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Forum Name: Arrhythmias

Question: AVNRT - Ablation


 FlowerDust - Wed Jul 29, 2009 10:40 pm

Hi,

Five years ago I started having rapid heart rates after increasing my exercise level or going up stairs. It would go (resting 90) to 100...110....120...BAM...180...190...200...at 200 I would grey out so I would stop what I was doing and it would take about 40 minutes to come back down to 80-90.

I did various treadmill stress tests which all showed the same pattern over and over again...I would push all 10 minutes running even though it hurt just to prove it...

The EKGs, Echos...all showed normal structures and rhythms except that it was fast. Tried a beta blocker but it made me feel like crap.

I am only 29 (28 at the time, 24 when it began) and decided I do not want to be on meds forever and I want to be active, climb with my friends, bike, run!! So I manage to get in with my Cardio's partner who is an electrocardiologist. He took one look at my tests and suggested I had SVT.

Based on the symptoms I have I think it is AVNRT. It is not always present..sometimes it will flutter now and then and speed up but never for more than a few seconds but if I exert myself...BAM....without a shadow of a doubt.

I decided to have an ablation at his request as this seems to be the best option. I just wanted to know if there are any other rhythms that present "normal but just really fast" on exertion to consider as far as the kind of SVT.

My triggers:
Excersise
Caffeine
Stress
2 servings of alcohol

Anything more than moderation will put it over. But I have never just been "struck" and it has never gotten over 220 (and that is when I forced myself to run a mile and it hurt my chest like fire!)

Also, I know my heart is fine if the ablation is successful but how long do you recommend I wait before attempting a jog or run?

Thanks for your assistance.
 John Kenyon, CNA - Thu Aug 06, 2009 12:12 am

User avatar Hi there --

While most of your symptoms are consistent with SVT due to AVNRT, the fact that they can be induced by exercise and never come on spontaneously leave me wondering just what is really going on. Some sort of SVT seems most likely, and AVNRT isn't out of the question, but the onset and triggers are both fairly unusual for that. An ablation would involve an electrophysiological (EP)study to try and locate the source and if it is AVNRT that would be discovered during the EP study. If the origin is somewhere else it's usually still amenable to ablation, so it sounds like a win-win to me, even though it behaves in a somewhat atypical manner (for AVNRT). The extremely high rates certainly do make it sound like AVNRT, which is the most common cause of SVT.

I would definitely go with the EP study/ablation, and as for the waiting period afterward, the main consideration is the catheter insertion site, which will keep you limited in activity for a couple days tops, but won't allow you to start running for probably a week or so. The heart part is more forgiving by comparison, but you really don't want to insult the insertion site and your cardiologist can give you the best time frame for resuming vigorous activity, but my best guess would be a week or two. You should be up and around in a day , two at the most, but will have to take it easy for about a week and then you still need to allow the site to heal beyond that time.

Hope this is helpful to you. Please follow up with us as needed, and also update us as to the findings and outcome of the EPS/ablation. Good luck to you.

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