What to do when in SVT (supraventricular tachycardia)?

Posted by ashby1947 @ashby1947, Jan 7 8:18am

I have had several episodes of SVT, the last of which landed me in the hospital for several days and a change of medication to diltiazim (along with my many others). I will be reviewed by an EP in a few months (!) and probably discuss having an ablation. I have a very complicated heart history – open heart surgery to repair mitral valve, episodes of Afib, cardioversions, an ablation, etc., but overall am in very good health. My heart and I get along pretty well! This SVT is annoying, however. When I’m in an episode, I try vagal maneuvers, which has worked a couple of times. Otherwise, I have to head to the hospital with my heart rate thundering at 160 – 190. I’m not really frightened by all this, probably because I”ve been through so much; however, the fear of SVT is ever present. This causes me to restrict airplane travel and activities which would involve not being close to a hospital. I mean, what do I do at 35,000 feet when I can’t get my heart rate down and I’m 4 hours ( 8 hours on an oversees flight) away from land? If you have had any experience with SVT, I would welcome your experience and suggestions. I hope this finds you all well! Thank you, Sue

Hi i can definitely relate to you situation. Has anyone mentioned a pacemaker difibulator. I too would get vts that ranged well up in the 150 to 200 range and lots of them would be corrected by pacing me and on occasion a shock to get me back in sinus rhythm. At least then you would not have to worry about not being near a hospital as much.

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The best thing I did was to have the ablation about 15 years ago. It worked and never had it again. Tired of going to hospital and have them stop my heart and then restart it .

Liked by slynnb

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My experience with SVT's is quite different. I have an un-diagnosed autoimmune disease. I have been admitted to 5 different hospitals from Sept. 2017 through June 2018 including about 2 weeks in the Mayo hospital in Minnesota. SVT and fluid filled lungs were my first of many symptoms. I did not know why I was so exhausted and could hardly stand up or walk until going to the ER and being rushed in an exam room because my heart was racing. They tried the "vagus" maneuvers and had no luck. They used medication (too much) 60 mg because my husband said I flat lined and my whole body was shaking violently. But it worked. Throughout my illness which was total body inflammation finally going into total kidney shut down included many times of SVT but after this initial time they occurred only in the hospitals leading me to believe, in my situation, to be somewhat driven by anxiety. Cardiologist did say I needed ablation but had to recover to even consider it. The last time I was in the hospital, I kept having SVT after SVT with me losing count after 5 and the hospital staff panicking and bringing the crash cart in, hooking me up, etc. etc. I finally said to a specialty nurse that I wanted to take a Xanax and wait 30 minutes to see if I could stop it myself. He allowed it and it worked. Two times in a row, it worked. I have not had any SVT since which is about a year now but my body is recovering in other ways. I do not take Xanax regularly. But I do have anxiety and use it as needed. I do not have any heart issues that were found except fluid around my heart that was removed, inflammation again, and have recovered enough to have normal inflammation markers for the last almost year and my kidney's recovered in 4 months so that I was removed from dialysis.
Every doctor I have seen says I am a puzzle. I take Colchicine and a very low dose of Prednisone (2 mg at present) and pray that I can recover if my illness comes back. They say they can't give me anything else because they don't know what it is.
This story may not have helped you and after having 5 lengthy hospital stays, I have left much out. I just felt that my SVT story is different because I recovered without an ablation.
I wish you the best.

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First, find a cardiologist whom you trust and can easily discuss EVERYTHING. My husband was in a situation similar to yours; I'm an RN and accompanied him to everything. After 2 scary hospitalizations, endless testing, recommendations, certain suggestions he did NOT want to follow… We decided on ablation. It is a very common established procedure, and very low risk in the hands of an experienced interventional cardiologist. Don't be afraid to ask the doctor about his complication rate, experience, alternatives to ablation, etc. For example, my husband did NOT want an ICD, but he also didn't want any more adenosine.

The procedure went very well, and he's been symptom free since that very day! Keep in mind: you'll need to be on a blood thinner for a while, the procedure is typically done under general anesthesia, be certain you get a clear picture of the risks and benefits of both the procedure and the anesthesia, and that you'll need pre- and post-procedure testing and follow up. He is doing great, and we're very happy with our decision.

Liked by slynnb

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I had SVT . Best thing I ever did was have the ablation. Didn't have to be on blood thinner.

