Living with SVT Without Worries

Posted by opiestrer @opiestrer, Apr 8, 2024

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.

Interested in more discussions like this? Go to the Heart Rhythm Conditions Support Group.

@harveywj

This thread is about PSVTs and and not Afib. Comparing the 2 can be very confusing. There is no need to hijack the thread comparing your history of Afib ablation to someone with PSVT ablation.
Key Differences:

Nature of the arrhythmia: SVT is a regular, fast heartbeat, while AFib is an irregular, often rapid heartbeat.

Target area: SVT ablation targets specific pathways or foci, while AFib ablation focuses on the atrial tissue, particularly the pulmonary veins.
Success rates: SVT ablation generally has higher success rates than AFib ablation.

BTW Afib can kill you and or leave you permanently disable with a stroke. The statistics are all over the web.

Jump to this post

If you were to read my comment in toto, With comprehension, you'd have seen that my mention of AF was only to situate me as a patient who has had an ablation, and that ablations fail, not that I have AF. AF is the only difference between me and the person to whom I replied, and it would be unethical to claim otherwise, as you well know. Nothing else about my comment is incorrect, misinformed, or in any way inaccurate. If you'd care to challenge that assertion, kindly produce any evidence you may have. For example, that AF can kill you; nobody dies solely from AF. They may go on to develop comorbidities as a result of unmanaged AF, but people live with AF for literally decades, as you would recall if you had read claims from many posting here. https://drjohnday.com/will-atrial-fibrillation-kill-you/
AF ablation focuses on the pulmonary veins, but also the coronary sinus [ https://pmc.ncbi.nlm.nih.gov/articles/PMC1540703/%5D and the left atrial appendage. Finally, while I cannot dispute that SVT ablation has a substantially better success rate for index ablations, it still has-significant rate of failure which the poster should be aware of, but more-so its rate of recurrence varies depending on the type of arrhythmia that falls under SVThttps://pubmed.ncbi.nlm.nih.gov/34792208/ .
I accept your rebuke that I could have focused my response less on AF than I did.

REPLY
@gloaming

Sorry this has happened. My first ablation was also a failure. The fact is that, statistically across all practicing EPs, the failure rate of first, or 'index', ablations is about 25% with some variance between individuals.
For those new to this topic, after an ablation there is a 10 week 'blanking period' where the heart is meant to re-right itself, calm down, and for the various many burns or lesions created by the ablation procedure to heal and to form a sort of 'coffer dam' around the pulmonary vein mouths, four of them, in the left atrium. The research suggests that many patients will have some ectopy or arrythmia in the first two or three weeks, but a successful ablation will have those incidents drop off quickly. If all seems find, no ectopy, in the first few weeks, but then some incidents begin to happen, the prognosis is poor and the patient and EP should begin to come to terms with the reality. BTW, a 'successful' ablation is one that rids the patient of the treated arrhythmia for one full year. After that, the history across patients is mixed. Some go literally years without incident, some begin to experience a relapse a few months later. The science and practices are still in their infancy.
I wish people, especially those active in treating arrhythmias, were a bit more careful about their use of terminology. Patients are usually keen listeners, and we hear individual words that seem to stand out, or we remember strings of words that we think mean something other than what the counseling practitioner intends. For example, there is no 'cure' for atrial fibrillation....period. The heart after a successful ablation is still a disordered heart. All that has happened is that the EP has ablated successfully and has surrounded the re-entrant for the extra beat signal(s) with scar tissue and prevented the signal from crossing that scar tissue. The signals for the atrium to beat comes from a spreading wave of polarization, of electrical current, that enters and spreads across the entire endothelium. If that signal can be blocked by scar tissue, the signal cannot disperse and cause the unwanted contraction. Still disordered, but no longer able to beat chaotically...which means the EP has improved the symptomology, something he/she is really intent on doing.
I get arguments, but by itself, AF will not kill you. It can make you darned good 'n miserable, and it can be highly intrusive and almost run your daily routines, but it won't kill you. What it MAY do is to progressive to more intractable forms of it, they being persistent, long-term persistent, and permanent. As the heart spends more and more time in AF, its structure begins to change, and this remodeling, as it is called, will bring on other problems that CAN lead to a premature death. So, long to short, I am always pleased to see that people get up the gumption to undergo an ablation. They don't always work, not the first time in some cases, about 25% of the time, but second and third ablations have a higher success rate, and the improvement in quality of life is priceless.

