Any opinions here? Either based on studies you’ve seen, experience, anecdotes? I’m contemplating one for SVT and I saw a five-year follow up study saying close to 30 percent either had svt return or they’d developed a new arrhythmia. Does having one arrhythmia predispose you to the others or do the ablations cause them?
Do ablations create new arrhythmias? - Atrial Fibrillati...
Do ablations create new arrhythmias?
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Timsywhimsy
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I was just diagnosed with SVT and isolated pacs/pvcs. I was able to catch one on my holter moniter. I’ve dealt with pvcs/pacs for over 6 years and have only felt svts once’s In a while last one was about a month ago ( that’s the one that was picked up on the monitor). My cardiologist said I’m not a candidate for an ablation because I’m only 36 yrs old and my heart otherwise normal with no structural problems. What’s your take on this?
I’m 42 and my cardiologist referred me to an EP (I think to discuss ablation). I’ve had pvcs and pacs too. I think doctors vary greatly in how they treat SVT. Some are aggressive and recommend ablation right away, so meds. Some go by patient tolerance for the episodes. I was super hesitant on the ablation but then I had a second episode a little less than three weeks later and now I’m pretty interested! I have two little kids and I’m terrified of having to call an ambulance when I’m home alone with them. (I had adenosine twice in the ambulance already). But one of my doctors is telling me to hold off because they’re irreversible and don’t always work etc?
Also, don’t know if any of you know this but there’s a drug in phase three clinical trials (here in US and Canada) that can convert SVT pretty reliably. It’s a nasal spray. I may try to get in on that! It could be a real game changer for those suffering with SVT
I’ve also heard they get more frequent and last longer the older you get. As I look back I think I’ve been having fairly short episodes since my 20’s.
Where did you hear about this nasal spray??? I would love to keep tabs on it. In my life time I think I’ve felt SVT episode around 5 times. Normally I get those hard thuds when I’m laying down or sitting watching tv. And smaller ones when I’m moving around- walking, working, bending over etc. I also have 3 boys and it has caused my quality of life to take a toll. I’ve been dealing with high anxiety for the past 4 months and I feel them daily for these past 4 months. I also wonder if all this can really just be stress. But like I’ve told my gp and my cardio that I can be just relaxed having a meal or watching tv when BOOM! so I can grab my hands around how my anxiety can cause this horrible symptom
I’m sorry about the anxiety. I totally get it! I feel like you do though, the months surrounding my two biggest SVT attacks had been stressful, but I didn’t have the attacks in a moment of stress or anxiety. Very low stress moments, actually. The nasal spray is called entripamil. Try googling it and you can read about it.
Interesting I Just read it. So the ones I’ve expired Ed were only about 9 beats and the holter recorded only 4 second run. This one seems as its for people who’s episodes last long and doesn’t convert back. How ever this is great news!
How long have your SVT episodes been?
4 seconds
Sorry, I must have asked that question just as you were posting about your episodes. Yeah, that super short. Mine used to be like that or maybe up to 30-60 seconds. Then boom, they just started lasting for 30 minutes. That was intolerable and I didn’t even recognize it as the same thing. Hopefully if yours ever get longer the nasal spray will be out by then!
Oh man! That’s scary I can’t even imagine how I could handle that. I can barely handle my short runs.
Any little thing I feel around my chest/stomach area I always connect it to my heart and I get this rush that comes over me and my heart starts beating fast!
My Dr’s look at me and tell me I’m fine I just can’t seem to believe them
I couldn’t handle it! I called an ambulance! There are folks on here (with nerves of steel IMO) who say they go hours and hours in SVY until it naturally converts.
I’m still trying to wrap my head around SVT. It’s certainly not just anxiety or stress or a panic attack. If our hearts were wired this way it wouldn’t be happening right? But I wonder if there are people who are wired this way who just never get triggered.
Also, I’d say with 4 second runs your doctors are right, there’s not much to do or worry about. Even the long episodes they say are ok. But it’s hard to believe that when they also tell you to get to the er to get it converted. And it just feels so wrong!
I’m right there with you! And yes Some people seem less nervous about them. Im petrified!!! No matter what I’m doing I’m always on edge because I’m waiting for the next episode. It’s really hard to live like that. Something inside me tells me to just go with life and f*** it. Not to let this symptom run my life. But it’s sooooo hard! And it also seems that a lot of people are dealing with this in the UK. I’m in the US. Not many of us here on this site. I wish there was so we can possibly meet and talk. I’m sure talking with someone in person would help some.
