Kardia for SVT?

[Sasical]

Hi there

I hope someone can help me. For the past 2-3 years I've been having episodes where my heart rate goes up to about 150 bpm. This used to happen every 6 months approx, now it's happening more regularly. My cardiologist said (because I'm terrified of having the ef test) to call an ambulance or go to hospital when it happens to get an ecg while it happens. So far, no luck, it's over by the time I get there.

So I was wondering wether Kardia might be useful, from what I explain to him he suspects SVT.

Thank you x

[Hidden]

My understanding is that it’ll detect AF, bradycardia and tachycardia, but not specifically SVT, which is different from normal sinus tachycardia. Some doctors also aren’t at all interested in the readings from a Kardia, and for proper diagnostic purposes, you really do need a 12 lead ecg during an episode. What tests specifically are you worried about? During my first ep, all I had was an ecg and some bloods before they gave me meds to stop it - I’d been at 240bpm for about an hour and valsalva manoeuvres don’t work for me, unfortunately.

Although my more minor episodes (150-170 range) were usually self limiting, they all lasted more than 15 minutes. Most were over an hour, and many were in excess of 2. If your episodes aren’t lasting long enough to get to a hospital for an ecg, it would make me slightly suspect of SVT being the cause from my own understanding and experience: the whole issue with SVT is that the heart gets ‘stuck’ in overdrive having been triggered by an ectopic beat.

[dawny1908 in reply to Hidden]

Hi I also suffer from svt reaching 196bpm. I have been told to give mine 15 mins and if they don't stop by themselves to go to hospital. Which I do. I have been twice in the last 6 weeks. I also have the 12 lead ecg. Nothing gets mine down apart from adenosine. I was on 1.25mg of bisoprolol which I have been told by my cardiologist I can increase to 2 tablets a day. One in morn and one at night. So this week I have started to increase the dose but only by half a tablet (hoping the initial side effects aren't so bad😁) I also have high BP and ectopics. I have recently been feeling the ectopics now that I know they are there. But this extra half a tablet has stopped me feeling them so far. All mine seems to be caused by stress

[Sasical]

Thanks both for your replies.

Hidden the test I'm afraid of (terrified would be a better word as I have health anxiety) is the electrophysiology test where they put a catheter up to your heart to provoke an SVT.

I sent my cardioligist a whatsapp yesterday asking him was it worth buying the kardia and he said yes, but posts here only mention it being good for afib.

dawny1908 the told me go wait 15 mins at home too, and my episodes usually last about half an hour, that's why when I get to hospital it's usually too late to record it.

[Hidden in reply to Sasical]

Where are you based? Perhaps I’m now going to find out my experience is unusual, but I’m in the UK, and an ecg at the time has always been the only requirement to diagnose SVT. No one has ever mentioned trying to trigger an episode, I’ve never even heard of this being done prior to your reply (at least, not for SVT), nor can I understand what purpose this would serve?! Have they told you this is what they’re going to do to you? No wonder you don’t want to present at hospital for an ecg if that’s the case - I probably wouldn’t either! Post my first episode I was referred to cardiology, where I had a resting ecg, an echo and a holter for a week, but that was it. The echo is used to determine whether there’s an underlying cause like Wolff-Parkinson-White or if it’s idiopathic. In my case it’s just something my heart seems to like doing for the lols 🤦‍♂️🤷‍♂️

Wherever you are in the world, you can absolutely refuse any procedure that you don’t want to have, they can’t make you have the EP test, but the bottom line is that you do need to know what exactly is going on so that you can get the correct treatment and understand the outlook. Although unpleasant, SVT is relatively benign in the grand scheme of things, and with dietary changes and medication I haven’t had a single episode in 5 years having had dozens in the 5 years prior to that. But you need to know it’s SVT you’re dealing with.

[Sasical in reply to Hidden]

I'm sorry I'm not English so msybe I didn't explain very well. I'm from Barcelona.

I went to the cardiologist because of my episodes of sudden very fast heart rate. He did an ecg, 48 hr holter and echocardiogram, all OK.

