Anyone with SVT (supraventricular tachycardia)? Have you used Kardia Mobile?

I meant to reply to this.

One reason I bought the Kardia device is because it was cheaper ($99) than an Apple Watch. And it is easy to use. It does not give continuous monitoring like an Apple Watch but I didn't need that since my episodes last much longer.

If my SVT episodes were less than a minute, then by the time I gathered up the Kardia device, and my iPad, and sat down, the SVT episode would have stopped. So there's an advantage to continuous recording.

Anyway, regarding the data you have captured, is the Apple Watch able to distinguish between atrial fibrillation (which is a more serious problem), and SVT, and all the other types of arrhythmia?

My Kardia device has sometimes been confused when it tries to analyze an ECG even when I could tell it was yet another SVT episode.

I know very little about types of heart arrhythmia. I just wanted to mention that it might be worth showing the data from your watch to a doctor.

In short, I wonder whether it is wise to assume this is SVT? I know my issue is SVT based on age of onset, all the years of describing it to doctors, etc., etc. And then finally confirmed with the ECGs I captured.

Not trying to worry you, just trying to be cautious/helpful.

 

Thanks for the info @ahimsa - I really have no idea what kind of arrhythmia it is! I just get mostly very short episodes where my heart rate suddenly doubles.. never caught on an ECG and never actually captured by anyone medical!
At least I now have evidence that something happens.... and if the doctor is interested then I can show her!

 

Adding a link about the relatively new "modified valsalva maneuver" (vs. the old valsalva maneuver) for SVT:

https://canadiem.org/modified-valsalva-maneuver-stable-svt/

I guess this has been around at least 5 years but I hadn't heard of it until recently.

 

My wife has svt and me. While controlled most of the time by a mix of tablets she finds laying down brings on Her attacks reaching 235 bpm for two hours just after Christmas. She also has inverted t wave.

All very worrying to watch, with her refusal to seek medical help due to Covid. Laying on her left side and breathing out slowly or ice cube under the tongue is the only medical advice we have received.

Does ablation improve quality of life or just stop the SVT episodes and need for tablets?

 

I'm so sorry your wife is having this problem! It sounds terrible.

I want to emphasize that our forum does not allow sharing any medical advice! Especially with something this serious a doctor needs to be consulted directly.

Is there some way for your wife to talk with a doctor over the phone, or via a video call, to get advice on what to do next? This seems too serious to rely on advice from online searching or patient forums.

As I said in an earlier post, I don't know know much about different types of arrhythmias. I do know that there are different types of SVT (mine has been identified as the more common AV Nodal Re-entry Tachycardia). And even with the same type of SVT patients can have different symptoms. I never feel faint, or get pain, or feel nauseated. I have read that other patients do.

More importantly, very fast heart rates can also come from different types of arrhythmia that are more dangerous than SVT, such as atrial fibrillation.

I hope you can get help from a cardiologist about what options are available. I don't know any details about cardiac ablation but a cardiologist should be able to discuss that option.

Best of luck to you and your wife!

EDIT: There are lots of websites with basic info about SVT - different types, treatments with medication vs. catheter ablation, etc. Here's one site:

https://www.webmd.com/heart-disease/atrial-fibrillation/what-is-supraventricular-tachycardia

This is NOT a replacement for advice from a doctor but it may help to further refine the questions you might ask the doctor. I hope it helps.

 

I just saw this article on Medscape:

Nasal Spray for Converting Paroxysmal SVT Seems Feasible, Safe for Long-term Use
https://www.medscape.com/viewarticle/973808

I thought I'd post it on this SVT thread for anyone here who might be interested.
(mainly me - this way I can easily find it again!)

 

Quick update to this thread (mostly for my benefit).

I've just had 4 SVT episodes in past 2 weeks.

I've been resisting catheter ablation because my SVT episodes were infrequent.

But I guess I'll be talking about this procedure, and other options, at my next cardiologist appointment (January).

 

Thank you Trish

Most recent was last night at 10 PM.

 

I have been diagnosed with typical AVNRT’ (atrioventricular nodal reentry tachycardia) which is the most common form of SVT (supraventricular tachycardia). It is not dangerous (as long as your symptoms aren’t too bad and aren’t causing you to lose consciousness etc.) The management options I discussed are:

• Do nothing and live with it.
• Take medication when it occurs. (There is a new nasal spray looming called Etripamil and this might be a good option according to my cardiologist cousin if it gets approval).
• Take medication all the time to reduce chances of having an episode.
• Ablation. The most effective treatment (>90% success) but also has risks. The main risk would be ~1/200 chance of needing a pacemaker due to inadvertent damage to the conduction system.

I tried a beta blocker and found that I felt too exhausted to continue with it. Now I am on a calcium-channel blocker which is suiting me better..
I was getting a couple of episodes most days and now I get fewer and also my heart rate is less high when they do occur.

