Your experiences of SVT

[MyFriendFlicker]

Have you had ablation? Did it work? Did you find anything else to stop it?
I was diagnosed recently and have been on calcium channel blockers.
I can go weeks or months feeling ok but the slightest infection sets it off. I'm fed up of dreading it.
I'm seeing the cardiologist soon and want to ask about ablation. He mentioned it when I first saw him but was a bit dismissive and said it didn't often work. I wonder how bad it has to be before you can be considered for surgery.
What I'd really like is just to have a pill to take in emergencies.

I was having episodes several times a day, some lasting 3-4 hours and I had severe symptoms with it. I was blue lighted to hospital a few times. Initially the cardiologist tried me on Bisoprolol, a beta blocker, but although it helped with the SVT the side effects were awful, particularly the excessive sweating. He then put me on to a calcium channel blocker (verapamil slow release 240mg daily) and it's been terrific. I also have a lot of ectopic beats, which used to trigger SVTs, but now although I still have the ectopic beats they don't often trigger an SVT. The SVTs I do get are short-lived - a few seconds or minutes now. In my case the cardiologist said he thinks I have an excitable heart, so ablation wouldn't necessarily be successful. He said he wouldn't rule ablation out if the medication didn't work, but I'm happy it's working sufficiently well as I really don't want to have that procedure unless there's no option.

I was blue lighted a few weeks ago and have felt rough ever since. Lots of palpitations.
I'm on a lower dose of CCB - diltiazem 120mg a day. Maybe worth trying a higher dose. It lowers my blood pressure though, which was on the low side already.
Why wouldn't you have the procedure?

What triggers SVT for you? Mine is triggered by exertion and infections.

Anyone else?

I’m going for tests this week for suspected SVT. Mine happens quite rarely compared to some - I’ve gone several years with nothing, and I don’t think it’s ever been above once every six months. But when it happens it’s not much fun! I’d also be interested to know if anyone has had treatment and how successful it’s been.
Also, what was your diagnosis process? As mine is so infrequent my GP said they may struggle to record an episode so I’m not sure how it’s going to work. Maybe just go on my description and rule out anything else going on with tests?

My triggers are ectopic beats, turning over in bed, bending and stress. Sometimes it just happens without an identifiable trigger. The reason I don't particularly want the procedure is that I don't want tissues in my heart burned unless I have no other way of controlling the SVT.I suppose I just don't want an unnecessary procedure. I wouldn't totally rule it out, but it would be a last resort for me personally.

My triggers are movements - bending or turning too quickly, and also sometimes if I throw up. Have any of you had children? I’m currently pregnant and wondering what would happen if I had an episode during labour.

I work in the labs where we treat ablations, a high success rate and very well controlled environment

Well, I was being tested for all kinds of heart/lung issues for four or five years prior to diagnosis. I have chronic pulmonary oedema, which is normally, but not always, due to heart failure. I had numerous ECGs, echocardiograms, a nuclear scan, cat scans, cardio-pulmonary exercise tests etc. The SVT didn't show up on any of them, although I was reporting lots of palpitations etc. Then the symptoms became more frequent - several times per day and night and lasting for longer and longer periods. I started sweating and having dizzy spells, almost fainting, my heart was racing and I felt it in my throat and I had chest tightness. After thirty minutes or so it would go away. Then I had an episode that lasted for three -four hours and I was quite ill, it was similar to heart attack symptoms really, so my daughter phoned an ambulance - to cut a long story short, the paramedics and A and E doctors then caught it all on ECG. They told me they would try a modified Valsalva manoeuvre and if that didn't work they would stop my heart with Adenosine and then it should go back into sinus rhythm, if that didn't work they would anaesthetise me and defibrillate. Thankfully the modified Valsalva manoeuvre (and the verbal support/cheering of the doctors, nurses, paramedics etc. who came to watch, as they hadn't tried this before!) worked and they didn't have to go to plan b/c. Google it and you should find some videos - not very dignified, but I've successfully done it at home too, with the help of my daughter.

I was urgently referred to a cardiologist and he did another echocardiogram which showed a slightly leaky valve and he also gave me a three day Holter monitor to make sure it was only SVT and that there wasn't any other arrhythmia going on. (I in fact had another couple of prolonged episodes while wearing it).

