r/SVTHeart

I had an ablation for atrial tachycardia three weeks ago. A focal source was found and ablated but EP had trouble confirming if it was the true source (they found a spot that when stimulated started firing off runs of AT, but wasn't having enough AT at baseline to confirm that's where it was coming from). They also found an Atrial Flutter circuit and ablated that as well, a nice bonus.

Anyway, so far things have only been worse, especially recently. EP wanted me off of flecainide so maybe that's why but have yet to see any improvement. Anyone who's had ablation for AT share a similar experience? EP was upfront about AT being difficult to ablate so I had an inkling that this might not work. Just curious if I need to wait months to find or if the fact that my arrhythmia still exists unchanged gives a good idea that it may not have worked.

five years ago, I discovered that I had WPW syndrome because I was always having arrhythmia and horrible palpitations. I went to get EKG and it showed up as WPW. after talking with my cardiologist We decided to do an ablation. after the ablation he claimed it was “successful “and apparently it wasn’t WPW but an extra nerve instead of an extra pathway so I just went on about my life, he never told me what it was or any more information about it. He just said it’s not Wpw it’s a nerve but he also mentioned that it was always gonna show up on the EKG as WPW even if they removed it. i never questioned it. A couple days back. I had a horrible episode when I was laying in bed and felt like someone had just punched me in the chest like a big thump, which was unfollowed by what was probably 200 bpm. After I did some breathing and tried to call myself down it went down to 110. I had one today as well, which is why I’m sharing this. but earlier in the morning, I went to get a second opinion and saw another cardiologist and he did an EKG and an echo. He got the EKG and he said that it’s showing up as WPW still like the other cardiologist had told me, but he said that it’s a red flag that they “removed” said nerve and it’s still coming up as WPW. He said that they might’ve not fully completed the ablation. I have an appointment with the cardiologist that performed it in a month but if anyone has any ideas, what could be happening now I would greatly appreciate it.

Hi everyone, does anyone take flecainide for PACs or PVCs? I also have SVT. The electrophysiologist wants me to take it, but I'm very scared.

About 10 years ago, when I was 23, I was diagnosed with nonsustained VT after a Holter monitor caught an episode of 23 beats of NSVT. Before that, I had already had extensive testing, including multiple EKGs, echocardiograms, and stress tests, which were all normal.

At the time, I was also having a lot of panic attacks and anxiety about my heart. The Holter actually recorded around 200 episodes of what appeared to be panic-related sinus tachycardia, but only one episode of NSVT. I subsequently had an EP study and cardiac MRI, and the NSVT could not be induced. I was put on metoprolol and had a loop recorder implanted.

Over the next 10 years, I very rarely had NSVT — maybe one episode every 2–3 years — and eventually I stopped taking metoprolol because I felt like I didn’t really need it.

I’ve always had occasional panic attacks, but last year I started exercising again for the first time in about 10 years. After that, I started having panic attacks much more frequently, including some at the gym. But then I started experiencing something that felt different: episodes where my heart would suddenly start speeding up even though I wasn’t actually feeling panicked beforehand.

The strange thing was that these episodes didn’t have a sudden onset. My heart rate would gradually accelerate over maybe 30 seconds to a minute, sometimes going from around 80–100 bpm up to 150–180+, and then gradually come back down. It felt almost exactly like sinus tachycardia from a panic attack, except sometimes there was no panic or anxiety triggering it.

Because I became worried about these episodes, I started having even more actual panic attacks as well. My implanted monitor would show sinus rhythm/sinus tachycardia during some of the episodes, but there were also some episodes that felt different and had the same gradual “warm-up” and “cool-down” pattern.

Over the past year, these episodes became increasingly frequent — initially maybe once a month, then every couple of weeks, and eventually about once a week.

A few days ago, I had a particularly bad episode while I was just standing at work. I suddenly got a warm sensation in the center of my chest and my heart started accelerating for no obvious reason. My heart rate went from around 80 bpm to 187 bpm in roughly 10–15 seconds, and I was terrified enough that I called 911 because I thought something was seriously wrong.

I was hospitalized and saw an electrophysiologist. He reviewed the rhythm recording from my implanted monitor and thought there was a possibility that these episodes were atrial tachycardia, because some atrial tachycardias can have a gradual warm-up that resembles sinus tachycardia.

I had an EP study yesterday, and they actually induced the atrial tachycardia and confirmed that I had it. It was located very close to the SA node, which apparently made it particularly difficult to distinguish from sinus tachycardia just by looking at the rhythm strips.

I ended up having an ablation.

My EP explained that some atrial tachycardias can have a gradual onset and gradual termination, making them look very similar to sinus tachycardia from things like exercise, anxiety, or panic attacks.

So it seems like I was dealing with two different things: actual panic attacks with sinus tachycardia, and these separate episodes of atrial tachycardia that could happen without feeling panicked beforehand.

