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Old 02-15-2006, 01:44 PM   #1
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Question A.K.A S.V.T. - P. A.T. at 25 -hmmm

Hi,

My name is Graciella and I'm 25 years old. A couple of year back, I started having rare incidences of palpitations, Rapid heart beats. It was bothersome but since it would occur so seldom, I didn't think much of it. Over the past year it has become more frequent and it wouldn't just happen when exercising. I am a healthy individual, none of the risk factors apply to me (no coffee, no alcohol, no obesity).
So, I had myself checked recently and found out I suffer from P. A. T. or supraventricular atrial Tachycardia.
The treatment involves a procedure called ablation, the removal of tissue by heat or cold with a catheter.
I am not sure where to go from here. I haven't experienced any fainting yet, so, I don't really want to do it, since I am not at a very serious stage.
Is this really a serious condition? I don't want to have to worry about it.

Last edited by Graciella; 02-17-2006 at 02:23 PM.

 
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Old 02-15-2006, 02:06 PM   #2
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Arrow Re: Paroxysmal Atrial Tachycardia-hmmm

Oh, I forgot to mention that my breathing really bothers me. Every other minute you'll see me gasp for a good breath because I feel like I am not having enough exygen intake. Usually i try to take that full breath by yawning, and it really bothers me, cuz it's not an induced yawning, it just comes over me. Maybe this has nothing to do with my condition but I thought I should mention it.

 
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Old 02-15-2006, 02:51 PM   #3
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Re: Paroxysmal Atrial Tachycardia-hmmm

Most people on this board refer to paroxysmal atrial tachycardia as SVT or PSVT (supraventricular tachycardia). SVT isn't life threatening, unless you have an ailing heart to begin with and it doesn't sound like you do. Generally they want to treat SVT if it starts to become frequent, because SVTs beget SVTs; the more you have the more you have. How often are you having episodes? Have they put you on meds for it?

Several people on this board have had ablation for SVT, and have had really good experiences with it. If you do a search, you'll find their posts.

It won't kill you, but it can start to really interfere with your life if it happens frequently or starts to cause fainting, and other troublesome symptoms. In that case, you might want to get treated.

 
Old 02-15-2006, 05:07 PM   #4
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Unhappy Re: Paroxysmal Atrial Tachycardia-hmmm

Oh yea, I know about the alternate naming of the condition. I have also read over posted going back quite a bit, and it seems that going through the non-surgical procedure of ablation really has its ups but also downs. Some said they encountered complications, some confirmed a 95% safe outcome. I'm still uncertain.
My palpitations happen maybe once a month, but it really depends on how I'm feeling (stress, overexertion...).
The cardiologist did not mention anything about medication, instead he recommended ablation from the start after the results of the ECG from the holter monitoring.

 
Old 02-17-2006, 02:39 PM   #5
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Re: Paroxysmal Atrial Tachycardia-hmmm

Any more advise?

 
Old 02-17-2006, 04:19 PM   #6
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Re: Paroxysmal Atrial Tachycardia-hmmm

PersonallyI would suggest having the Ablation done and eliminate the problem before it gets worse.
I have been dealing with various forms of SVT for ten years now. I had an Ablation but my situation is a little different and the Ablation worked for a while. I have tried several different meds and had problems with all and even ended up with a Pacemaker because of a drug side effect. I just went yesterday for my consult regarding my Ablation that will be done sometime between now and July of this year.

I am affected with SVT episodes about once every three months to every month that requires ER treatment and sometimes 3 episodes a month that the pacemaker handles. I know that I have two distinct pathways causeing problems so eliminating one or both will lessen my episodes.

Don't let SVT control your life in the future when you could possibly prevent it now.

 
Old 02-20-2006, 03:35 AM   #7
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Re: A.K.A S.V.T. - P. A.T. at 25 -hmmm

Hi Graceilla, I'm a 24 year old male and might be able to offer some advise through a story... hopefully it will give you some perspective and what to expect from your problem...

