SVT Medications

If I had a choice, I would take the ablation. I am on Diltiazem and Metoprolol. An ablation will not work for me so I take the meds. I have had no adverse reactions. Good luck!

Hi @lisadib and welcome to Mayo Clinic Connect. I am terribly sorry you have been dealing with this for 20+ years with no relief or answers! That must be frustrating when you are such an active person. We have lots of members that are in similar situations as you are currently.
I'd like to invite @damari, @bbeebe1943, and @cturner01 to the conversation. Along with the groups mentor, @predictable.

You might also be interested in the following articles related to your topic.
– Metoprolol Succinate Side Effects by Likelihood and Severity https://www.webmd.com/drugs/2/drug-8814/metoprolol-succinate-oral/details/list-sideeffects
– Mayo Clinic: Diltiazem https://www.mayoclinic.org/drugs-supplements/diltiazem-oral-route/side-effects/drg-20071775

Damari also started a similar conversation that you can view here. https://connect.mayoclinic.org/discussion/afib-5/

Lisa, have you discussed with your physician the side effects you are experiencing? Has he or she mentioned the quality of life return with the medication versus the ablation?

Hi,
Thank you. The medication is new to me, I've only been on for about 5 weeks. Prior it was as needed. Yes, discussed with the doctor yesterday, but was very disheartened as although I'm very active -- but not an athlete -- I felt like the EP was pushing me towards meds vs. ablation, which I was very frustrated with. He was also very dismissive. My SVT episodes last a long time and vagal maneuvers no longer work to break them. I haven't started the Diltiazem yet as after reading it's side effects, seemed very unappealing. I'm essentially biding my time until Feb. 10th when I get another opinion from another cardiac group. Just was curious about others' experiences and side effects. I'm on a small dose of metoprolol - 1/2 25mg tablet twice a day. The EP recommended 120mg of Diltiazem once a day. I am very active and don't like how I'm feeling on the meds.

Hi @lisadib. I'm glad to make myself available at Amanda Burnett's invitation in the hope that I can help settle your mind about dealing with SVTs. My own electrophysiological problem is atrial fibrillation. My wife endured several months of SVT about 9 years ago. Her treatment was -- and continues to be -- simply 25mg of Atenolol every morning. She can't remember her last episode of tachycardia. Atenolol is a beta blocker, a cousin of Metoprolol, but its narrower range of effects appears to make it easier to accommodate.

My medications, like yours, include a beta blocker, Carvedilol (Coreg brand name), Lisinopril, and Amiloride (a diuretic) mostly to treat high blood pressure. When I had a small stroke a few years ago, Carvedilol became a primary medication. Before that I was on Diltiazem for some time, but talked my medical team into a change because of swelling in my ankles and feet.

That takes me to another emphasis that might be helpful. I have been fortunate to get my medical care from an HMO that (like Mayo) puts a premium on teamwork and counts the patient as a member of the team. When I need to change therapy my doctors give me advance notice so that I can get prepared to discuss it with them before a decision is made. In an emergency situation, I'm at their disposal and anxious to have them take over without waiting for me to argue about it. As you can imagine, I have found a relationship with my medical professionals that I value and will preserve, and if it becomes necessary, I'll make every effort to replace them with equally partnering people. Are you situated so that you could build your own medical team to work with? Martin

I have SVT following heart surgery for five holes in the middle of my heart. I have recently discovered why I had so many problems with medication. I am a poor metabolized of several heart meds due to the CRP2d6 gene. I am wondering if anyone else has had gene testing done for meds.With this gene there is only one antidepressant that my body can metabolize properly.

Thank you for all of this useful information, Martin. I had a day and a half-long svt (with some atrial flutter mixed in) 5 days ago for the first time since getting a pacemaker about 8 weeks ago. My doctor has asked me to take 25 ml of Metroprolol per day. While I'm relieved to have the protection, I don't like the way it makes me feel, though some of how I feel may just be sadness and frustration since - while I knew the pm couldn't prevent arrhythmia - I had felt so much better with it and hopeful that it would pave the way to a life more free of these disruptions and all of the fear and worry they produce. It's good to know that there are other medications out there and other people who have some experience with this.

@daliea, I moved your question about SVT and medications to this existing discussion.
- SVT Medications https://connect.mayoclinic.org/discussion/svt-medications/

I did this so you could read past suggestions by members and connect with others like @ajnewyork @predictable @lisadib and @bjanderson.

Genetic testing or pharmacogenomics has great promise and has made important strides in recent years. While pharmacogenomics is still in its early stages, progress in this field points toward a time when pharmacogenomics will be part of routine medical care — at least for some drugs. https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/personalized-medicine/art-20044300

@daliea, what led to your getting genetic testing to discover that you metabolize some drugs poorly?

Hi @daliea, I'm not sure I have experiences you'd find valuable, although it's possible that my gene tests are slightly relevant. For context, my main problems are AFib, hypertension, and related kidney disease. The nucleus of the diseases is my high blood pressure that was studied, diagnosed, and treated by Nephrology rather than Cardiology. Gene testing was useful for exploring a kidney cyst and checking for excess aldosterone from my associated adrenal glands, but pivotal in identifying potassium deficiency as a basic cause of my blood pressure problem.

One cause of that hypokalemia was the Liddle Syndrome, an inherited mutation of kidney tissues that fails to recover potassium from urine as it is withdrawn by the kidneys from the blood. As a result, my diuretic is an offbeat variety, Amiloride, which preserves potassium. Eating potassium-rich foods rounds out my therapy for that problem.

In contrast, genetic tests established that neither my kidney cyst nor excess aldosterone were attributable to my heritage, and that simplified my medicinals greatly. My AFib may be a result of hypertension, but that seems speculative without genetic information to prove it, so my main medicine is Coumadin (Warfarin), an anticoagulant for preventing formation of blood blots within an atrium of my heart. That failed me once, and I suffered a "small stroke" that has caused minor problems with physical balance and sensory functions, but no other conscious symptoms of heart dysfunction.

This calming of my heart beat may be attributable to Carvedilol, a beta blocker that slows and eases heart beats and widens arteries to improve blood flow. Like you, my wife encountered SV tachycardia some years ago and has dealt with it with Atenolol, another beta blocker; it has essentially eliminated incidents of accelerated heart rate. Martin

I find that any information from others about their conditions and treatments are very valuable to me.Having a conversation about medical issues with others who are struggling gives me hope and I don’t feel so alone knowing that there are many others just like me.