My question is: has anyone else here had atrial tachycardia that behaved almost exactly like sinus tachycardia?

Specifically, I’m interested in people whose AT had gradual onset/“warm-up” and gradual termination/“cool-down,” rather than the sudden on/off pattern that is often associated with SVT.

If you’ve had something similar, did your AT also feel like a panic attack or sinus tachycardia, and was it difficult to distinguish from sinus tachycardia on a monitor?

I had an ablation nine days ago and feeling extremely nervous. I was put on a calcium blocker three times a day which worked great for two days but they changed it to the one a day and I had a long episode of 25 minutes at 110. Now today, I am super scared. Does anyone else feel like they can relate? This is my second ablation. I do not remember the first one causing all of this anxiety, but I was not having the events afterwards either as those came later.

After my factory reset and the constant SVT on/off during ablation, I just don’t have any reaction to scary/exhilarating experiences. Is that common?

My heart was only switched off for 3 seconds. But it felt way longer and it was telling me, “this is the real deal, you’re dying”. Then with the full experience of ablation featuring them putting me in and out of SVT constantly as a part 2.

So now if I do a rollercoaster with the kids or a haunted house or something. I get none of the fear/nervousness I would have before. Especially the rollercoasters. I really didn’t like them. But the sensation is completely gone.

I recently got an ILR implanted in my chest to monitor for SVT after having an episode in my doctor’s office. I’m conflicted on whether I think it’s SVT or just normal sinus tachycardia as I have POTS/dysautonomia but my cardiologist (who specializes in POTS) is already calling it SVT.

Would triggering an episode be unnecessarily risky? From what I’ve read SVT isn’t life threatening it just feels scary? When my POTS is well managed and I’m not sick I have to push myself really hard in order for an episode to happen. My nephew also has SVT and has had two unsuccessful ablations, his mom had him run hills to trigger an episode which was then caught on his holter monitor and I’ve been debating doing the same.

I guess I’m just hoping to get confirmation asap and find out if I’d be a candidate for ablation. I do understand there are risks that come with ablations but the thought that I could potentially be a part of the majority that finds relief is really tempting.

So far my triggers have been high adrenaline and cardio-heavy intense exercise, especially if I’m bending over a lot during the exercise. I feel a slight pressure/buzz in my chest when it’s about to happen, and then a squeezing sensation around my heart followed by shortness of breath, dizziness, and obviously a really fast heart rate. I’ve always been able to use an ice pack on my neck and lay down, and then it stops after a minute or two as long as I’ve calmed down.

I should add that these episodes started at the same time my dysautonomia was triggered or worsened enough to become an issue. I went most of my life without daily palpitations or a racing heart beat and then I got covid and strep throat at the same time and was really really sick, my autonomic functions haven’t been the same since. Structurally my heart is healthy and I did all the normal heart tests to rule out other issues. The tachycardia also got more frequent after I started to wean myself off of my beta blocker, I assume the extra adrenaline receptors my body made to compensate for the beta blocker were ultra sensitive when lowering my dose and just causing this issue to become more obvious.

Long story short, I had to see a new doctor for my ADHD meds, mentioned a recent SVT event and he won’t prescribe my medications until I’m cleared by a cardiologist because while my file says “tachycardia”, it doesn’t say “why” I have had an episode of tachycardia.

And because I have severe health anxiety, I’m now freaking out that I’m going to have to see a cardiologist. Of course, it’s allllll the way in January so I get to worry about it for months. What can I expect?

Also, this doctor prescribed me propanol- a literal heart medication- for panic attacks and I’m terrified to take it because my blood pressure is 116/64. But I also read it can help prevent SVTs. (In 10 years, I’ve maybe had 6 episodes…)

23M with a history of SVT. Over the last ~6 weeks I’ve had a major change from baseline. Minor activity like showering, stairs, walking or working causes tachycardia, chest pain/tightness, SOB and pounding/palpitations, and my HR can stay elevated for hours afterward despite resting.

At complete rest, my HR can be normal or even in the 50s–60s.

I also get episodes of significant flushing/feeling hot, sweating, head/neck pressure, nausea and occasional lightheadedness when struggling with this chest pain/palpitations.

Workup so far: CAD-RADS 0 coronary CTA, echo showing mild LVH, 13.4-MET treadmill without ischemia/significant arrhythmia, and negative ER cardiac workup. The tachycardia captured so far appears to be sinus. Awaiting holter results.

Higher-dose metoprolol lowered my resting HR into the 40s–50s and BP into the 90s/50s without resolving the exertional symptoms, so I was switched to low-dose nebivolol.

I recently saw a new cardiologist for another opinion. An S4 was heard on exam, and based on the overall presentation, the doctor also raised concern about ruling out a catecholamine-secreting tumor such as pheochromocytoma/paraganglioma. I also have a longstanding small lateral neck lump that may be completely unrelated but is now being considered as part of the workup.
I’m not looking for a Reddit diagnosis—I’m curious whether anyone has experienced a similar situation where the cardiac workup was largely reassuring but the symptoms persisted and something systemic/endocrine ultimately explained it.