I tell myself all the time to remember 4 months ago when everything was fine. I would put with my wife and kids everywhere now I don’t even want to help around the house cuz I feel as if I’m going to bring on pvcs/SVT with any physical movement
Have you looked at the AFA - US site? Plenty of get togethers and I believe there are other organisations in the US who organise Arrythmia Patient Days. AND they are seeking SVT patients right now... take a look heartrhythmalliance.org/aa/us
Our social get togethers start with someone posting a - ‘I live in ......- anyone want to meet up?’ and although this started in UK - we seem to have just as many US members now!
I know! I’m afraid to take my kids out and get overheated because I think that may be a trigger. Or pick up the house because bending over might be. My husband has found three people (family of co-workers) who have it. Two live with it one had an ablation after a few episodes. It’s so hard to know stress could play a role and then be told to reduce it....while we’re more stressed than ever by the episodes! If you don’t mind my asking, what type of stress have you been dealing with over the past four months?
Honestly I don’t know! I can’t chalk it up to anything. That’s what drives me crazy because I’m asking myself what can be making me stress and since I can’t pin point it I automatically tell my self it’s something sinister. Of coarse that add more fuel to the anxiety and more skipped beats. It really is a nasty cycle that I can’t seem to shake off. I go to sleep every night hoping I wake up feeling like my old self again. Just this morning as I dosed back off to sleep in my dream I felt one. Me not knowing if it was a dream or actual real symptom I’m now sitting on my couch depressed Thinking what this day will bring
I’m sorry, I do get it. I think all of us do. My two biggest episodes came right after a very stressful few months. Things were getting better though. I think our bodies handle stress in crazy ways. That being said, I honestly think SVT happens to non stressed people too. He’ll, it happens to infants, teens etc. and saying there’s a cause also sort of implies blame and that’s just not helpful. I’m trying to use it as a wake up call for mental and physical health.
They feel soooo bad like I’m going to drop dead at that moment.. if all though I’ve been told they are benign. If that’s not what death feel like. Shit, I can’t imagine what that might feel like 😬 are you also in the states?
Yes. In the states. Any more today?
Not yet😬 but I’m sure I will!
I sometimes get SVT's and take Verapamil to told it in check. 240mg slow release.
I asked my EP what to do if it goes on longer than 30 mins. (I've been converted twice with Adenosine which put me into Afib). My EP told me that some people go for days with SVT's and it doesn't bother them. He said just to go to emergency when I feel I can't put up with it any longer.
Really, days?!?! Both the paramedics and my cardiologist said to go in soon or basically right away if maneuvers don’t work. I pushed back a little and said well, if they’re so benign why is it important to come in? I just sort of got a smirk and was told to come in.
Does the drug convert you? After how long? I
I arrived at the ER and they give me an injection of striadyne or adenosine. This stops the heart for three seconds. When it starts again, the tachycardia has stopped. I was frightened the first time they told me the heart would stop but in fact you don't really feel it and 3 seconds is very fast. The first time the injection put me into Afib, this can apparently happen to some people. The second time it was a different doctor who before injecting me told me to cough very hard during the injection. This seemed to do the trick and the tachy stopped without starting afib.
For lasting days, the cardiologist gave the example of climbers who are up mountains and can't get back down quickly and they deal with it. He says people are different and a lot of people can deal with it really well. My GP however says it's best to go to ER as soon as I feel I can't take it anymore.
The laying down is exactly my trigger too. I am out in the yard shoveling trailer loads of soil and sweating...and I am fine. I come in and lay on the couch /settee/sofa, and watch telly, and I am totally at rest on my left side......and that is when the thuds start... I have taken to sitting upright instead of laying out on the settee on my left side, and I have not had another episode of flutter since my original in early April.. Ps Nobody in Wisconsin has ever heard of a settee so I have to remember to say couch.....and an IV isn't a drip..... Doctor was laughing coz he worked with Brits so he knows all the alternative words... lol.....
Mine seem to happen during a restful moment after some exertion, too. I’ve also read to stop looking for triggers because it’ll ruin your life! Probably true
My EP looks for triggers such as 6 pints of IPA .. I think triggers exist so I don't go looking for triggers.......
Lying on the left puts pressure on the heart, so many people find it is better to lie on the right.
