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Cardiologists - Question about SVT

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March 27, 2020, 11:16 AM
PHPaul
Cardiologists - Question about SVT
Younger grandson, 21 years old, has a preliminary diagnosis of SVT after wearing a heart monitor for a month.

Early days, but the cardiologist that made the diagnosis is suggesting surgery.

Can you give me a layman's explanation of the problem and the ways it may be corrected?




Be careful when following the masses. Sometimes the M is silent.
March 27, 2020, 11:30 AM
snoris
This is fairly long, but I think it gives the most understandable description of the condition, how to live with it, and the different treatments that are available.

https://www.mayoclinic.org/dis...-causes/syc-20355243
March 27, 2020, 12:09 PM
PHPaul
Thanks, snoris.

Jarod's symptoms are random. Light-headedness, a couple of episodes of fainting. He hiked into a pond to go fishing with some buddies, felt no symptoms whatsoever, but the company monitoring him called the cardiologist as his heart rate was so high they feared damage.

Based on the above, I'd suspect they think it's serious enough to warrant a pacemaker or an ablation.




Be careful when following the masses. Sometimes the M is silent.
March 27, 2020, 02:33 PM
ryan81986
They'll probably go with the ablation rather than an implanted defib/pacemaker, basically just "burning" the accessory conduction pathway or reentry circuit to prevent the electrical current from re-entering causing the rapid heartbeat. Or they may start with medications.




March 27, 2020, 03:10 PM
El Cid 92
Ablation.... 85-90% curative on the first try.

Definitely, not a surgical problem.

Only risk is if the accessory pathway is near or close to the AV node (connection btwn the upper and lower chambers of the heart). If the AV node gets burned then it's pacemaker time. This event is a very small risk.

Go see an Electrophysiologist of good quality.

Andrew



Duty is the sublimest word in the English Language - Gen Robert E Lee.
March 27, 2020, 06:38 PM
08 Cayenne
I've been down this rode. Wore the monitor for a month, they saw multiple problems which I never knew about. I didn't remember any of the episodes they referenced. Ablasion is what they recommended but only when they got bad enough to to effect my quality of life. They said it was safe and quite common. I didn't get the procedure and after about a year my symptoms went away.
March 27, 2020, 07:08 PM
Butch 2340
My wife has lived with it for at least 15 years. With medication (Metoprolol) and if she behaves herself she has a pretty normal full life. It's basically a short circuit in the electrical pulse that makes the heart beat. Get him to a good cardiologists and he should be fine.


******************************************************************************
Never shoot a large caliber man with a small caliber bullet . . .



March 27, 2020, 07:21 PM
sjtill
PHPaul, I’m a general cardiologist, now retired.
What your grandson needs is to be referred to an electrophysiologist—that is the specialty of cardiology that deals with supraventricular tachycardia (SVT).
There are several types, but an electrophysiology (EP) specialist can diagnose the type from his monitor tracings and his EKG; and would be the specialist to do an ablation. The specific type of ablation depends on the type of SVT; but as noted above the procedure is highly successful, usually 95% success rate, with usually no need to take medication after that.
Some forms of SVT are associated with abnormalities of the heart electrical conduction system that can potentially carry high risk of not just fainting, but of cardiac arrest.

I don’t know about Maine, but Harvard and Dartmouth have excellent electrophysiologists. If your grandson might be seen at Dartmouth, send me an e-mail and I will put you in touch with my former chief who is now at Dartmouth and used to be on the faculty at Harvard.


_________________________
“ What all the wise men promised has not happened, and what all the damned fools said would happen has come to pass.”— Lord Melbourne
March 27, 2020, 09:00 PM
PHPaul
Thanks everyone, I'll keep you posted.

Now my wife is in the hospital suspected cardiac issues. Upper stomach/chest pain starting about 10:00AM, not gone by 3:00PM so we went to the ER. Initial diagnosis was indigestion, but a follow up EKG was a little wonky so they decided to give her a nitro pill. Wham-bam, pain is gone.

I guess that's a good diagnostic hint. They want to do a stress test but can't because her BP is over the moon. We've always attributed it to White Coat Hypertension, but they're not so sure.

They'll be keeping her both for observation and to try and get her BP down so they can do a stress test.

Oh, and my daughter got laid off today.

Other than that, it's been a great day...




Be careful when following the masses. Sometimes the M is silent.
March 27, 2020, 09:04 PM
BOATTRASH1
ON Paul, Best wishes sir. Hope everything turns out fine.
March 27, 2020, 09:48 PM
Green Highlander
I was diagnosed with dialated cardiomyopathy in 2001 and have had very serious episodes of VT. My EP doc at Mass General has been phenomenal and taken me through a variety of treatments including ablation, cardiac resynchronization and sympathetic dennervation. Feel free to reach out with questions or for doctor recommendations.


"You know, Scotland has its own martial arts. Yeah, it's called Fuck You. It's mostly just head butting and then kicking people when they're on the ground." - Charlie MacKenzie (Mike Myers in "So I Married an Axe Murderer")
March 27, 2020, 10:24 PM
sjtill
PHPaul,
The doctors may be able to do a non-exercise stress test, for example a nuclear medicine stress test using a medication (Lexiscan or the like) instead of having her walk; that will not raise BP.
Some kind of stress test certainly seems advisable.


_________________________
“ What all the wise men promised has not happened, and what all the damned fools said would happen has come to pass.”— Lord Melbourne
March 27, 2020, 11:05 PM
Donothing
In 1996 I Started having serious problems with AFib and uncontrolled SVT. My heart would go into an episode of AFib and then kick into runaway SVT--heart rate north of 200bpm. A really wild experience.

After the third hospitalization, and having tried about every Beta blocker (all of which either had side effects I could not tolerate or did not work) I had an ablation in 2005. The procedure was about 7 hours long and my doc burned off 25 spots. I was in my early 50's at the time. I have been fine since. No issues with Afib or SVT.
March 28, 2020, 07:22 AM
PHPaul
Well, poop.

Called the hospital, took them a minute to find her. She's fine, but will be there until at least Monday so they can do the stress test.

NO visitors, not even me. Which, I guess under the circumstances, makes sense but it sucks.




Be careful when following the masses. Sometimes the M is silent.