It can be very difficult to catch this on ECG as you have to be having an episode at the time you have an episode. They may give you a monitor, Yorkshire, and hopefully any issue is caught then. I don't know if they can diagnose without catching it, to be honest.

I do have (grown up) children, Yorkshire, but I didn't have SVT back then - or if I did it wasn't severe. You can have it and not really know you've got it - the severity of symptoms differs between people.

If you're diagnosed and do happen to have it in labour I'm sure they will be able to deal with it, so try not to worry too much about it. It can of course be frightening at first, but you get used to it.

Thanks @apostropheuse, that’s really helpful. Sounds like you’ve had a really rough time of it - I hope diagnosis and the medication you’re on are helping to make it more manageable for you.

My DS was diagnosed with SVT before birth. He was very resistant to treatment and had cardio version 5 times in the first few weeks. He was on amioderone, propranolol and flecainide but 6 years later has just stopped the final medicine and is doing well.

Ah yes bending is a trigger. I thought it was my imagination but when I mentioned it to cardiologist he said that was common.
I'd had dizziness and palpitations. My diagnosis came after a 24 hour holter showed some pvcs. I then had a stress test which triggered an DVT. Apparently that was lucky as often you can be perfectly ok when the test is done.
jazzyfizzles that's interesting, can you tell me more about ablations?
It's the unpredictability that bothers me, I dread every cold or virus in case it's set off. They don't happen often but the last one was hugely dramatic, ambulance, resus, and weeks of flickering palpitations afterwards. I like to travel and the thought of having a major SVT abroad terrifies me.

The procedures are very well controlled, we have doctors carrying out the procedure, a physiologist closely monitoring your rhythm and nurses administering the sedation should you chose to have it. The procedure itself can be a bit uncomfortable (not always) some handle it better than others, but there is always plenty of pain relief should that be the case.
Occasionally the nurse will give a drug in an attempt to stimulate an arrhythmia, however that's not always the case. Generally the procedures take a couple of hours. The cardiologist will insert catheters into the femoral artery which will show specific electrical currents of different parts of your heart on a screen in front of them, so they can see the pathway that they want to ablate. You'll then need to lay flat for a couple of hours after the procedure because of the arterial access, but many of our patients are able to go home the same day

Sorry if you've read up on this and I've just repeated it to you!

I’m currently under the care of a cardiologist for the last 12 mts. SVT diagnosis but about to have my third holter monitor next week. Not sure why except that my cardiologist is very thorough. No treatment as such as my BP is normal. Mine is triggered by bending over and also illness/ viruses.Also triggered by exercise. Not pleasant to have but not the end of the world either. Slightly leaky valves also. Cardiologist recommended drinking a lot of water every day.

@MyFriendFlicker I had an ablation 4 years ago age 28. It has really made a difference. I'm 39 weeks pregnant tomorrow and have sailed through the pregnancy with only a few tiny episodes of fast heart rate, but caused by external factors (e.g. overdoing it, heat etc). Not once in this pregnancy have I had to seek medical attention because of it. Before the ablation I had spent time on resus (scary!) and cardiac care. The consultant wasn't sure if ablation would work for me, as he had a feeling the troublesome area was really near the sinus node (he was right!) and apparently ablations really near this area are less likely to be successful, but it really worked for me. The actual procedure was uncomfortable in places and I had some spectacular groin bruising afterwards, but it was so so worth it. I don't take any medication now. It is such a clever procedure. Within the first hour and a bit they had found the troublesome spot using 'mapping'. Fascinating!

jazzyfizzles that's really helpful thanks.
What I had read of it ablation send to be a clever cure in many cases. I'm wary of googling though.
Fletcher101 my blood pressure was normal, not sure how that fits with SVT but the drugs do lower your BP so mine can now drop a bit too low which is why I'm concerned about increasing the dose.
My DC are grown up now, I would not have considered surgery if they had still been dependent. What I don't know is whether the cardiologist will consider me suitable - how bad does it have to be?

I had my first Episode when pregnant with baby number 4 (age 32). They did an ECG, Echo and holter monitor for 24 hours which just showed ectopic beats.