Taking magnesium may help in the long run. Research on here for details, there are lots of threads dealing with it.
The connection may well be the vagus nerve - again research on here for details. It tends to respond just when we are resting . . .
Yes definitely!!! I never had ectopics before my ablation. Only had a-fib sometimes but i would go back to sinus through cardioversion! I had my ablation a year and 8 months ago! I get ectopics now for months at times! Alll the time...went for a heart checkup etc..all’s normal! Still never had those damn ectopics b4 the ablation...now i’m left with them and they give me anxiety and i’m always in that viscous cycle!! 
I already have pvcs and pacs too, on top of SVT
You ask whether ablations create new arrythmias - it’s an interesting question as I have developed more complex arrythmias in the years since my 2 ablations but I would not say they create or cause them. Our hearts aren’t like a wiring system with defined routes for electricity to pulse through so we can’t be ‘wired’ incorrectly and maybe therein lies the difficulty in relating it to an electrical system in a house.
I was doing some research last night trying to get my head around the different types of SVT’s and how each differed and it is quite difficult to understand - probably way above my understanding and skill level. From my limited understanding the paths the rogue pulses which give rise to arrythmias can be caused by tiny differences or alterations in the sinus node, the AV node, the structure of the heart muscle, a stretching of the heart chamber as when elite athletes who train very hard develop much larger hearts to compensate for the demands of their body, scarring on the inner wall of the heart - which is what ablations create, and the different types of cell tissue lining the heart if it’s in the wrong place and last but not least - the energy created - or not when the nutrition or electrolyte levels within the cell are deficient. Very complex and difficult to diagnose.
SO ....... I think both are true, you can have a disposition and ablations could create the environment for other arrythmias to develop because ablations cause scarring within the heart and therefor alter the conductivity of the electrical pathways - intentionally - so it is reasonable to assume they would also have the capacity to unintentionally cause other pathways which may give rise to other arrythmias.
The whole area of Electrophysiology is still a relatively new speciality and I think we have a whole lot more to learn but what I have noticed is that there is a lot more differentiation between SVT’s these days and therefore more hope that effective treatments may be found if the origin of the rogue pathway can be diagnosed.
What we do know is that inflammation causes physiological changes and inflammation is caused by stress - both physical and psychological so there is a lot we can do to help ourselves through Lifestyle changes so working on the stress and anxiety has to be No1 priority.
For ectopics and Anxiety - slow breathing techniques really help - learn and practice and you will find they will ease both. Vagal manoeuvres also help some types of SVT so also worth learning and trying. Unfortunately anxiety and arrythmias are not a good mix so those of us who have dealt with this for many years are no different to you, our nerves no steelier than yours - we’ve just learned to deal with it because we had to and so got used to it - yes you do get used to it and learn how to deal with it and believe me when I say we know just how scary it can feel.
Best wishes CD
Thanks for such a thoughtful reply. It’s all confounding and pretty profound, actually. It’s sort of like a saying I read years ago when I was struggling with insomnia. It was a French saying, something like ‘to learn to sleep well is to learn to live well.’ It’s all related, in other words. Nothing like a heart problem to make you confront mortality. It’s very upfront!
Good question, I'm 71 & 9 weeks post ablation for svt, seems to have completely stopped svt but ectopics are now an issue. Svt runs increased two years ago & were lasting up to 3.5 hours with adenosine administered 10 times in 6 months. Great to get rid of svt, but I wonder if the ectopics were being masked somewhat in the first place & now I'm more aware of them.
Congratulations on being free of your SVT! That’s great! I think it’s very believable that you could have had some ectopics all along and not noticed. How long were you dealing with SVT in general?
Thanks, I had them for over 40 yrs but the longest they lasted was about 20 minutes or I was able to use vagal techniques ( self taught)!! So the first time I sought help was when they went mad a couple of years back & was told in no uncertain terms to call an ambulance in future !! I'm now extremely confident it has been cured after ablation, but keeping fingers crossed too. Best wishes.
How does yours feel like. Mine starts beating fast and then the adrenaline kicks in and I jump out of my chair and I start to move around and my breathing gets fast
Often ectopics is a normal beat followed quickly by a weaker beat but then have a delay during which there is a distinct flutter before being hit with a very strong beat, which some produces an audible gasp!!! they can recur frequently or seem to disappear for 20-30 mins before another.On occasions especially when lying in bed a heart beat is almost imperceptible for several seconds before becoming noticeable again. Like most folk they seem more prevalent when settling down to sleep, most annoyingly.The SVT's used to start as a tightening in the upper chest & sudden in of heart rate up to 250 bpm requiring Adenosine to convert them, nice not to rely on it now, it was a love hate relationship but an amazing drug. Best wishes.
