Newly Diagnosed SVT and on Metropolol.

Hello @mrm50,

I'd like to invite @marybird, @kmk66, @kate26, @dugroad, and @jpeters6930 to this discussion as they have all discussed being diagnosed with SVT and being prescribed different medications and metoprolol to help with their SVTs. They may be able to share a bit more about where they are now and what it felt like when first diagnosed.

@mrm50, when you say your symptoms were becoming more frequent, how often are you experiencing them? Have you noticed any particular triggers?

@JustinMcClanahan
Good morning Justin. Thank you for reaching out. I used to have them once in a blue moon, but now they have become more frequent in the last couple of months to a daily basis. They happen at any time. I could be laying down resting, or walking, and sometimes at the gym while working out. They are short and brief, but 2 weeks ago I had longer lasting one that I ended up going to the ER. The doctor told me about natural vasovagal remedies but I am new to this and they feel alarming. They gave me a low dose Atenolol to start and after meeting with my cardiologist, they changed me over to Metropolol.

How do you cope with these episodes. I have been on these new meds for 3 days. Do the SVT's ever fully stop with the medications? Your advice and input is greatly appreciated. Thank you.

I had increasingly worse SVT symptoms and had ablations July 2025 and February 2026. Flecainide and metroprolol made symptoms worse, causing bradycardia and tachycardia with long pauses, so I stopped them and felt much better. Third ablation in March was extensive but it really helped. I'm trying to build back my strength though it's a slow process. Still have some mild symptoms. I highly recommend vagal maneuvers.

I have a long history of SVT's probably dating back to my early adulthood, but until I reached my early 50's the episodes only lasted a couple minutes and occurred so infrequently (once every few years) I paid little attention to them and would forget about them after the episodes. The episodes became more frequent when I hit the 50's, and the first one that took me to the ER was an episode that didn't stop on its own after several hours, and was hovering around 210-220 beats/minute when I got there. They slowed it down with an adenosine IV, followed by a digoxin drip overnight and it was back to normal the next morning. They did ultrasounds to see if I'd thrown any clots ( none seen), and started me on 100 mg metoprolol succinate ( extended release)

With subsequent visits to a cardiologist and my primary care doc, I was reminded that I had high blood pressure ( I knew it but had been mostly ignoring it for too many years, assuming that diet and exercise would control it) and started taking Diovan HCZT ( valsartan combined with a diuretic) for blood pressure.
At first this combination of medications made me light-headed and sort of "loopy", but these side effects disappeared after a couple weeks.

The metoprolol did an excellent job of controlling the SVT, and it continued doing so for quite a few years. The cardiologist wanted me to have an SVT ablation, but I refused it, thinking the metoprolol was doing so well in keeping the SVT at bay, I didn't need the ablation. The cardiologist said without the ablation I'd have to take the metoprolol for life, and that SVTs/arrhythmias tend to worsen as we get older, and the medication becomes less effective in controlling them. I said "so be it", and refused the ablation.

The metoprolol continued to do a good job at controlling the SVT over the next 10-12 years or so, even when the amount was cut down to 50 mg/day ( at my request), and the PCP added 180 mg/day of diltiazem ER for added blood pressure and SVT control. And I didn't have side effects I was aware of during these times. I took my meds, lived a full busy life and didn't think much at all about the SVT- or my blood pressure, for that matter.

Fast forward to my mid-60's ( about 15 years after that first trip to the ER for SVT), I woke up with the same SVT symptoms ( for me, that was a fluttering in my chest, some chest discomfort- like an overworked muscle is the best way I can describe it, light-headedness and slight shortness of breath) in the wee hours of the morning, got up, sat in the lounger, took my meds and waited, and waited, and waited for the episode to stop. When it didn't about 4 hours later we headed to the ER, where they hooked me up for an EKG and informed me I had atrial flutter- not the same SVT I'd had in earlier episodes. This episode stopped, finally, right after I got into an ER bay, but the doc insisted on admitting me overnight and referred me to a cardiologist.