Quote:
Originally Posted by Graciella
Hi,

My name is Graciella and I'm 25 years old. A couple of year back, I started having rare incidences of palpitations, Rapid heart beats. It was bothersome but since it would occur so seldom, I didn't think much of it. Over the past year it has become more frequent and it wouldn't just happen when exercising. I am a healthy individual, none of the risk factors apply to me (no coffee, no alcohol, no obesity). So, I had myself checked recently and found out I suffer from P. A. T. or supraventricular atrial Tachycardia.
This is exactly what I had. I had about 10 random episodes of PSVT or Paroxysmal supraventricular Tachycardia, which is a rapid heartbeat originating from above (super) the ventricles (atria) within about a 4 year period. My PSVT (or P. A. T. as you call them) episodes were triggered by either ceasing exercise or interestingly enough, by accidental vagal manouvers, usually bending over or squatting quickly. btw, Vagal maneuvers are supposed to stop tachycardias!


Quote:
Originally Posted by Graciella
The treatment involves a procedure called ablation, the removal of tissue by heat or cold with a catheter.
I am not sure where to go from here. I haven't experienced any fainting yet, so, I don't really want to do it, since I am not at a very serious stage. I'm not sure how serious this is, but from what you're describing it's pretty darn serious.
Radio Frequency Ablation is exactly what you are talking about. Heres my story about it.. About 4 weeks ago, I triggered an episode of PSVT by bending over to pick up something off the ground. Up until that day, my docs thought I was having episodes of atrial fibrillation, (which are not necessarily serious, so they didnít care much about it). I knew all along that they were wrong and I finally decided that these episodes needed to be documented on an EKG. I also have anxiety problems that are exponentially increased when I have these episodes. So this time I decided it was time to call 911 and get to the ER. Ambulance showed up in about 4 mins and I told them I was in A-fib (cause thats what the docs had been saying it was all along). So they hooked me up and they were like.. "uhh.. no your not, your in SVT". whatever.. it was news to me. haha. So they rushed me to the nearest ER.

In all my episodes before, I just waited them out. Vagal maneuvers never worked, but the SVT's just seemed to stop after about 20 mins. This time it wasnít stopping. Iím guessing that was due to my high level of anxiety. The paramedics finally got an IV in my art in the field and decided i needed 6cc of adenosine, which is a quick acting chemical that disrupts the AV node's ability to carry an electrical impulse and basically stops your heart, then hopefully it starts again. (there is always a crash cart on stand-by when adenosine is used). The first dose was ineffective. It was the paramedics first time administering adenosine and he wasn't aware that you need to just slam the dose into the IV as hard as possible. I arrived at the ER still in SVT at 260 bpm, they stripped me naked (embarrassing at first, but now i just laugh about it) and the doctor gave me a 12cc adeonsine shot in my IV. She administered it correctly said "this is going to feel weird". You feel the drug make its way to your heart and then BAM! Death knocks at your door and boy does it suck! you feel your heart stop, you get nauseated and writhe and strain, then suddenly your heart starts again in a normal sinus rhythm and you feel just fine.

For whatever reason, I went into PSVT 7 more times that day and was given an adenosine shot each time and it worked. What a day! I was admitted to the ICU so they could figure out what to do. I saw an electrophysiologist the next day and they decided the RF ablation was my best option. Cryo ablation was also an option, but has a higher incidence of failure (I don't know if that is proven, but its what the doc said)

The Ablation Process


After a few days of waiting in the ICU (there were scheduling problems) I went in for the ablation at a different hospital with a catheterization lab. Apparently the ablation can be routed from the femoral artery/vein or through the carotid artery in your neck. Mine was in the femoral (groin). They shaved me (again, embarrassing but funny now that i think about it now) and you get taken into a large room with tons of amazing looking equipment. You lay flat on this very hard metal bed and you are given an initial sedative to calm you down. After the prep work is done, you are given the stronger sedative. Apparently, they are using a brand new anesthesia. It doesn't put you completely out.. you are awake, but so relaxed and out of it you don't even know what's going on. It also has an amnesia component so that if you are aware of any of the procedure, you will be more likely to forget it later. I do not know the name of this anesthetic.