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Hello @ashby1947,

Supraventricular tachycardia (SVT) is caused by faulty electrical signals in your heart that originate above your ventricles. Your ventricles are the lower chambers of your heart, and if there’s an extra electrical pathway (or pathways) in your heart between your atria (the top chambers of your heart) and your ventricles, it acts like a short circuit. https://www.mayoclinic.org/diseases-conditions/supraventricular-tachycardia/symptoms-causes/syc-20355243

Treatment for SVT aims to control your heart rhythm and rate, and depends on your symptoms. Some people don’t need any treatment at all, and symptoms may go away on their own. Most people with SVT are able to fly safely – flying does not increase your risk of having an episode. Make sure to stay well hydrated and avoid caffeine.

I’ve had SVT ever since I can remember, so I do know how debilitating these episodes can be. There were no restrictions placed on flying, and I underwent cardiac ablation a few years ago – my episodes were getting prolonged, occurred very often, and I couldn’t stop the fast heart rate with any of the vagal maneuvers. In my case, my heart rate was 210 beats per minute –– in SVT, your heart may beat between 140 to 250 beats per minute. Most people experience an improvement after SVT ablation, but there’s a small chance that palpitations may return, and the procedure can be repeated.
But, here I am, and so far so good!

Fortunately, SVT is rarely life-threatening, yet if your heart races for more than a few minutes, or if you start experiencing chest pain, you should go to the emergency room. SVTs are not considered to be dangerous or life threatening, but frequent episodes can weaken the cardiac muscle over time.

I’m tagging @ronbyrd @sue225 @ajmario @ktcrosswalk1 @jigglejaws94 @loli @cheris @martishka @texas7777 @mikeyp @anniegk @predictable to see if they can shed more light on your situation. You may also wish to view these discussions on Connect:
– Supra Ventricular Tachycardia (PSVT) and Running https://connect.mayoclinic.org/discussion/supra-ventricular-tachycardia-psvt-and-running/
– Feeling Skipped Beats, Palpitations: What could this possibly be? https://connect.mayoclinic.org/discussion/what-could-this-possibly-be/
– New and totally lost https://connect.mayoclinic.org/discussion/new-and-totally-lost/

@ashby1947, has your doctor mentioned if medication could be causing these episodes?

Liked by yoanne

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Hello Ashby, I can certainly relate to how you feel. I have had SVT since I was a little girl- And I clocked in between 210 and 240. I reached a point, about 7 years ago when meds were not working. A PVA (pulmonary vein ablation) solved the problem for me. I understand your feelings about flying , or being in a situation where an emergency room visit isn't viable. I realized, once I started feeling limited in my choices because of my heart I had to find a more permanent solution. I would like to say that I avoided any suggestions regarding a pacemaker, mainly because you would have to be pacemaker dependent, with a sinus node ablation. I think that there are other avenues and choices before making that one. I had SVT since I was a young child, (am now 68) and in my 50's I developed atrial fibrillation and atrial flutter. I did have 4 failed attempts at ablations but it was the 5th, more extensive, PVA that was successful. So far, so good. If you are feeling that your symptoms are interfering with your life choices I would think its time to find a better solution. I wish you luck and an appointment with a good EP!!

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When we have someone like Kanaaz (@kanaazpereira) to reassure us on a medical problem that gives us worry, we don't need much else until it's time to submit to medical professionals for treatment. Her posting on SVT is the best I have seen on this vexing problem and the outlook needed by SVT victims to keep on keeping on despite a rushing heartbeat, sometimes with chest-rattling palpitations, but often not so fearful.

In my case, the SVT is a condition that recurs in my wife's heart (while I deal with atrial fibrillation). Her SVT started with her diagnosis of diabetes-2 about 25 years ago, then stayed in the background until last year when it returned for two worrisome episodes. Last Spring, a new cardiologist tried medicinal cardioversion with XCartia (a version of Diltiazem) that warded off palpitations for several months, but side-effects (mainly edema in her extremities) ended that therapy. He switched her to Flecainide which lasted a few months until dizziness, instability, and fatigue forced a return to the Tenormin (Atenolol) she had taken for several years to combat the arrhythmia that manifested as PSVT — paroxysmal (unpredictable) supraventricular tachycardia.