What did it end up being, and what testing finally gave you an answer?

Are you able to tolerate caffeine after having an ablation?

Ablation was two months ago, doc thinks 80% successful. For about a year before I cut caffeine due to pregnancy and SVT going rogue. Haven’t had it since.

Lots of “almost episodes” lately where it feels like I’m going to go into SVT but it doesn’t. Lasts a few seconds. Could caffeine push me over?

I have been taking Diltiazem for SVT (could not tolerate Beta Blockers) and I find it increases exponentially the number of ectopics I am experiencing, though it does seem to keep the SVT from happening. I know this is totally contrary to its usual effect - anybody else experience this?

I have had various arrhythmia episodes over the last 4 years. Usually comes with a sudden spike out of the blue and sometimes heart flops accompany it. I am on a 14 day heart monitor to check for arrhythmia. I was on a walk today in the heat and heart rate was 107 then suddenly spiked to 160 and stayed elevated for 10 minutes. I was light headed and short of breath and I could not get it down. Ambulance came and gave me ekg and it was just sinus tachycardia. I didn’t go to hospital and they didn’t recommend that I do. Does it sound like it was SVT? I had same thing happen two weeks ago on walk but episode was shorter but had worse irregular palpitations with it. Cardiologist put me on a monitor. 3rd time in 4 years I have been on one and never caught anything.

This is my second ablation and four days out. I’ve had two episodes today. Both very quick but one was 163 and the other one was 148. They are putting me on FLECAINIDE.
Has anyone else had issues after their ablation?
I’m so scared since this is the second one that I will never be fixed.
Thank you all so very much

Original post here: https://www.reddit.com/r/askCardiology/s/pnynlZpYfT

Update:

I finally got the ablation they’d been pushing off this whole year, and semi-gaslighting me about for the last 5 years (mainly because I’m a CYP2D6 ultra rapid metabolizer, and Metoprolol doesn’t work for me, but that’s another story).

The EP study showed that my SVT was orthodromic AVRT caused by an accessory pathway, an extra muscle between the atrium and ventricle that I’d apparently had since birth. Then the EP dr said something about needing to approach it from the left side, and that took a little longer, but was still quite fast and straightforward. I hope I’m explaining that correctly. I’m delighted because I was warned at least half a dozen times that the procedure might not work and that was why they didn’t want to put me through it. (I gathered from my EKG readings of an SVT with aberrance the EP was expecting a complex issue — but they only had Kardia / holter readings to go on.)

They asked me if I wanted to try going in with “no sedation” because they thought my case would be difficult and starting with no sedation would be more effective in triggering the arrhythmia. I have no idea what happened because I fell asleep anyway, then awoke when they triggered the SVT strongly, then fell asleep again until they moved me.

So after months of uncertainty and “maybe this won’t be fixable,” the actual answer turned out to be surprisingly concrete and treatable. I hope recovery goes well. 10/10 care at EP surgery clinic, would prefer not to be a repeat customer, no offense to the clinic.

I had an ablation four days ago. My events are getting higher, but they are short under two minutes. They are not a fib, but SVT tachycardia.
The electrophysiologist wants to put me on FLECAINIDE but that did not work after my first ablation. It also constipated me very badly.
If anyone can offer me, any advice, I would appreciate it as I am so depressed. Day two I only went to 127 day three 112 and now I’m hitting the 160s again thank you very much.

I’m 33F, around 130 lbs. Non-smoker, no alcohol, and no caffeine. My normal resting HR is usually around 50–60 bpm. Normal hormones and blood work, no vitamin deficiency either.

I’ve been dealing with episodes where very minimal activity in hot weather can suddenly make my heart rate shoot up dramatically. Today I walked outside for less than 4 minutes and my HR reached 170 bpm.

I was hydrated, had electrolytes, and was actually applying ice to my hands, chest, and face while walking because my HR was so high. I slowed/stopped, but it still wasn’t coming down quickly.

Before everyone says POTS: I’ve already considered/discussed that and I don’t believe my pattern fits. My blood pressure doesn’t seem significantly affected, this does not consistently happen from standing or walking, and I can walk/exercise normally at other times. The major trigger seems to be heat.

Doctors keep suggesting beta blockers, but I’m hesitant to simply suppress the heart rate without understanding why this is happening. Since my normal resting HR is already in the 50s–60s, I’m also concerned about how a beta blocker could affect my HR or blood pressure during the many times when my heart rate is completely normal.

Has anyone experienced this specific heat-triggered pattern and eventually figured out the cause? What testing actually helped Holter/event monitor, stress test, echocardiogram, electrophysiology evaluation, bloodwork, or something else?

Not looking for a diagnosis or medication advice. I’m mainly interested in hearing from people who experienced something genuinely similar and what eventually helped their doctors figure it out.