SVT symptoms sporadic; cancel ablation?

Heart health and blood vessels
1

I was diagnosed with SVT two year's ago (now 57) but the symptoms were infrequent enough and manageable so my doctor agreed that doing nothing was perfectly acceptable.  In my case, symptoms have been a racing heartbeat (190 - 205 bmp) while doing aerobic exercise (jogging, cross country skiing) but I have learned how to restore the bmp to a normal rate fairly quickly.  

I decided to see if it was time to consider catheter ablation only because the rapid heart beat incidents had become more regular while jogging, etc. this fall.  So, I have an ablation scheduled for late January of 2016 but now I am having second thoughts.  The reason is that occurrences of an elevated heart rate while exercising (jogging) have seemingly gone away over the past 4to 6 weeks.  Not sure why as I've gone back to drinking as much caffeine (a likely trigger in my case or so I've thought) as I used to drink, etc.  I hope to finally be cross country skiing in the next couple of weeks which will be a better test.  If the SVT incidents don't resume while skiing, I'm wondering whether I shouldn't cancel the ablation.

Have any of you had the symptoms appear regularly and then disappear just as quickly?

Thanks for any and all feedback.

Jim 0 votes  Report  Share reply to jim53704

 

2

Hi Jim

I've been in the same quandary before.

I'm 43, diagnosed with SVT at 30 and I had a 30 minute episode every 18 months or so for the first 6-7 years. Then every year, 9 months, 6 months until I was getting it every 12 weeks.

My heart rate was similar to yours, upto 240 BPM.

What's interesting though is that exercise never brought mine on. Cycling, swimming, rugby - nothing.

I visited the cardiologist again August 14 and had the same conversation, it was comical really because he just sat there and said "you know all the options, what do you want to do"!

I hate medication and have never taken any. Not wanting to be tied down to taking regular meds, as well as the side effects.

What made me sit up on this visit was the fact that SVT can be controlled by breathing etc (in 10 years I've only needed adenosine twice) but it will never go away and in 99% of cars the episodes increase in frequency and duration. There's also an increased risk of stroke as you get older.

So I booked in for the ablation and had this done Nov 14. It was honestly the best thing I've ever done.

I've had no SVT since, it is incredible but a quick blast of the rouge electrics and done. They put you into SVT in the cath lab and for me whilst ablating the cardiologist removed the pathway and it instantly put my heart into sinus rythum.

I now have a resting heart rate of 50. The biggest win though is the psychological effect. Will it start on the ferry, plane, motorbike, wedding reception? I was beginning to let it rule me and it's like I've never had it.

I had AVNRT the most common SVT and 97% treatable.

You're a fit guy, why don't you go for the procedure, they do the physiology at the same time. Let them figure out which type you have, how easy it is to treat and then give it the final nod. That's what I did, when I knew it was easy to fix I said go for it and he did.

It's a personal decision, but my advice is sort it now while you're in good shape and not let it effect you any more.

Enjoy the skiing!

All the best

Chris

3

Pasty Man,

Thanks much for your response.  What gives me pause about going ahead with the ablation is:  1) now that I know what works for me in terms of interrupting an episode (bearing down like you're going to have a BM), my rapid heart beats never last more than a few minutes; 2) I finally skied again today (we were lacking snow) but didn't generate an episode; haven't had one in weeks; 3) somewhat worried that I could make an infrequent "nuisance" into some other bigger issue if they have trouble generating the symptoms at the time of the ablation and zap the wrong area.

Are you saying that they do the "physiology) once they put the catheters in and, thereby, correctly determine the type of SVT and the area to be zapped all as part of the ablation procedure?

thanks again for your time sharing your knowledge!

4

Hi Jim

I'm not sure how much you know about the procedure, apologies if I'm overlapping.

You're correct, basically they give you a large shot of local in your leg, they insert a decent sized cannula and then feed in 4 catheters. You can see them on the monitors in your heart which is a bit weird!

Once everything is in place they send an electric pulse to the nodes in your heart to trigger the SVT. Mine was hard to trigger and after 30 minutes of trying I had two big hits of adrenaline to get it going. It's not common that they need to do this, but mine didn't trigger by the usual methods.

When your heart is in the SVT rythum, by pulsing parts of your heart they can determine your type. At that point it's go/no go. If a go, they insert an ablation catheter and then quickly and accurately ablate the identified pathways.

There's a difference of option on this stage. Some people can feel it, I didn't feel a thing - and I had no sedation.

You have identified something I was worried about and that's hitting the AV node whilst ablating. As you know this can make things worse and result in a pace maker. I was slightly more relaxed about this though because the cardiologist doing my procedure is one of the most experienced in the field with a near perfect success rate for not hitting the AV nod during this procedure after doing over a 1000 of these over 10 years - a question to ask yours?

I work in the NHS and have gained a wide range of advice but it is a tough personal choice. With a good consultant at the helm though it can have a positive life changing effect.

I hope that helps.

All the best

Chris

5

Yes, that helps a LOT.  Thanks so much!  Happy New Year!

6

Hello Chris,

may I ask for the name of your cardiologist with whom you had the ablation? I am thinking about having it done -- even though my episodes are not that frequent (1 per year, 240bpm) I am lately so terrified of having one, that I refuse to climb stairs or do any sort of exercise as a slowly increased heart beat gives me a massive pannic attack . I am also petrified of choosing the wrong person to have it done by and hence, would appreciate the information!

Thanks a lot!

Pavli

7

Hi Pavli

Dr Alistair Slade, Royal Cornwall Hospital is the chap that did mine.

I am assuming that you know and use all of the rescue techniques?

This is clearly having an effect on you, I wouldn't hesitate to get it done. The success rate is very high.

Do what it did - tell them to do the study, find the problem and then take their advice. Mine was a quick blast (no pain) and I've had no SVT since.

Good luck, happy to answer more if needed.

Chris

8

Thank you for the answer. I am seriously considering having it done, albeit the rare episodes. I have been told about the squatting and breath holding manouvre, but so far it has been unsuccessful for me, probably because out of panick I am not doing it right. I read somewhere that drinking very cold mineral water does the trick for some people, so that's on my list for next time. I have just moved to London from Germany and research has shown a certain Dr. Schilling to be quite good (although his main interest is AF ablation), so am going to try and get an appointment with him. It is amazing how hard it is to find statistics on procedures and Dr. names or am I not hitting the right websites ?

Cheers,

Pavli