Crucial to my wife has been her moderately heavy exercise regimen. She was forced off of that with her PSVT episode last Spring and remained largely unexercised through last November. But now, back on Atenolol, she is pretty comfortable with the prospect that an episode is unlikely, but if it recurs, she knows how to handle it. Her Flecainide is now on standby for use only as-necessary if a new episode occurs.

Ablation of the errant tissues in the heart is on her list of options, but in reserve if any serious recurrence sends her to the Emergency Room a mile from home.

I hope her experience with PSVT and its treatment is reassuring for Connect members with the problem. She has learned how to handle the threat and the episodes themselves and looks forward to her 83rd birthday in the coming Summer. Martin

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@predictable

When we have someone like Kanaaz (@kanaazpereira) to reassure us on a medical problem that gives us worry, we don't need much else until it's time to submit to medical professionals for treatment. Her posting on SVT is the best I have seen on this vexing problem and the outlook needed by SVT victims to keep on keeping on despite a rushing heartbeat, sometimes with chest-rattling palpitations, but often not so fearful.

In my case, the SVT is a condition that recurs in my wife's heart (while I deal with atrial fibrillation). Her SVT started with her diagnosis of diabetes-2 about 25 years ago, then stayed in the background until last year when it returned for two worrisome episodes. Last Spring, a new cardiologist tried medicinal cardioversion with XCartia (a version of Diltiazem) that warded off palpitations for several months, but side-effects (mainly edema in her extremities) ended that therapy. He switched her to Flecainide which lasted a few months until dizziness, instability, and fatigue forced a return to the Tenormin (Atenolol) she had taken for several years to combat the arrhythmia that manifested as PSVT — paroxysmal (unpredictable) supraventricular tachycardia.

Crucial to my wife has been her moderately heavy exercise regimen. She was forced off of that with her PSVT episode last Spring and remained largely unexercised through last November. But now, back on Atenolol, she is pretty comfortable with the prospect that an episode is unlikely, but if it recurs, she knows how to handle it. Her Flecainide is now on standby for use only as-necessary if a new episode occurs.

Ablation of the errant tissues in the heart is on her list of options, but in reserve if any serious recurrence sends her to the Emergency Room a mile from home.

I hope her experience with PSVT and its treatment is reassuring for Connect members with the problem. She has learned how to handle the threat and the episodes themselves and looks forward to her 83rd birthday in the coming Summer. Martin

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hello martin, as I wrote before in some posts, I showed a unexpectent development after the implantation of the 2-chamber pacemaker. shortly after the implantation I was told, that I had A-Fib's, which is not unusual. I should not worry, as long as I do not feel the A-Fib's.In the following months the number of the A-Fib's went up (recorded by the pacemaker). I should again not worry.
but one year later my clinical condition deteriorated quite fast. echo-cardiog. showed a left and right heart failure, only digitoxin saved my life. but still I have 94% A-Fib's. my cardiologist thinks, that the A-Fib's from the atrium went over to the ventricles and causes the ventricular arrhythmia. I feel good now thanks to the digitoxin, but who can assure me, that this won't happen again? (I have still 94% A-Fib's).
I proposed the cardiologist an ablation , but this would be new. on the other hand I know that an ablation is done in patients with an implanted defibulator, where the Defi has to "chock" too often , a very unpleasant experience for the patients. Only a few hospitals are able to do this kind of ablation (in the ventricles). My cardiologist does not like the idea of an ablation in a patient with a pacemaker ,.
so I do not know what to do. It is easy to say, look for an expert, but honestly said, I won't disappointed my cardiologist.
my story shows that doctors and patients should be alert all the time don't you agree?.
yoanne

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@yoanne

hello martin, as I wrote before in some posts, I showed a unexpectent development after the implantation of the 2-chamber pacemaker. shortly after the implantation I was told, that I had A-Fib's, which is not unusual. I should not worry, as long as I do not feel the A-Fib's.In the following months the number of the A-Fib's went up (recorded by the pacemaker). I should again not worry.
but one year later my clinical condition deteriorated quite fast. echo-cardiog. showed a left and right heart failure, only digitoxin saved my life. but still I have 94% A-Fib's. my cardiologist thinks, that the A-Fib's from the atrium went over to the ventricles and causes the ventricular arrhythmia. I feel good now thanks to the digitoxin, but who can assure me, that this won't happen again? (I have still 94% A-Fib's).
I proposed the cardiologist an ablation , but this would be new. on the other hand I know that an ablation is done in patients with an implanted defibulator, where the Defi has to "chock" too often , a very unpleasant experience for the patients. Only a few hospitals are able to do this kind of ablation (in the ventricles). My cardiologist does not like the idea of an ablation in a patient with a pacemaker ,.
so I do not know what to do. It is easy to say, look for an expert, but honestly said, I won't disappointed my cardiologist.
my story shows that doctors and patients should be alert all the time don't you agree?.
yoanne