Mine give no warning that I notice—Maybe it feels like my heart ‘drops’ right before it starts, but then it’s just off to the races. Like going from first to fifth gear in an instant. Then it’s just hard pounding, like it’s going to come out of your chest. Honestly, though, I never would have guessed it was getting up to 240 if someone hadn’t told me. It feels awful and sets off a physical panic attack on top of it.
I had an ablation in feb 2018 for svt. I had only had 3 episodes. Mine wouldn't stop on its own and I needed adenosine to help. I had no trigger for it. Although I do believe they all started with an ectopic beat. It's my understanding that everyone has ectopic beats and you can have up to 6 per minute and be completely normal. Most people just don't feel them. Being hyper aware of your heart and stressing makes you more aware of them and cause more of them. I wasn't aware they were classified as an arrhythmia either.
Thanks for the reply. Are you happy you had the ablation? You were three and done, huh?!?! That’s kind of how I’m feeling. As I said I think I’ve had short ones for years but as soon as you start needing adenosine the ablation starts sounding better and better
Mine were spaced out and I never knew when they would happen. I had a bout of 246, 190 that went up to 250, and 160 while on preventative meds. The last one was really what did me in since I was on medication to prevent svt from happening. I tolerated meds perfectly fine, but they weren't stopping the svt. I was 27 when diagnosed and have three kids, my youngest is nearly school age so I was ready to start college and get my degree. I couldn't imagine having a career in which at a drop of a dime, I had to go the er to get my heart rebooted. I do have ectopic beats here and there, especially when I am stressed, sometimes if I eat too much, or if I don't get enough sleep, but I don't regret my decision at all.
Yeah, it’s no way to live—never knowing when they might strike. Did you have small ones over the years or were those big ones the first that you know of? Did you need adenosine even on the meds? Can I ask what you were on? I’m on toprol xl and it makes me feel like a zombie and gives me insomnia. Just awful
Big ones are the only ones I know of. Yes, even on meds or doing pill in the pocket (I did with the second where I took flecanide), I had to have adenosine. I was on Cartia XT/diltiazem 180mg and Flecanide 50mg 2x a day. I was put on metoprolol for about 6 weeks after my second episode. I felt like a zombie for a few weeks on it before I got used to it. I tolerated Cartia and Flecanide very well though
How far apart were your three episodes and how long were you in it before you got adenosine? Sorry, just so curious—yours sound a lot like mine!
March 2016 - over an hr, it also had been going on so long I also had afib with it, April 2017 - 1 hr, Jan 2018 - 45 min. I had 2 doses of adenosine with the first, 2 1/2 with the second, and 1 with the last.
My last one started with a pvc then I went into SVT. Now every time I feel a ectopic it scares me thinking SVT is next.
I get them from time to time, too. They just start for no reason and can last for days, not all day, but they will last for an hour then go away and come back a couple of hours later and last an hour. My EP said everyone has them but most people don't feel them. He said, 'even me, as I'm sitting here talking to you now, I must have them but I don't feel them'.
Thanks for replying. How are you 14 months out?
I had my 2nd ablation on April 3. I had A flutter 2 months later and had to be cardioverted. I had another episode 6 weeks after that. My new EP stated lesions can sometimes create this new arrhythmia I had developed.
I just now had another ablation where he said he was able to pace and ablate the flutter. It seems the answer is yes.
Best Wishes,
What was your original ablation for?
Afib
I had an ablation for atrial fibrillation, a year later I developed atrial flutter. Consultant said it was due to the isthmus line he had done during the AFib ablation.
If it’s any help my son had a history of SVT for six years, eventually with long episodes. He took sotalol when needed but felt the side effects were worse than the SVT. He decided to go for the ablation as was told it is one of the easiest and most successfully treated arrythmias plus it was very unlikely to return. He had it done in London and had a few episodes post op but after six months there were no further episodes. That was 10 years ago! It gave him back a normal life.
Good luck.
Thank you! I met with the EP today and I think I’ll schedule the ablation. He was very confident and made it seem like the way to go.
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