Jump to this post

I don’t have atrial fibrillation and have been told by my cardiologist and EP that SVT is a benign condition that one can live with if the episodes are sporadic and short lasting. Just disappointing that the ablation did not resolve them.

REPLY
@gloaming

Sorry this has happened. My first ablation was also a failure. The fact is that, statistically across all practicing EPs, the failure rate of first, or 'index', ablations is about 25% with some variance between individuals.
For those new to this topic, after an ablation there is a 10 week 'blanking period' where the heart is meant to re-right itself, calm down, and for the various many burns or lesions created by the ablation procedure to heal and to form a sort of 'coffer dam' around the pulmonary vein mouths, four of them, in the left atrium. The research suggests that many patients will have some ectopy or arrythmia in the first two or three weeks, but a successful ablation will have those incidents drop off quickly. If all seems find, no ectopy, in the first few weeks, but then some incidents begin to happen, the prognosis is poor and the patient and EP should begin to come to terms with the reality. BTW, a 'successful' ablation is one that rids the patient of the treated arrhythmia for one full year. After that, the history across patients is mixed. Some go literally years without incident, some begin to experience a relapse a few months later. The science and practices are still in their infancy.
I wish people, especially those active in treating arrhythmias, were a bit more careful about their use of terminology. Patients are usually keen listeners, and we hear individual words that seem to stand out, or we remember strings of words that we think mean something other than what the counseling practitioner intends. For example, there is no 'cure' for atrial fibrillation....period. The heart after a successful ablation is still a disordered heart. All that has happened is that the EP has ablated successfully and has surrounded the re-entrant for the extra beat signal(s) with scar tissue and prevented the signal from crossing that scar tissue. The signals for the atrium to beat comes from a spreading wave of polarization, of electrical current, that enters and spreads across the entire endothelium. If that signal can be blocked by scar tissue, the signal cannot disperse and cause the unwanted contraction. Still disordered, but no longer able to beat chaotically...which means the EP has improved the symptomology, something he/she is really intent on doing.
I get arguments, but by itself, AF will not kill you. It can make you darned good 'n miserable, and it can be highly intrusive and almost run your daily routines, but it won't kill you. What it MAY do is to progressive to more intractable forms of it, they being persistent, long-term persistent, and permanent. As the heart spends more and more time in AF, its structure begins to change, and this remodeling, as it is called, will bring on other problems that CAN lead to a premature death. So, long to short, I am always pleased to see that people get up the gumption to undergo an ablation. They don't always work, not the first time in some cases, about 25% of the time, but second and third ablations have a higher success rate, and the improvement in quality of life is priceless.

Jump to this post

This thread is about PSVTs and and not Afib. Comparing the 2 can be very confusing. There is no need to hijack the thread comparing your history of Afib ablation to someone with PSVT ablation.
Key Differences:

Nature of the arrhythmia: SVT is a regular, fast heartbeat, while AFib is an irregular, often rapid heartbeat.

Target area: SVT ablation targets specific pathways or foci, while AFib ablation focuses on the atrial tissue, particularly the pulmonary veins.
Success rates: SVT ablation generally has higher success rates than AFib ablation.

BTW Afib can kill you and or leave you permanently disable with a stroke. The statistics are all over the web.

REPLY
@slw7252

I was diagnosed with PSVT in May 2024. I had a cardiac ablation in July after having reaction to Cardizem. My medication was switched to Metropolol and Flecanide and I felt the ablation was the better option. However began having episodes again in October. Have averaged 3-4 per month. They never go above 165 and either resolve in30 seconds or with valsalva maneuver. My cardiologist didn’t feel the need for me to go back on meds. Needless to say I was upset that this reoccurred after being told 96% cure rate. I appreciate your comments about not getting upset or stressing over it. This month of March I had one 17 days after the last in February then 9 days later but had one for the next two days. I have started stressing again because of 3 days in a row all while sitting. I walked 4/12 miles three times a week, so feel I am active. I have been reading the forum comments which I was really happy to find this forum. As a retired nurse I know this is a benign condition but there are times… thank you again