So, I met the cardiologist the next day, who took me on as a patient, and I still see him to this day. He changed the metoprolol succinate I'd been taking to the shorter acting version ( metoprolol tartrate), changed one of the blood pressure meds, and ordered a 3 week cardiac monitor to see if I had subsequent episodes of A-flutter or fib ( they worry more about these than the garden variety SVT due to the stroke risk associated with these arrhythmias). Over the years I took the metoprolol, diltiazem and blood pressure drugs and we were on the lookout for any of those arrhythmias. My SVT increased several years later after the doc stopped the diltiazem, and this was frequent and bothersome enough to cause quality of life issues, so he increased the metoprolol to 150 mg/day, and this helped to keep them under control.

Fortunately this doesn't happen to everyone, but over the years I developed bradycardia in addition to the SVT- so I had both. I don't know how much of this might have been due to the metoprolol ( bradycardia is a side effect) or whether the metoprolol just made an underlying condition I had worse, or surface, but the bradycardia got worse over a couple years as it became symptomatic and it definitely effected my quality of life. I had three cardiologists ( two EPs and this guy) inform me that the bradycardia was due to an underlying problem I had- sinus node dysfunction- though it was probably aggrevated by the metoprolol- and I had a dual chamber pacemaker implanted in June 2019.
The pacemaker was a game changer in that it made me feel much better, and to this day I continue to take the metoprolol at 150 mg/day, now to control the SVT ( identified as atrial tachycardia by the EP that put in the pacemaker), atrial flutter and atrial fibrillation that I've developed over the years. This drug still does a respectible job at keeping the arrhythmias/tachycardia at bay most of the time. I have some breakthoughs, but these episodes are for the most part brief ( less than 2 minutes, mostly), and don't happen every day. My quality of life is still good, I think I have the pacemaker to thank for that, as it keeps my heart rate where it should be, and also allows me to take enough medication to control the SVTs and company without my heart rate tanking.

@dugroad Thank you for sharing this. My cardiologist told me that I am nowhere near ablation. I wish you well in your strength recovery. I have acquaintances that have had ablation done and fully recovered. I am hoping these SVT's can be controlled with the meds I am on now. I am definitely incorporating vagal maneuvers too. They seem to help. Thank you again.

@marybird Thank you so much for sharing your experience with me. It really opens my eyes to how things can possibly progress. I am happy that the pace maker has made a big difference in your quality of life. That is very important and quality of life is very important to me too. I am a caregiver and need to make sure that I am at my best health possible. I wish you continued good health!

Same here. Symptoms began in my 50s and have become more and more frequent over the past five years. All are short SVT’s, but cause me to begin to lose consciousness. After all the tests and a neurology consult, metoprolol 25mg 2x day, I am headed for my first ablation soon. I am hopeful that the ablation will stop the severe symptoms ,if not the SVT ‘s altogether. This has severely disrupted my quality of life.
If I had one piece of advice to give, it would be to be a strong advocate for yourself, or have someone in your support system who will advocate for you. Don’t give up when you know something is not right

Hi, I have been taking metoprolol 25 mg twice a day for about 3 years. I was diagnosed with SVT and am now 70 years old. I do not have high blood pressure. As I understand it, I am taking this to slow down my heart. It took me about 6 months to adjust to it. I have found it's very important for me to take the pill at the same time every day and with food. Otherwise I get dizzy. I have had some side effects such as insomnia, night sweats occasional shortness of breath and fatigue in the afternoons. I get occasional palpitations and about once a year have a longer lasting episode of SVT. It is scary and my cardiologist says that even on metoprolol you can have occasional breakthrough episodes. I have not personally had any luck with the many vagal maneuvers I've tried. I did take 1/2 a metoprolol tablet during an episode which stopped it within a few minutes . Good luck with your new regimen, I wish you success .

@mrm50 Hi, I'm Marcia, 73 years old. I was born with SVT. Jump over to my storyline for my SVT journey, which exploded like a runaway freight train in Nov 2025. A dedicated cardiologist who jumped right on it when it got out of control, but metoprolol stopped working and my cardiologist strongly recommended an ablation. An excellent electrophysiologist who also jumped right on it. An ablation in March 2026 was a total life-changer for me, as in I have my life back now, no SVT, can do all activities to the fullest of my abilities. Boy did I make the right choice for me!

@osgilian Marcia, may I ask who your electrophysiologist was who did your ablation?