I remember the nurse shooting the drug into my IV and then I was gone. I remember my eyes being open, and hearing people talking, but I didnít really care about anything.

The electrophysiologist runs the catheters to the proper locations in the heart and begins testing various locations in the heart to create a complete electrical map of your heart. Once done, he chemically or electronically induces the SVT (or whatever tachycardia problem you have) to pinpoint the problem area. (One interesting thing i remember is one of the technicians was working at a terminal that I could see.. the doctor would tell him to increase my heart rate to a specified rate, and he would turn a dial and i would feel my heart increase to exactly that beat. when he was done, he would turn the dial back down and my heart would slow down. very strange!)

Once the problem spot (or spots, i had several) is located, it is ablated and tested again to insure that the SVT or other tachycardia CAN NOT be induced or sustained at that particular point. If the electrophysiologist is unable to induce the problem, the ablation is considered a success. One risk that is always a possibility is ablation of an incorrect, normal, functioning electrical pathway in the heart. If this happens, an implanted pace maker will likely be necessary. Unfortunately, no surgery is foolproof or guaranteed, and this is especially one of them. Be sure to always ask the doctors about the involved risks!

I am able to remember enough of the procedure to tell you that there is not much pain. When they ablate the problem areas in the heart, you can feel it. Its a sort of wierd burning sensation that to me was similar to really bad heartburn or indigestion. The rapid changes in my heart rate during the surgery were also somewhat uncomfortable. I do also remember trying to adjust myself due to being unformfortable and forgetting that i was having surgery. I was promptly scolded for moving.

Once the ablation was done and I was in the recovery room, and when I woke up enough to realize what was going on, the first thing i thought of was how much my back, more than anything hurt. Laying flat on that metal bed KILLED my back. The procedure took about 3 hours (it was originally estimated to take only 1 hour). I was still too out of it to tell someone in the recovery room about how much pain i was in, so i just dealt with it. After about an hour or so, I was taken to my new room. Within an hour or so, I developed some pretty severe aching pain in the entry point (groin). A shot of demerol took care of that (even though i found out at that moment I was allergic to it and went into shock!) I didn't care too much, cause the pain was gone.

I was released the next day around 5 pm. I had moderate pain only when attempting to walk or stand. When i was laying down, I had no pain at all. The doctors said it would be a 2-3 day recovery. Unfortunately, my recovery was more like 2 weeks. I had to walk very slowly and very hunched over for a long time. I think i was an exception to the case though.. I think i have sensitive arteries and veins, as i had problems with hardening and calcification with my IV's in both arms and the pain in my groin/abdomen was exactly the same as my arms.

I am about 95% back to normal now. Although i do notice much more frequent palpitations (possibly PVC's, but im trying to figure that out still). They almost always occur when I go from a standing position to a laying position. They are very strange, and actually rather alarming.. but I think thatís something I'll need to deal with over time. I've come to realize, as I'm sure you have, that cardiac issues can be quite traumatic and frightening. I've heard that the ablation procedure can not stop the extra beats (palpitations) that induce SVT, but it actually eliminates your heart's ability to sustain the SVT. So you get the initial beat, but it cant cause a sustained episode. I think that might be what i'm experiencing and apparently this constitutes a successful RF ablation. I think i just need to re-learn to trust my body and what my heart is trying to do.

To sum up, I would say that if your doctors feel that you would benefit from an ablation, then do it. It is considered to be a minor operation and has a very high rate of success on the first attempt 90-95% with relativly low occurrences of negative side effects. It sounds very scary (and some might feel that it is) but looking back, I think having an ingrown toenail removed a long time ago was more traumatic than an ablation.