Jump to this post

Sorry this has happened. My first ablation was also a failure. The fact is that, statistically across all practicing EPs, the failure rate of first, or 'index', ablations is about 25% with some variance between individuals.
For those new to this topic, after an ablation there is a 10 week 'blanking period' where the heart is meant to re-right itself, calm down, and for the various many burns or lesions created by the ablation procedure to heal and to form a sort of 'coffer dam' around the pulmonary vein mouths, four of them, in the left atrium. The research suggests that many patients will have some ectopy or arrythmia in the first two or three weeks, but a successful ablation will have those incidents drop off quickly. If all seems find, no ectopy, in the first few weeks, but then some incidents begin to happen, the prognosis is poor and the patient and EP should begin to come to terms with the reality. BTW, a 'successful' ablation is one that rids the patient of the treated arrhythmia for one full year. After that, the history across patients is mixed. Some go literally years without incident, some begin to experience a relapse a few months later. The science and practices are still in their infancy.
I wish people, especially those active in treating arrhythmias, were a bit more careful about their use of terminology. Patients are usually keen listeners, and we hear individual words that seem to stand out, or we remember strings of words that we think mean something other than what the counseling practitioner intends. For example, there is no 'cure' for atrial fibrillation....period. The heart after a successful ablation is still a disordered heart. All that has happened is that the EP has ablated successfully and has surrounded the re-entrant for the extra beat signal(s) with scar tissue and prevented the signal from crossing that scar tissue. The signals for the atrium to beat comes from a spreading wave of polarization, of electrical current, that enters and spreads across the entire endothelium. If that signal can be blocked by scar tissue, the signal cannot disperse and cause the unwanted contraction. Still disordered, but no longer able to beat chaotically...which means the EP has improved the symptomology, something he/she is really intent on doing.
I get arguments, but by itself, AF will not kill you. It can make you darned good 'n miserable, and it can be highly intrusive and almost run your daily routines, but it won't kill you. What it MAY do is to progressive to more intractable forms of it, they being persistent, long-term persistent, and permanent. As the heart spends more and more time in AF, its structure begins to change, and this remodeling, as it is called, will bring on other problems that CAN lead to a premature death. So, long to short, I am always pleased to see that people get up the gumption to undergo an ablation. They don't always work, not the first time in some cases, about 25% of the time, but second and third ablations have a higher success rate, and the improvement in quality of life is priceless.

REPLY

I was diagnosed with PSVT in May 2024. I had a cardiac ablation in July after having reaction to Cardizem. My medication was switched to Metropolol and Flecanide and I felt the ablation was the better option. However began having episodes again in October. Have averaged 3-4 per month. They never go above 165 and either resolve in30 seconds or with valsalva maneuver. My cardiologist didn’t feel the need for me to go back on meds. Needless to say I was upset that this reoccurred after being told 96% cure rate. I appreciate your comments about not getting upset or stressing over it. This month of March I had one 17 days after the last in February then 9 days later but had one for the next two days. I have started stressing again because of 3 days in a row all while sitting. I walked 4/12 miles three times a week, so feel I am active. I have been reading the forum comments which I was really happy to find this forum. As a retired nurse I know this is a benign condition but there are times… thank you again

REPLY
@sarahmac

I was diagnosed with SVT 2 years ago and have managed to deal with the symptoms fairly well. I'm 49 and a single mom of two busy teens so to say I'm stressed is probably an understatement. Lately my SVT episodes have been more of the "fluttering" kind - that feeling like my heart is about to start racing with the chest tightness, shortness of breath, tunnel vision but then it fades and goes away - like it changed its mind! But these happen multiple times within a short time frame- over a couple of hours. Anyone else experience this kind of episode?

Jump to this post

The arrhythmia known as SVT has several categories, and among them are flutter and atrial fibrillation. Most patients don't feel flutter, or aren't so annoyed by it that it prevents them from focusing on other business and interests. Atrial fibrillation is a whole 'nuther animal. There are many who also don't feel AF, at least not enough for them to stop what they like doing and to do something about it. But for people like me, it's almost a show stopper. I also felt a bit anxious, sometimes short of breath, feeling like I might keel over. The incessant thumping in my chest wall was what really put me off. I couldn't sleep on my left side because my AF would start within seconds. On my back or on my right side were usually calming...oddly.

