Apple Watch ECG - is this SVT?

[Arrythmiaconfusion]

I have had both IST and SVT (short runs) caught on holters previously. Also had a bad case of myocarditis a few years ago that left diffuse scarring.

Recently my HR went above 160bpm, when I would have expected 100-120, and I may have had a longer run of SVT (attached). I was stressed and walking slightly upslope in the heat, but not far or fast. Not sure how quick it went to 160, but it did come down fairly slowly - 140 when I stopped, then 120 and 100/90.

Grateful to know if this is IST or SVT. If it is SVT it was probably exercise triggered, so I will address it with a cardiologist. I certainly didn't feel the jump from under 100 to over 150 I have had with previous SVT episodes (which were very short) or the thumping in my chest. Hoping it was just a slightly fast heart rate from exertion, stress and heat.

Thanks so much - typically it happened on a weekend so I can't address it easily until next week. I know the limitations of a watch versus a 12 lead.

Also anyone have experience of SVT and what works? I carry cold water - chuck it in the freezer overnight. Do breathing exercises daily and use them if I have a high heart rate.

Reposting here for traffic (put it in General Health and got no replies).

I can’t read the ecg but I do have SVT. To me it’s very obviously when it happens, I get a run up and very sudden onset and then reset. With SVT you can’t just bring it back down by breathing etc, you have to stimulate the vagal nerve, so I’d say it’s unlikely that this episode was SVT.

It can be pretty rough (I’ve been in a&e many times) but also very common and almost always benign. Happy to answer any questions.

Most people manage it well and don’t need intervention, mine has got worse as I’ve got older and I’ve had 2 failed ablations to try and fix it. I’m on calcium channel blockers atm which helps but I still get episodes multiple times a week.

the cardiologist will be able to give you more info about your particular experience but I don’t think what you describe is SVT

Thank you so much for replying @Edenmum2 It definitely didn't feel like SVT (I get a fluttering sensation and adrenaline rush), but the ECG looks disturbingly like when it has been caught. Hopefully something weird from the Apple Watch because of movement. I also get IST and sometimes POTs like symptoms. Please do let me know if there is anything that helps? I try to sleep well, stay hydrated, do breathing exercises, etc. Carrying a small frozen water bottle has really helped.

With trips to AandE are these for longer episodes that don't convert? I was told to make an emergency call if it happens, but luckily it has been fairly short lived. I would have felt really stupid as the recent high heart rate could have been partially explained by weather and walking up a slope.

Attached is an ECG from when I definitely caught a short run of SVT.

Thanks again for replying, it can be lonely and scary. And difficult to know when to seek help.

i lived with it for years and then got it confirmed on a holter monitor after one very prolonged episode. I used to be able to get it to revert by doing a really big yawn (!) but that stopped working and they just became longer and longer. I went to a&e when I just couldn’t get it to go back one day, and since then I’ve been back a few times because it got way worse when I was pregnant. My problem is that the extra pathway is in a very unusual place and hard to fix, hence the two failed ablations. I don’t really have any triggers apart from bending over sometimes, probably dehydration …and being pregnant! Oh and lack of sleep, but it sounds like you’re ok on all those fronts.

in the beginning my GP told me that a&e wasn’t necessary, but now they tell me to go if it’s going on for longer than 20 mins. The actual a&e staff tell me to come in immediately but honestly that would be mad and i can get it to go back 99% of the time. My current system is to bear down hard (so almost blow really hard with my mouth closed whilst holding my breath) - i do this for about 20 secs and it normally works a charm. At the hospital they give you a big syringe thing to blow into as hard as you can. Drinking ice cold water really fast works for some people. Look up valsalva manoeuvres - there is probably a YouTube vid explaining them all. Different ones are effective for different people. Honestly for most people it does just convert back on its own so it might not be necessary at all for you.

i wouldn’t worry too much if i were you, especially if you have a cardiologist to talk it through with. The heart surgeon said to me ‘if you’re going to have something wrong with your heart - this is the one you want’ 🤣 it’s very rarely dangerous just horrible to experience so I would say if you have an episode that drags on more than half an hour or so just go to a&e for help - they should take you straight into resus and sort you out. I know how lonely it can feel, but I would say try and put it aside until you talk it through with cardio. Stressing about it definitely makes it worse for me!

Thanks so much for the replies @Edenmum2 So sorry you had to deal with this while pregnant.

I will properly look up the valsalva manoeuvre and learn it. DC has a lot of trauma from when I was in hospital with myocarditis, so I try and hide it from them.

I do need to book a check-up with a cardiologist as I have a risk of heart failure from myocarditis scarring. It certainly doesn't help with anxiety around arrhythmia.