So he then said I could have a test done where they put a catheter up to your heart to see wether they can provoke an SVT episode and if they can they would then do an ablation then and there.

Because I was terrified with this option he then said, what we can do is when you have an episode go to ER and get an ecg done and then we will see if it is SVT or not. The problem is that every time I get to the ER my fast heart rate has already stopped.

[Hidden in reply to Sasical]

So, in the UK, you can have holters for anything between 24 hours and a month in certain circumstances. If the episodes are frequent enough, that’ll usually catch at least one. The other thing they may entertain if episodes are quite infrequent but fairly severe is a loop recorder: these are implanted under the skin and can stay in for about 2 years. My understanding is that it would be unusual to have a loop recorder for suspected SVT, but not completely unheard of. Ablation is not generally offered here unless your episodes are frequent, severe (prolonged, very high hr, often accompanied by other symptoms), and/or not managed by medication and lifestyle changes: although it does work for some, in quite a lot of cases ablation can actually make arrhythmias and palpitations worse for those with SVT. My understanding is that it tends to be more successful for things like AF.

If it were me, and I say this as someone who respects that the ambulance service exists purely for emergencies, I would call the emergency number for an ambulance. The reason for that is they will come out to you quickly as it’s heart related, and the first thing they’ll do is an ecg: whatever is going on, you’ll have a trace of it for diagnostic purposes without having to try and get yourself to the hospital and the episode stopping en route. For me personally, ambulance to get to the hospital would be the only safe option anyway as my bp tends to crash within ten minutes of a major ep starting - suggesting people drive or otherwise ferry themselves seems somewhat dangerous.

[Sasical in reply to Hidden]

Thank you so much for getting back to me. The last two episodes I called for an ambulance and they did not have an ecg machine, I don't know why, they certainly used to have them.

I only live 5 mins from the hospital but between the ambulance coming, taking me there and then a few minutes wait, by the time I have the ecg done I'm done and dusted.

I asked the cardiologist about a loop recorder (because I had an o line consultation with Dr. Sanjay Gupta and that is what he suggested) but my cardiologist said no, he said we might as well go for the electrophysiology test BUT when I asked him about Kardia he said, yes ok, but get the 6L one 🤷

[Hidden in reply to Sasical]

I really feel for you - you’re doing all the right things but just can’t catch a break, or your arrhythmia. An ambulance not having an ecg on board when attending a cardiac call is absolutely abysmal, whether you live 5 minutes from the hospital or 15! The cynic in me is saying he’s ok with the Kardia because you’re paying for it - it would be a quicker option, but I suspect an EP test may work out cheaper than sorting you out with a loop recorder. Sanjay Gupta is an extremely well respected cardiologist and well-known name in the U.K., and as I said, I’m not aware of EP testing being something used that often over here on the NHS (just had a look and it seems to be something offered more in the private sector), so the fact that he’s suggested a loop recorder makes me think that would be the first choice if you were being treated in the UK. Could you ask for a longer spell with a holter? Or a second opinion with someone else with a view to a longer holter or a loop recorder? Failing that, the Kardia may be your best option: it will at least exclude AF as an option and show if your episodes of tachycardia are normal sinus rhythm: SVT shows as normal sinus rhythm, so if it’s not NSR, it excludes SVT. Does seem like a big faff though when an ecg as it occurs would be definitive.

[Sasical in reply to Hidden]

I go privately because our equivalent of the NHS would take for ever at the moment. I will do as you suggest, ask for a longer Holter and if not I will go for the Kardia, I don't mind paying for it as long as there is a chance that it might be helpful.

Thank you for hour help x

[dawny1908 in reply to Sasical]

I woke again early hours of this morning about 2.40 and thought I coukd feel palpatations and didn't know if it was because I had maybe been dreaming and startled myself. I checked hr and was 138. As it never lowered I had to take a trip for adenosine again! On first name terms now with all in resus! They are a good bunch. Chest xray and bloods came back fine again was back home in bed for 6am. Its just soooo annoying as I never know when it's going to happen