It is possible you are becoming more sensitized to the symptoms, maybe because they're more frequent, maybe you're health is iffy in one or more respects so far undiagnosed, you are under more stress....you can figure that out for yourself. However, heart arrhythmias are indications of diseased substrate...the tissue under the endothelium lining each of the four chambers. They can be indications of malfunctioning valves, of fibrosis and collagen deposition from stretching that happens when one side of the heart, or one of the chambers, is 'blown out' by the pressures of the others. Hypertension, as an example, can cause atrial enlargement, even when the arrhythmia is well controlled.

What I am getting at is that your heart lives, and it moves through time, just like the rest of your body and organs. Over time, it changes, and it might not be for the better...especially if it's already disordered, which yours...and mine...are. Your brand of SVT may be premature atrial complexes or they may now be atrial fibrillation. It's not unheard of for hearts to develop multiple foci for re-entering and vortex/rotor signals that can keep a hear muscle contracting in ways that are both counterproductive and awful in how they feel.

Bottom line, if this is new, and it might be new to a specialist, you really should apprise that person. Consult an expert and get them behind you in your struggle to control whichever condition or arrhythmia you have.

REPLY

I was diagnosed with SVT 2 years ago and have managed to deal with the symptoms fairly well. I'm 49 and a single mom of two busy teens so to say I'm stressed is probably an understatement. Lately my SVT episodes have been more of the "fluttering" kind - that feeling like my heart is about to start racing with the chest tightness, shortness of breath, tunnel vision but then it fades and goes away - like it changed its mind! But these happen multiple times within a short time frame- over a couple of hours. Anyone else experience this kind of episode?

REPLY

I have had SVT for 30+ years. My cardiologist verified that one can be in SVT with a heart rate less than 100 BPM. That’s what’s been happening to me daily for over a month, and it’s very uncomfortable. When an episode kicks in for me with a fast HR (>120-130), I have great success aborting it quickly with a Val Salva maneuver. It’s much harder to convert back to NSR (normal sinus rhythm) when it’s SVT with a rate less than 100. Twice I’ve had to dunk my face in an ice bath, after all my other methods failed. Last night lying in bed , my HR was only 84, but again it was SVT and I was able to abort it down to what it should have been, HR of 64, by blowing into my 10 cc syringe.
Just wondering if anyone out there has suggestions.

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@cmcg

Note that we now have two different streams talking about SVT. Here’s a recent article from. The National Library of Medicine on SVT and it mentions the REVERT procedure. Do note however, it talks about the initial Valsalva being done for 60 seconds. We would all likely pass out if we did Valsalva for 60 seconds. The specific literature on REVERT says 15 seconds for both has one and two of the REVERT. Because I am usually exercising when this happens ( so already have elevated BPM, I can barely hold my breath for 15 seconds… sometimes it is only 10-12 but it still works!
https://www.ncbi.nlm.nih.gov/books/NBK441972/
PS I am an RN, so always want to see the official evidenced based researched articles… particularly w the complexity of arrhythmias and the many different types!

Jump to this post

Thanks for the article! The original research came out of Europe (France, I believe). The 60 second valsalva must be an error. I will send letter to the editor. Have to find the original article to share the correct evidence. No one could hold a valsalva for 60 secs!

REPLY
@cmcg

Note that we now have two different streams talking about SVT. Here’s a recent article from. The National Library of Medicine on SVT and it mentions the REVERT procedure. Do note however, it talks about the initial Valsalva being done for 60 seconds. We would all likely pass out if we did Valsalva for 60 seconds. The specific literature on REVERT says 15 seconds for both has one and two of the REVERT. Because I am usually exercising when this happens ( so already have elevated BPM, I can barely hold my breath for 15 seconds… sometimes it is only 10-12 but it still works!
https://www.ncbi.nlm.nih.gov/books/NBK441972/
PS I am an RN, so always want to see the official evidenced based researched articles… particularly w the complexity of arrhythmias and the many different types!

Jump to this post

Hi…. I too am an RN and learned the REVERT procedure from ED doc friend. I am now 11/11 successful REVERT procedures. I have been med free for over a year! I too typically get my SVT when exercising. I find that I can only do the initial valsalva for 10 secs max. And I just blow into my fisted hand to mimic the 10 ml syringe ( that the research used). Important for people to know that a 10 ml syringe is not essential. What is important is doing a valsalva maneuver for 10+ seconds at a 45 degree angle. Best to look at valsalva maneuver on google to see it demonstrated.

REPLY
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