"Pill in a pocket" for SVT

It is a widely adopted practice, both recommended and prescribed by cardiologists and electrophysiologists, and by patients who report anecdotally that they have tried that approach and that it works for them.

Once a PIP is taken, it should act within an hour or two. Once it gets beyond that, it's really hard to assign success to the drug and not just that it's your typical time-limited arrhythmia, which most of them are in the early stages. What I mean is that, had you not taken the PIP, it's often the case that your heart would revert to NSR on its own within those next 2-24 hours. (24 hrs is the point at which patients are advised to seek help, especially for rates higher than 100 BPM because they could signal RVR, or 'rapid ventricular response', and you don't want your ventricles thrumming away like a sewing machine for long.

Hi I also have SVT, I considered an ablation however I am not sure I feel comfortable with the risks. I have a pill in the pocket but I have not used it yet. This is a good option for some peace of mind. Have you tried putting your face in ice water for 10 seconds, it is also a way to stimulate the vagus nerve and has been effective for me. With an ablation you need to weigh out if you feel the benefits outweigh any potential risk. It’s important to create an SVT action plan so you know what steps to try first. You can also do the modified valsalva at home.

Does anyone have discomfort in diaphragm area with afib. Have had 2ablations for very symptomatic afib (HR 250 bpm). Post ablation had terrible ache in diaphragm, terrible reflux and S of B. It subsided but now is back with a vengeance a year later. In addition, I feel like i need to belch but find it difficult to do so. And swallowing can be slightly 'interesting'. I'm beginning to worry that damage may have occurred yo my esophagus in the ablation or maybe a hiatl hernia. The sensation I have is weight on my chest and that everything is pushed up into my chest. Thoughts appreciated.

There is a nasal spray (Cardamyst, drug name Entripamil) that is slowly working its way through the FDA approval process, for PSVT. It ran into some glitches earlier this year, and is now slated for consideration by FDA in December of this year, I believe. It would be the equivalent of a “nasal spray in pocket”, if approved, and seems to provide a quick onset of relief in a significant number of PSVT sufferers. You can find more information online.

@cdk43 Your esophagus is high, in your throat and descends through the diaphragm and on down to the stomach. It 'could be' damage to the esophagus, although why you had a significant respite and now it has returned suggests to me that there is something else going on. An ulcer, hernia....something an endoscopy would reveal in all probability, something to run past your doctor/internist. And that is really my message...run this past two experts and see what they suggest.

Thank you Gloaming. I so respect your insight. My thoughts exactly about esophagus damage. As for the respite, I think I may have had the discomfort continually but bc it improved from it's original severity, it just felt like it dissipated. And now has gotten progressively worse. My fear: how bad could it get????