Sorry that was so long! I wish you the best of luck!!!!! Let me know how things go.

 
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Old 02-20-2006, 10:51 AM   #8
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Re: Paroxysmal Atrial Tachycardia-hmmm

Kslager,

Thank you for your post. Your side comments were quite amusing! But reading through the ablation procedure made me feel weak and dizzy. Alright, here are my comments now and more questions.
First you said you had about 10 episodes over about a 4 year period. How do you know? And you felt you needed to see a doctor having only 2 episodes a year (I mean that concerned you?), because that doesn't sound like a lot.
You mentioned vagal manouvers: I had an incident exactly as you describe it!
Going over the procedure you said, and I quote "death knocks at your door" when the drug makes its effect - wow, that doesn't sound very safe. Who's to say you will wake up? You have to really trust today's tech. equipment. You went into 7 PSVTs after - great, sounds even worse.
Oh, what is the difference between RF and cryo ablation?
The surgeon can "accidently" burn of a healthy pathway in the heart. Yea, that's what I fear. I don't want to live with a pacemaker.
You mentioned aching pain in the groin entry eliminated with medication. Is that ok now, for good?
Can you explain the statement:"I think I have sensitive arteries and veins, as I had problems with hardening and calcification with IVs...."?
How are you about 95% back to normal if your palpitations have never stopped. Yea, it doesn't last that long because there is no short circuit but still....
I am thinking if I don't do this, is it going to affect me when I'm pregnant? Probably...
I also have difficutly breathing- it bugs me lots . And it's not that I don't get enough sleep. I get plenty.
Alright, back to you...

 
Old 02-21-2006, 01:14 PM   #9
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Lightbulb Re: Paroxysmal Atrial Tachycardia-hmmm

Thanks for all the clarifications. I will let you know if I ever decide to go through with ablation. At this point I'd rather not, but I'm sure I'll have to if I want to have kids.
If I have more concerns, I'll be back...

Last edited by Administrator; 02-12-2012 at 07:04 PM.

 
Old 02-21-2006, 04:49 PM   #10
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Re: Paroxysmal Atrial Tachycardia-hmmm

I personally do not regard Ablation as a simple and safe procedure, I'm not trying to scare you but the simple fact is people have died from this procedure, for example there are cases of holes forming between the oesphagus and the heart after ablation resulting in death.

There is also the danger of the Radiation exposure from up to 3 hours of X-rays, that's right the Doctor sees what he is doing with the aid of a Fluroscope which uses X-rays to show him the inside of the Heart. And this also presents another problem in that all the doctor sees is a 2 dimensional picture, not a 3D image like you get with ultrasound.

I suffer from Atrial Fibrillation and need an Ablation, but I will use drugs to control the AFIB until they start using Magnetic Resonance Imaging and Ultrasound to see the Heart, making the whole procedure a heck of a lot safer.

If you need and Ablation to save your life then do not hesitate to have it done, but if your Doctor says that drugs can control your condition, then the longer you wait for an Ablation the more effective and safer the methods used will become.

 
Old 02-22-2006, 02:46 PM   #11
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Re: Paroxysmal Atrial Tachycardia-hmmm

Ok, yea, I am pretty hesitant, too, because I hear both sides of the story through this forum from people that have experienced it.
Quote:
I personally do not regard Ablation as a simple and safe procedure, I'm not trying to scare you but the simple fact is people have died from this procedure, for example there are cases of holes forming between the oesphagus and the heart after ablation resulting in death.
There is also the danger of the Radiation exposure from up to 3 hours of X-rays, that's right the Doctor sees what he is doing with the aid of a Fluroscope which uses X-rays to show him the inside of the Heart. And this also presents another problem in that all the doctor sees is a 2 dimensional picture, not a 3D image like you get with ultrasound.
Quote:
I suffer from Atrial Fibrillation and need an Ablation, but I will use drugs to control the AFIB until they start using Magnetic Resonance Imaging and Ultrasound to see the Heart, making the whole procedure a heck of a lot safer.