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Sorry @yoanne to hear about your A-fib difficulties in this posting, especially the decline in your clinical condition. A similar decline in mine appears to be attributable more to my kidneys than my heart (my hypertension shot up to an emergency level a few weeks ago). Relentless alertness for symptoms that signal trouble ahead is absolutely necessary, and I'm glad to report that my Personal Care Physician once again surprised me with a warning that my kidneys may have caused or contributed to the emergency, and she referred me to Nephrology again (after three years of previous treatment there). I learned from this and previous experience with my medical team that "to be alert" should not mean calling the tune for the medical team to satisfy my personal, subjective view of what's happening. Instead, the alert should lead me to ask questions that are suggested by my experience with my symptoms, affording my doctors crucial information that may lend more meaning to results of various medical tests and medications. In this way, a respectful relationship with the doctors gives more meaning to the word "team" in describing cooperation toward control, if not cure. Martin

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@yoanne

hello martin, as I wrote before in some posts, I showed a unexpectent development after the implantation of the 2-chamber pacemaker. shortly after the implantation I was told, that I had A-Fib's, which is not unusual. I should not worry, as long as I do not feel the A-Fib's.In the following months the number of the A-Fib's went up (recorded by the pacemaker). I should again not worry.
but one year later my clinical condition deteriorated quite fast. echo-cardiog. showed a left and right heart failure, only digitoxin saved my life. but still I have 94% A-Fib's. my cardiologist thinks, that the A-Fib's from the atrium went over to the ventricles and causes the ventricular arrhythmia. I feel good now thanks to the digitoxin, but who can assure me, that this won't happen again? (I have still 94% A-Fib's).
I proposed the cardiologist an ablation , but this would be new. on the other hand I know that an ablation is done in patients with an implanted defibulator, where the Defi has to "chock" too often , a very unpleasant experience for the patients. Only a few hospitals are able to do this kind of ablation (in the ventricles). My cardiologist does not like the idea of an ablation in a patient with a pacemaker ,.
so I do not know what to do. It is easy to say, look for an expert, but honestly said, I won't disappointed my cardiologist.
my story shows that doctors and patients should be alert all the time don't you agree?.
yoanne

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@yoanne ho yes i had a few ablations over my 10 years with a pacemaker im surprised your doctor is Leary of it. All of my EP Doctors i had over the years did ablations on people with pacemakers. So if you live in the Phoenix Arizona area i can suggest some. But also my last ablation was at Mayo Clinic in Phoenix and even tho my heart was too far gone they had no problem doing it with a pacemaker. Good luck and God Bless. Im here if there are any questions you may have.

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So glad to read your post. but there is one big problem, as I do not live in the united states. It is good to know though, when I should contact the Heart center /University clinic Germany/Cologne. . These institutes have international contacts all over the world.
thanks for your encouraging words!
yoanne

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@kanaazpereira

Hello @ashby1947,

Supraventricular tachycardia (SVT) is caused by faulty electrical signals in your heart that originate above your ventricles. Your ventricles are the lower chambers of your heart, and if there’s an extra electrical pathway (or pathways) in your heart between your atria (the top chambers of your heart) and your ventricles, it acts like a short circuit. https://www.mayoclinic.org/diseases-conditions/supraventricular-tachycardia/symptoms-causes/syc-20355243

Treatment for SVT aims to control your heart rhythm and rate, and depends on your symptoms. Some people don’t need any treatment at all, and symptoms may go away on their own. Most people with SVT are able to fly safely – flying does not increase your risk of having an episode. Make sure to stay well hydrated and avoid caffeine.