My cardiologist put it down to hormones and said that most people get them until 40's?!

Anyway I've had episodes since (triggers for me are stress and funnily enough indigestion/feeling full up). I control it by coughing and that puts it back into rhythm.

most people get them until 40s
Not heard that but the cardiologist did say it was normally much younger people than me. I guess it makes a change from everything being attributed to my age!

Google it and you should find some videos - not very dignified, but I've successfully done it at home too, with the help of my daughter.

Please do not ever do this outside hospital. I'm glad it worked but it may not and can be serious ie can cause cardiac arrest.

OP

Kepp a diary of what triggers the SVT.

Remember that if you are exercising your heart rate should go up and although technically it is SVT it is not something to worry about.

If you are getting SVT for no reason (I only get it when I have too little thyroxine which is not normal) then the only two things I would try outside hospital are.

Rubbing ice on your nose.

Swallowing a big a chunk of ice cream as you can in one.

Ablations work when there s a single focus causing the SVT, basically a patch of excitable tissue, normally in the left atrium, this can be burned or frozen to kill it. Once the tissue is dead it cannot interfere with the normal conduction so for things like Wolf-Parkinson-White ablation is normally successful.

If there are multiple sites or you have an enlarged left atrium it can involve burning/freezing multiple sites.

It is also possible in some cases to ablate the AV node and implant a pacemaker.

If you think of your heart like your central heating boiler, it has a pump to pump the water around the system, it also has an electrical system and with SVT the electrics are 'shorting'.

Your options are to get rid of the current wiring and insert new - pace and ablate.

Remove the 'extra' wiring - ablation of a single spot or node eg the bundle of Kent (only applies if you have one)

Remove any bit of wiring that looks like it might short and see if it works. This is the one that is most tricky and most cardiologists won'r do it unless the SVT is having a big impact on your life.

Before having an ablation you should have an electrophysiology study, this is done in the cath lab, basically the cardiologist will pace your heart in an attempt to set off SVT

It can be done as a stand alone procedure or directly before an ablation.

sashh Thanks for that, very helpful explanation. I don't have WPW.

I was told by Cardiologist and GP to try valsalver manoeuvre as a first attempt to stop and episode. I was given a leaflet produced by the BHF which illustrated how to do it. Bearing down has successfully stopped a couple of minor episodes.
I did google the modified valsalver manoeuvre and it seemed to be the same as the syringe method but with leg elevation?

I think my fear of exercising stems from the fact that the stress test in hospital triggered an SVT. It was only ten minutes on a treadmill and I wasn't even out of breath. Afterwards the cardiologist told me not to do strenuous exercise. Not that I was ever very sporty .

Myfriendflicker, you're quite right the modified version is very similar to the original version, but the success rate is much higher. The difference is you sit on the bed have someone lower your head and another person raise your legs as you start to blow/bear down. At home my daughter lowers my head and I raise my legs myself.

Like you, I was told by my GP, A and E doctors and cardiologist to try it at home, so I'm quite happy to do so. I've also read the booklets you referred to.

I believe that carotid artery massage which also lowers heart rate, should only ever be done in hospital by a medical professional. Is that maybe what you're thinking of Sashh?

OK fair enough if you are doing something your cardiologist/GP is OK with.

Carotid artery massage is something else I was going to say don't do, but didn't in case I was giving anyone ideas.

Update, I saw cardiologist this week and I asked whether he thought I was a suitable candidate for ablation. He's referring me for 3 day monitor and EP studies.

Bumping this thread to ask if any fellow SVT sufferers have got a blue badge?
I am fairly successfully medicated at the moment, but still get occasional episodes. My triggers are infection, ectopics, bending, turning over in bed, stress and exertion, and I also have to watch my food intake, as large meals can set it off 😔 and alcohol, of course ☹️
I'm quite cautious nowadays, to avoid another cardioversion procedure, which was fucking horrible.
I am also easily physically fatigued and get breathless on stairs and slopes... although this could now be due to the medication.
But it's a nightmare at work, because the car park is quite a walk away and although I have (quite a colourful) trolley, it's still a slog... but the guidelines seem to say that it isn't enough. Only, on some days, it is....