Supraventricular Tachycardia

I went to a cardiologist for symptoms that included heart fluttering and rapid heart beats that would make my neck muscles contract and make me a bit dizzy.  I am 43 and in good health.  My blood pressure is normal to low and I am 5'1 and way 125 lbs.  I am fairly active.  The cardiologist had me go for blood work as well as an echo - both of which came back normal and I wore an event monitor for 3 weeks.  The event monitor showed some extra beats but mainly I was diagnosed with SVT.  The first recommendation was for a cardiac ablation which I would like to avoid.  I was prescribed atenolol 50 mg a day - I started to take 25 mg yesterday because I am somewhat worried about the fatigue associated with this medication.  I don't think I fully understand what SVT is and what would happen if I only take the medicine and not do anything else.  Since I am fairly healthy and have never had any other heart issues do I need to alter anything that I do.  I eat very healthy and have 1-2 glasses of wine a night.  I don't smoke or do any drugs.  I started taking an aspirin a day when I started having these episode and extra potassium and magnesium.I feel somewhat panicky at the thought of having a heart issue and want to know if it is ok to discount the surgery and that this medication is accurate for treating SVT's.  Is there other options that I can take such as vitamins, diet, etc?  My cardiologist has suggested that I keep hydrated and drink at least 80 oz of water a day.  

Hi Lucky,

Supraventricular Tachycardia (SVT) is an arrhythmia that originates from above ("supra") the ventricle. This term encompasses a large number of arrhythmias and therefore the term "SVT" is only a general description, not a specific diagnosis. Most commonly, however, it refers to one of 3 commons types of arrhythmias, AV Nodal Reentrant TachycardiaAtrial Tachycardia, and Wolff-Parkinson-White syndrome.

Most SVTs can be treated with medications, but medications represent only a temporizing measure, not a cure.  For children or young adults (and probably you as well), life-long therapy with medication(s) may not be reasonable. If one of these potentially dangerous arrhythmias is confirmed with an EP study,  ablation is the only (but not always) curative treatment option for SVT.  It works by selectively destroying the "extra nerve" via a minimally invasive procedure. However, I am not sure, that ablation should be recommended on the basis of an event monitor recording alone. I'd recommend a 2nd opinion with an EP specialized cardiologist first. 

Also, remember that SVT (if true in your case) may be started because of certain triggers, which include caffeine, alcohol, some herbal medications, and some over-the-counter cold medications containing stimulants. Just because a large ice tea triggered an SVT attack, it does not mean that it caused the SVT.  For, without the ice tea, the "extra nerve" is still present, just waiting for another trigger to cause another attack later. 

An important question to ask before talking about treatment is whether you indeed have this 'extra nerve' in your heart and 2nd, how easy it would be to fix it. Despite what is often published not all ablations are truly a cure and occasionally they fail! Like all procedures, success is variable (including the expertise of your cardiologist)!

Hope this helps,

Dr T


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