 

Thanks for sharing your experience with AVNRT treatment options @Daisybell

I've had this condition since age 11 so I've discussed various treatment options with my cardiologist over the years.

I was just venting because my "do nothing" treatment option is no longer working.

On the bright side, the "do nothing" treatment did work for more than 50 years!

PS. In case it's not clear, short SVT episodes (less than a minute) happen all the time and don't bother me. It's the episodes which last anywhere from 20 minutes to an hour (one time longer than an hour) that are the problem.

 

I have a similar experience to yourself with SVT except I started having episodes in my late 20s/early 30s.
I went to my doctor and described my symptoms as "sporadic, short bursts of rapid heart beat". He tried to convince me that these were possible panic attacks but I insisted this wasn't case. He tried to establish a potential trigger but nothing stood out as obvious.

My first big attack (about 40 minutes long) came almost exactly 24 hours after my first covid vaccination. An ambulance was called but didn't get to me until my heart rate had dropped. It was still around 100 bpm when they arrived (this WAS probably due to panic!). I captured my episode at 190 bpm on my smartphone and showed it to the doctor at the hospital. He dismissed this saying "if that'd happened we'd be trying to resuscitate you right now!" and concluded my smartphone was wrong.

I persisted with my doctor and eventually got a referral to my local hospital's cardiology department. I learned about the Kardia gadget from the woman I spoke to there and purchased one a week later. I caught a short SVT episode about a month later but the Kardia app came back as "Unclassified". I was still able to download the data to my cadiologist who then told me it 'probably' was SVT but a definitive diagnosis couldn't be given unless the episode was caught on a 'proper' ECG machine.

Fortunately, this occurred May this year when I happened to be in France and staying 20 minutes walk from a hospital. They provided me with the ECG results as well as blood tests to forward to my doctor.

So in my experience, the Kardia monitor and app are very useful to prove you have these episodes but won't necessarily get you officially diagnosed as having SVT.

 

@R31d0 - So sorry that you had such bad experiences with doctors. I can at least understand a doctor asking about panic attacks, but the doctor should always believe the patient when they say it's not panic.

But a doctor saying that a heart rate of 190 means that someone would be trying to resuscitate you? That is pretty ignorant. I've never gone to the emergency room for any of the hundreds of SVT episodes that I've had.

I routinely record SVT episodes that are more than 200 beats per minute. One of my recent recordings had an average rate of 214 bpm for the 30 second ECG. (episode lasted about 25 minutes)

Absolutely true. Kardia software can do only very limited evaluation of the ECGs recorded by their device. And I'm not sure how accurate that evaluation is. Mine always say "unclassified."

So a doctor is needed for any diagnosis or interpretation of the data.

 

I don't think he didn't believe me, I think he'd just never come across these symptoms before. My consultation ended with him saying "Palpitations aren't an uncommon phenomenon and I don't think you have anything to worry about". I'm a physically fit guy and I think i just left him stumped.

Yeah, I got pretty annoyed at him. I'd had to wait a long time in A+E to be seen as well. Only to have this guy laugh like it was a joke. I told him that I physically felt my heart beating fast but I think he assumed this was panic brought on by my faulty smart phone.

I went back to my doctor, he seemed aggravated at the way I'd been treated and stated that I should have at least been given a blood test. Thankfully he organised a blood test at the local practice. By the time we got to discussing the results there were stories about top athletes suffering from heart conditions and a possible link to covid vaccines was rumoured. At this point I got my referral to cardiology.

The cardiologist put me through a load of tests. I had an ultrasound on my heart, a CT scan and I had to wear a 7-day holter recorder (sadly, didn't catch anything). Still, none of these tests diagnosed me as having SVT. The cardiologist still believed this was my condition and talked to me about managing episodes (Valsalva Maneuvers etc.) and Kardia mobile.

All in all, the biggest problem I've had with SVT is finding a doctor who's aware of the condition and getting a diagnosis. Now that I have been diagnosed I'm having regular cardiology consultations and have been prescribed medication for my episodes (Bisoprolol).

I still use my Kardia device as a way of keeping tabs on the frequency of my episodes.

 

Hi ahimsa,

Just wondering, how did the consultation go? Did you come to a decision about the catheter ablation procedure?

I've also been offered the surgery and am hesitant because of the potential risks involved. My cardiologist sent an information leaflet about the procedure which had some concerning statistics.

I'm leaning more towards the 'live with it and see' option as my condition isn't massively affecting my quality of life and my symptoms are still mostly manageable.

 

I decided to go ahead with catheter ablation. For me, the risks are worth it.

So now I'm in the queue, but there will be a delay of at least a few months because there's a shortage of anesthesiologists in my area (Portland, Oregon metro). I'm guessing it will be April or May before I'm scheduled.

It's a pretty serious shortage - the number of surgical procedures have been cut in half!

