What is the difference between an SVT and a PVC?

Posted by kmk66 @kmk66, Aug 18 12:10pm

I'm a 68 year old woman and I was diagnosed with atrial tachycardia after numerous tests. Prescribed metoprolol and Lipitor which I've been taking since December 2023 . I hadn't had any episodes since taking the meds until yesterday (8/17/24) and it was a doozy. Got dizzy , my heart felt like it was Ping ponging back and forth across my chest, and both jaws ached terribly . It lasted for 45 minutes. Tried several vagal maneuvers to no avail. Today I am wrung out. So in trying to find out what kind of episode this was, can anyone tell me if it was a SVT or PVC? I haven't been able to find a definition to aid my research. Thanks!

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You might want to get a Kardia device to do a home EKG, or a smart watch-or ask your doctor for a patch monitor. Do you have a cardiologist to discuss this with? My cardiologist would be concerned about the jaw pain (or any left arm pain) from what he has told me.

If this happens again maybe you could go to the ER and it could be documented and diagnosed. I am sorry you went through that!

In my experience a PVC, a premature ventricular contraction, feels like a pause and then a fast double or triple beat. There are also PAC's and atrial flutter, and atrial fibrillation, which a doctor can differentiate for you.

We cannot diagnose or give medical advice here, only share our experience. I get afib with "rapid ventricular response" meaning heart rate above 190 and a big fish flopping around inside. When I was younger I sometimes had PVC's for a period of minutes or even hours.

Hope you can get a device and also consult a doctor or go to the ER. Good luck!

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SVT, or supra-ventricular tachycardia, is merely the upper chambers of the heart beating more rapidly than the ventricles below them. It is a class of 'arrhythmia' because it is not normal NSR (normal sinus rhythm). Technically, atrial fibrillation and flutter ARE SVT because the beats happen rapidly, more rapidly than necessary for the body's demands. In windy's case, her ventricles operate in concert, or sympathetically, meaning they speed up as well (RVR, or rapid ventricular response). This was not apparent in my own atrial fibrillation (AF). My heart rate below the coronary sinus, meaning the two large ventricles, was normal. Only my left atrium buzzed along with its irregular rhythm.

PVCs are premature ventricular contractions, also an arrythmia, because the intervals between the R complexes varies, something like in atrial fibrillation where there are no discernible P waves and the intervals of the QRS complexes are irregular in length. In this case, the heart causes the ventricles to beat too often, and not in a regular rhythm....meaning extra beats. Those extra beats mean the patient feels thumping and bumping in the chest, just as most patients with PACs feel (premature atrial contractions).
https://litfl.com/supraventricular-tachycardia-svt-ecg-library/

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@windyshores

You might want to get a Kardia device to do a home EKG, or a smart watch-or ask your doctor for a patch monitor. Do you have a cardiologist to discuss this with? My cardiologist would be concerned about the jaw pain (or any left arm pain) from what he has told me.

If this happens again maybe you could go to the ER and it could be documented and diagnosed. I am sorry you went through that!

In my experience a PVC, a premature ventricular contraction, feels like a pause and then a fast double or triple beat. There are also PAC's and atrial flutter, and atrial fibrillation, which a doctor can differentiate for you.

We cannot diagnose or give medical advice here, only share our experience. I get afib with "rapid ventricular response" meaning heart rate above 190 and a big fish flopping around inside. When I was younger I sometimes had PVC's for a period of minutes or even hours.

Hope you can get a device and also consult a doctor or go to the ER. Good luck!

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Thank you windyshores, I've never heard of a Kardia device and will look into it. My previous episodes have always involved the intense jaw pain, so the cardiologist knows about them and doesn't seem concerned. I appreciate the information!

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@gloaming

SVT, or supra-ventricular tachycardia, is merely the upper chambers of the heart beating more rapidly than the ventricles below them. It is a class of 'arrhythmia' because it is not normal NSR (normal sinus rhythm). Technically, atrial fibrillation and flutter ARE SVT because the beats happen rapidly, more rapidly than necessary for the body's demands. In windy's case, her ventricles operate in concert, or sympathetically, meaning they speed up as well (RVR, or rapid ventricular response). This was not apparent in my own atrial fibrillation (AF). My heart rate below the coronary sinus, meaning the two large ventricles, was normal. Only my left atrium buzzed along with its irregular rhythm.

PVCs are premature ventricular contractions, also an arrythmia, because the intervals between the R complexes varies, something like in atrial fibrillation where there are no discernible P waves and the intervals of the QRS complexes are irregular in length. In this case, the heart causes the ventricles to beat too often, and not in a regular rhythm....meaning extra beats. Those extra beats mean the patient feels thumping and bumping in the chest, just as most patients with PACs feel (premature atrial contractions).
https://litfl.com/supraventricular-tachycardia-svt-ecg-library/

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Thank you gloaming, I'm checking out the website now.

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@kmk66

Thank you windyshores, I've never heard of a Kardia device and will look into it. My previous episodes have always involved the intense jaw pain, so the cardiologist knows about them and doesn't seem concerned. I appreciate the information!

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The Kardia documents the EKG so you share it with your doctor. It is credit card size; you put two fingers on each side after linking to your phone via Bluetooth and the EKG and diagnosis show up on the phone screen. You can send it or show it to MD. I also keep a blood pressure cuff handy in the closet.

My electrophysiologist was concerned about left arm or jaw pain and narrowing of arteries (ischemia) and ordered a stress test. Glad your doc is not concerned.