Can you tell me more about the effects of these drugs and potential side effects of long term complications from them?

Quote:
If you need and Ablation to save your life then do not hesitate to have it done, but if your Doctor says that drugs can control your condition, then the longer you wait for an Ablation the more effective and safer the methods used will become.

How long have you had this problem, and do you find it doesn't bother you as much to go for ablation? Did your doctor suggest drugs first? Because mine didn't.

 
Old 02-22-2006, 03:21 PM   #12
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Re: Paroxysmal Atrial Tachycardia-hmmm

Quote:
Originally Posted by Graciella
Ok, yea, I am pretty hesitant, too, because I hear both sides of the story through this forum from people that have experienced it.



Can you tell me more about the effects of these drugs and potential side effects of long term complications from them?


The drug that I take keeps me in Normal Sinus Rhythm for most of the day, it is very effective in my case and has no side-effects. A doctor is the only person who can recommend which drug is most suitable for your condition.


How long have you had this problem, and do you find it doesn't bother you as much to go for ablation? Did your doctor suggest drugs first? Because mine didn't.
My doctor only recommended an Ablation if the drugs did not work, his opinion is that an Ablation should only be considered when the drugs stop working, or the side-effects become a problem. At this stage the drugs work well, so hopefully an Ablation is not required for a few more years.
At the Boston AFIB Symposium (13-14 January 2006) it was noted by a number of Doctors that up to 60% of Ablation 'cured' patients revert to AFIB within 12 months, so Ablation is currently not the 'magic bullet' for everyone.

I have had AFIB for only 6 months, but I had problems with PVC for the past 8 years.

Ablation techniques are always improving, so the longer you can wait the better. If however you are suffering because of your condition, or drugs do not work, then by all means discuss an Ablation with an Electrocardiologist.
Questions to ask him-
How many Ablations have you performed?
What is the success rate for the Ablations performed?
What are the risks involved in the actual procedure?
What amount of radiation will I be exposed to during the procedure?

 
Old 02-26-2006, 10:13 PM   #13
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Re: Paroxysmal Atrial Tachycardia-hmmm

Well, it's been a month since I was diagnosed with PAT. I haven't had any recurrent symptoms, so, I am starting to wonder: can't I just live with it as I am? It is not causing any problems now, I don't know how it will affect me when I'm in labor if I will have a child, but really I don't feel I should be concerned. I think about it, but I'm doing fine now...hmmm.

 
Old 06-10-2006, 02:15 PM   #14
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Exclamation Paroxysmal Atrial Tachycardia-SVT-anxiety

Hi everybody,

It's been almost half a year since I wrote about my SVT and I would just like to give you an update.
Alright, so since last I was on I've had 2 incidences of SVT lasting about 3-5 minutes each. My remedy is lying down and taking it easy then it goes away.
I now seem to have a different problem that is bothering me even more since it's there ALL the time. I have difficulty breathing: by that I mean, I take short breaths and yawn all the time to gasp for more air (involuntary action). I also think I suffer from anxiety. I went to the clinic and explained that my heart rate increases tremendously and I feel it through my neck and chest when I am put in the center of attention. I even get nervous on any regular occasion. The doctor said I described symptoms of mild anxiety.
This is sooo bothersome. I feel I can't take on as many challanging projects because I'm afraid somebody will notice my "fear". It shows by my frequent swallowing action while carrying on a conversation.

 
Old 06-15-2006, 02:39 PM   #15
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Re: Paroxysmal Atrial Tachycardia-hmmm

My mom has had it all her life. In her later years she would have to go to ER and they gave her a shot to slow the heart down. Her beats would be at over 200 bpm sometimes. She would be very uncomfortable with it. She tried breathing in a paper bag, bearing down like she was having a BM, and other tactics. If your episodes aren't very long than you're not at risk. Mom's dr. put her on Inderal too.

 
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