxysmal, but reducing calcium intake, and doubling or tripling the amount of magnesium he takes on a daily basis. He has concluded that he's a magnesium 'dumper', so he ingests up to 1000mg daily...if you can believe it. He also uses Flecainide as PIP, or 'pill in pocket' to take when he moves into AF, which is rarely these days. This has been the case for almost 30 years. It's GeorgeN over on afibbers.org forum. Like you, very cerebral and methodical about managing his condition, and he offers a lot of advice and coaching over there.
Thanks for offering your experience.
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2 Reactionsopiestrer
I have heard about this valsalva even from one of my cardiologist.
I think, but correct me if wrong, it is like tyring to clear your ears when underwater and you blow air back into your sinuses by holding nose and blowing back. Is that correct?
I have heard other things like squatting down but the ones I have had VFIB have caused dizzyness and thus not a clear mind to try this. I think it is great you are able to use this techniques to stop yours.
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2 ReactionsCaution is warranted.
My understanding is that the Valsalva maneuver to compress the vagus nerve is only for SVT patients. That makes sense to me because SVT is when your valves are working great and your main heart signal is great looking on an EKG, but you have these pesky “extra beats” sometimes that arise from locations on your heart and your heart obeys them just like it does from the main beat source. My sports analogy is of a soccer match where the team’s coach is shouting instructions and the team listens and responds but then a dozen fans sitting in the stands each pulls out a whistle and blows it and the team stops and starts and gets confused! Same with your heart if extra signals suddenly appear. And while this is called “benign” by my cardiologist, it is certainly not pleasant or useful to the heart. So, the cardiologist says I have three choices, Valsalva, medicine, or surgical ablation. To continue my sports analogy, the Valsalva maneuver sprays a fire hose on the bad actors in the stands and they stop their whistles immediately. The medicine drugs the bad actors into a stupor where they don’t have the sense to even watch the game. And the surgical ablation shoots the bad actors (with burning radio waves, not bullets) and kills them, so no more extra whistles to confuse the soccer match!
As for me, I prefer doing as you describe, clearing your ears, or bending over, or trying to imitate a giant body builder and tightening your chest muscles. Many ways to do Valsalva! But, if you have an underlying heart defect in the valves, chambers, main signal, then there could be reason to really go over your condition with your cardiologist before you try.
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4 ReactionsI want to add this: My symptoms included 4 nights in a row last week, none this week, some years they occur once a month, a couple of years they didn't occur at all. That's why my cardiologist calls it PSVT and not SVT. And that may be the main reason he is not pushing metoprolol medication. Be cautious.
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2 ReactionsLast night I had another SVT episode.
I caught it all in Apple phone memory.
At 22:12:10 my heart started going up.
22:12:30 my BPM triggered my gentle phone alarm chime that I set at 110 bpm threshold.
22:12:40 my BPM peaked at 127
22:22:50 I had heard the alarm (both soft audible and haptic) at 22:12:30 but it took me 20 seconds to clear my thoughts and begin the Valsalva maneuver
22:13:10 all back to normal and back to sleep. My wife beside me never even woke up.
Once more, my personal opinion is that I prefer doing this occasionally as opposed to medication or ablation. It does not cause me anxiety. But that's me......
Products used:
Apple Watch Series 9, Apple Health App,
Smoky Cat Heart Graph app. (for the alarm and display graphs)
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2 ReactionsIt looks like your episodes, the blips here and there that stand out, might be coincident with REM-dreaming. Most of us go through a roughly 90 minute cycle between REM states.
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2 ReactionsI have had SVT since my 20’s (70 now). I get it 6-8 times per year…99% of the time while exercising. I take Inderal at the time and it typically resolves in 20/60 minutes. I just learned about the Revert procedure ( you can google it). It is a valsalva variation and I have used it 6 times now and it has worked 100% every time. I do it within minutes of onset and haven’t needed any medications. I am feeling liberated. I will see if I can attach the article. Apparently it is used in many Emergency Depts on patients w SVT.
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3 ReactionsWe all are fascinated with your success in alleviating your SVT without medication by the Revert procedure. Do you need a helper? Can you do this by yourself? Please describe your way of doing it.
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3 ReactionsHi….. it is much easier if you have someone w you to help w timing and holding up your legs. But Inhave don’t twice now successfully by myself. The attachment shows how clinicians do it in the ED. They ask patients to blow out the stopper of a 10 ml syringe (valsalva). You will never blow out the stopper but it gets you in to a good valsalva movement. I just blow into my fist and try to do it for 15 secs. I often get to only 11 or 12 seconds. I then lie down and put my feet up 45 degrees …. It’s an estimate. And then hold them up for 15 seconds. This is where it helps to have someone help you. But the first time I did it, I laid on the living room floor and then out my feet up on the couch (legs straight out). And yesterday, I had my SVT swimming and was going to get out of the pool by in the shallow end, I was able to do the 15 secs of valsalva and then I laid in the water and put my legs up on the side of the pool and it worked! Two times I have had to go through the procedure twice. And initially, I would take my 40 mg of inderal and then go through the procedure, but it has been so successful that the last 2-3 times I have done the procedure first and didn’t need the meds! Interestingly, I had my routine cardiology visit last week and my cardiologist had never heard of the revert procedure. She was happy to learn about it. I think it was first discovered in Europe and now is commonly used in Emergency Depts in the US.
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