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Thought that I'd followup on my original post after consulting with my cardiologist. I am currently taking 25 mg of metoprolol morning and night. After relaying my episode to the doctor she suggested adding flecainide. I've decided not to but asked about increasing metoprolol dose. I will now take 1.5 morning and night. I am also adding magnesium to see if that makes any difference. I asked too, if there is anything to abate an episode in progress and she said to try 1/2 to one metoprolol . We'll see.

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@kmk66

Thought that I'd followup on my original post after consulting with my cardiologist. I am currently taking 25 mg of metoprolol morning and night. After relaying my episode to the doctor she suggested adding flecainide. I've decided not to but asked about increasing metoprolol dose. I will now take 1.5 morning and night. I am also adding magnesium to see if that makes any difference. I asked too, if there is anything to abate an episode in progress and she said to try 1/2 to one metoprolol . We'll see.

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@kmk66 I take magnesium and also drink low sodium V-8 for potassium (should be over the day but I tend to have it in the am and magnesium in the evening).

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@kmk66

Thought that I'd followup on my original post after consulting with my cardiologist. I am currently taking 25 mg of metoprolol morning and night. After relaying my episode to the doctor she suggested adding flecainide. I've decided not to but asked about increasing metoprolol dose. I will now take 1.5 morning and night. I am also adding magnesium to see if that makes any difference. I asked too, if there is anything to abate an episode in progress and she said to try 1/2 to one metoprolol . We'll see.

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Metoprolol will do nothing except to try to keep a lid on your heart rate. It isn't an anti-arrhythmic drug, so your heart WILL go into, and out of, AF.....on its own. At least, in the early 'paroxysmal' stage, that is what you can expect. Metoprolol only works to slow the HR and to make the heart beat less forcefully, meaning less oomph or pressure. Why cardiologists insist on adding more of it is beyond me, unless it is strictly to keep your fibrillating rate closer to 100 than upwards of that number. If you are breaking into AF now and then, taking 200 mg of Flecainide is often the remedy prescribed by physicians, keeping a 'pill in pocket' or PIP approach. And that's only IF you can tolerate flecainide...many cannot.
https://www.webmd.com/heart-disease/atrial-fibrillation/beta-blocker-medications-afib
My point in responding, though, is that too much metoprolol can be too much of a good thing. I can't begin to tell you how many AF sufferers report going into dangerous bradycardia when their AF advances and they need more and more metoprolol, to the point where when they break into NSR again, their rate plunges down into the very low 30's. My own was only 30 BPM in the ER, which is the 'keep alive' failsafe rate of the AV node. Metoprolol was shutting down my heart!!

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Metoprolol IS an anti-arrhythmic drug. It is commonly used for arrhythmia control. That doesn't mean it doesn't have side effects. Everybody is different. If you are experiencing and increase in symptoms you should talk to you doctor. I am assuming it is an EP as they are the only type of cardiologists really qualified to treat rhythm problems. After 8 months of control and a break through like you describe I'd contact my doc. No one here can diagnose what you are going through and what the problem is much less how to treat it.
Most of us do not understand what are P, R QRS and other complexes and waves. ECGs are very complex to understand. Multiple things can happen at one time. Sorting them out takes a specialist. I will link a few articles designed to simplify the descriptions of these problems for the average layman to help understand these problems. See https://my.clevelandclinic.org/health/drugs/22867-what-are-antiarrhythmics
Note : from that article "Class II, beta blockers: These drugs slow down the heart rate, often by blocking hormones such as adrenaline. Examples include acebutolol, atenolol, bisoprolol, metoprolol, nadolol and propranolol."

SVT and and PVC are very different.
See this for a good description of SVT and treatment options. https://my.clevelandclinic.org/health/diseases/21800-atrial-tachycardia#:~:text=Focal%20atrial%20tachycardia%3A%20This%20type,can%20resolve%20multifocal%20atrial%20tachycardia.
Here is a link to what a PVC is https://my.clevelandclinic.org/health/diseases/17381-premature-ventricular-contractions.

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@harveywj

Metoprolol IS an anti-arrhythmic drug. It is commonly used for arrhythmia control. That doesn't mean it doesn't have side effects. Everybody is different. If you are experiencing and increase in symptoms you should talk to you doctor. I am assuming it is an EP as they are the only type of cardiologists really qualified to treat rhythm problems. After 8 months of control and a break through like you describe I'd contact my doc. No one here can diagnose what you are going through and what the problem is much less how to treat it.
Most of us do not understand what are P, R QRS and other complexes and waves. ECGs are very complex to understand. Multiple things can happen at one time. Sorting them out takes a specialist. I will link a few articles designed to simplify the descriptions of these problems for the average layman to help understand these problems. See https://my.clevelandclinic.org/health/drugs/22867-what-are-antiarrhythmics
Note : from that article "Class II, beta blockers: These drugs slow down the heart rate, often by blocking hormones such as adrenaline. Examples include acebutolol, atenolol, bisoprolol, metoprolol, nadolol and propranolol."

SVT and and PVC are very different.
See this for a good description of SVT and treatment options. https://my.clevelandclinic.org/health/diseases/21800-atrial-tachycardia#:~:text=Focal%20atrial%20tachycardia%3A%20This%20type,can%20resolve%20multifocal%20atrial%20tachycardia.
Here is a link to what a PVC is https://my.clevelandclinic.org/health/diseases/17381-premature-ventricular-contractions.

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Thank you for your thoughtful remarks harveywj. I really wasn't seeking a diagnosis. I was hoping someone would define the acronyms SVT and PVC., and what each displayed as. Folks who have been dealing with these conditions are in the know and I didn't understand what the abbreviations were referring to. I appreciate the links that you supplied. The are very helpful!

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