I’ve had SVT ever since I can remember, so I do know how debilitating these episodes can be. There were no restrictions placed on flying, and I underwent cardiac ablation a few years ago – my episodes were getting prolonged, occurred very often, and I couldn’t stop the fast heart rate with any of the vagal maneuvers. In my case, my heart rate was 210 beats per minute –– in SVT, your heart may beat between 140 to 250 beats per minute. Most people experience an improvement after SVT ablation, but there’s a small chance that palpitations may return, and the procedure can be repeated.
But, here I am, and so far so good!

Fortunately, SVT is rarely life-threatening, yet if your heart races for more than a few minutes, or if you start experiencing chest pain, you should go to the emergency room. SVTs are not considered to be dangerous or life threatening, but frequent episodes can weaken the cardiac muscle over time.

I’m tagging @ronbyrd @sue225 @ajmario @ktcrosswalk1 @jigglejaws94 @loli @cheris @martishka @texas7777 @mikeyp @anniegk @predictable to see if they can shed more light on your situation. You may also wish to view these discussions on Connect:
– Supra Ventricular Tachycardia (PSVT) and Running https://connect.mayoclinic.org/discussion/supra-ventricular-tachycardia-psvt-and-running/
– Feeling Skipped Beats, Palpitations: What could this possibly be? https://connect.mayoclinic.org/discussion/what-could-this-possibly-be/
– New and totally lost https://connect.mayoclinic.org/discussion/new-and-totally-lost/

@ashby1947, has your doctor mentioned if medication could be causing these episodes?

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I recently wore a heart monitor for 2 weeks and had frequent SVT episodes along with other symptoms of what I call " nerve dumping" I will get internal vibrations and SVTs/PACs and then like a release when it's over and I feel nerve pain I mostly in my left side and right Glute. It's the oddest thing, but no doctor in my area can explain it.
My SVTs/PACs started suddenly about 5 months ago. Should i be concerned about a sudden onset? I've had an ECHO and 2 EKG that show them, but my cardio says my heart is healthy. I find it odd that these started abruptly and wake me frequently in the night as well.

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@brayimee

I recently wore a heart monitor for 2 weeks and had frequent SVT episodes along with other symptoms of what I call " nerve dumping" I will get internal vibrations and SVTs/PACs and then like a release when it's over and I feel nerve pain I mostly in my left side and right Glute. It's the oddest thing, but no doctor in my area can explain it.
My SVTs/PACs started suddenly about 5 months ago. Should i be concerned about a sudden onset? I've had an ECHO and 2 EKG that show them, but my cardio says my heart is healthy. I find it odd that these started abruptly and wake me frequently in the night as well.

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@brayimee Hi I am so sorry you are not having much luck with the symptoms your having. I suffered with VT for quite a while and can honestly relate. I read thru your past posts and my question is have you actually seen a specialist in Electrical issues with the Heart. I see you mentioned a Cardiologist but there are different specialists in that field. You may want to find one called an EP Cardiologist who specializes in the electrical areas of the Heart and also even within EP's there are some that lean towards Afib and others that are more towards VT type issues. But I know those feelings of pain after an episode. They sound like Arrhythmias or basically a fast heartbeat but there different. Depending on what part of the heart is moving fast it starts to quiver and blood basically stops flowing. So when your heart returned to a normal beat it's like the feeling you get when as we used to call it "my arm fell asleep" when the circulation got stopped. But when it's your whole body it is a bit different. So my suggestion is to find a doctor that specializes with SVT. If you would like and let us know where about you live maybe someone here knows some good places in your area.
Have a Blessed Day
Dana

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Oh wow! Yes, I do feel that fall asleep pins and needles feeling and the nerve pain I feel is a burning in my left flank, along side my left navel along with a general ache, down into where I broke my left foot and in my right glute ( maybe sciatic nerve), I get very weak legs, I also become very bloated and full feeling frequently like my intestines shut down. So many weird symptoms, but I feel they coincide with my heart.
I hadnt realized there were different specialists. I've only seen a Cardiologist whom I see tomorrow to discuss my symptoms because I was t satisfied with his answer that they were not dangerous and if symptoms are to much, he'd give me medication. I thought he'd be more concerned that I've suddenly developed these episodes and I can't excersize these last 5 months because of these issues. Going up stairs raises my pulse to 150. For a thin, normally healthy person, I feel this is not normal.
I am in the Grand Rapids, MI area.
I sure do appricate all and any advice and help.
I also started a post of my own Internal vibrations and nerve "firing"
Aimee

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