News article (gift link):

https://www.oregonlive.com/business...tml?gift=27fb6c04-3998-4924-9bcc-3e74c6a2a70e

But I've waited for more than 50 years. (I'm 63) A few more months won't hurt. And the number and length of my SVT episodes has gone back down so it's not as bad as it was in December.

I completely understand! That's why I resisted this procedure for so many years even though my cardiologist asked me about it at each yearly appointment. I kept telling him that I'd do it when it got bad enough.

When I met my new cardiologist, and I told him that my SVT had started when I was age 11 or 12, he was so surprised! He said that he had never met a patient who had had this condition for more than 50 years! He said something like, "Most of my patients are so bothered by SVT that they want it to be corrected as soon as possible."

I said that this medical problem was much lower priority than my other medical issues, with my biggest problems being ME/CFS and orthostatic intolerance (not sure if that counts as a single problem or two). I said that if catheter ablation had a chance of fixing either of those problems then I'd do it in a second!

He mentioned that SVT almost always get worse with age. And it also gets more difficult (or takes longer, not sure of the phrase) for the heart to return to normal rhythm.

This matches my experience. I never had an SVT episode that lasted longer than 5 minutes until my mid-40s. Then over time my episodes have lasted longer and longer, with the longest one being more than an hour (about 1 hour 15 minutes? I think). And they happen more frequently.

Anyway, I'm ready to go through with the procedure. I'm ready to live with the risk that something may go wrong (tamponade or stroke, may need pacemaker, etc).

I'm pretty sure I've read all the risks but would you mind sharing what was in the leaflet that your doctor gave you? Thanks!

 

My procedure is scheduled for Friday, April 26.

Posting this info in case @R31d0 comes back to read this thread later. After it's over I'll be happy to share how things went. Crossing my fingers that all goes well.

EDIT: Adding links to the Merck Manual entries for SVT/PSVT and catheter ablation.

I found these descriptions helpful (it even includes a video) so I'm saving these links here for when people ask me about it.

https://www.merckmanuals.com/home/h...oxysmal-supraventricular-tachycardia-svt-psvt

https://www.merckmanuals.com/home/h...hms/destroying-abnormal-heart-tissue-ablation

 

Hi ahimsa,

Sorry for the late response.

This is the full list of possible risks that I received from my cardiology department:-

"Are there any risks?
Every medical procedure has risks associated with it. The overall risk of complication during an SVT ablation is 1-2%. This means 1 in 100 to 1 in 50 people have a complication whilist undergoing the procedure.
The risks of SVT ablation range from minor bruising in the groin area, to more major problems such as stroke, a need for emergency pacemaker or puncture of the heart requiring additional Surgery.
The specific risks are:
Damage to the nomal electrical system of the heart, resulting in the need for a pacemaker: up to 1 in 100 people (1%).
Most patients get some minor bruising. The risk of major bruising, bleeding or vascular (blood vessel) injury in the groin occurs is around 1 in 100 people (1%).
If you have received blood thinning medication (heparin) during the procedure, or you were taking blood thinning medicines beforehand (such as warfarin), the risk of groin bleeding afterwards is slightly higher.
Blood clot in the legs/lungs (deep vein thrombosis or pulmonary embolism): 1 in 200 people (0.5%).
Stroke: 1 in 500 people (0.2%) (almost exclusively in those procedures requiring access to the left side of the heart).
Puncture of the heart, leading to bleeding around the heart which may require emergency drainage or heart surgery: less than 1 in 100 people (<1%).
Damage to the nerve located close to the heart (phrenic nerve injury): less than 1 in 100 people
(<1%).
Death as a direct result of undergoing this procedure: less than 1 in 1000 people (<0.1%).
Risk from sedation or general anaesthetic, if used (such as reaction to the anaesthetics agents used, difficulty passing breathing tube, difficulty with breathing after anaesthetic): less than 1 in 100 people (<1%)."

There's probably nothing new here that you haven't already been made aware of but if there is I hope you'll find it informative.

Glad to hear you have a date for your procedure and I'll be looking forward to hearing how you got on. I'll keep you in my thoughts on April 26th and keeping my fingers crossed for you as well.

Best of luck!

 

There are multiple types of tachycardia - eight types according to wikipedia : https://en.wikipedia.org/wiki/Tachycardia#Differential_diagnosis

Is it possible to have more than one kind of tachycardia at a time? And if yes, how are they distinguished?

 

I think that's a question for a cardiologist! Too complicated for me.

I can share my personal experience, though.

The fast heart rate that I get when standing still (orthostatic intolerance), or from PEM, feels very different from a PSVT/SVT episode. If nothing else SVT is a much higher heart rate, 190-200 beats per minute. And strangely it is much less disabling. I don't feel like I need to sit down to avoid fainting. I don't get chest pain.

Also, I've had short SVT episodes since age 11 or 12. I never had any other kind of tachycardia (POTS/NMH/???) until after ME/CFS onset.

I have shown my ECG recordings (a couple images are posted in this thread) to my cardiologist to confirm the diagnosis.