Heart Problem - PSVT
 

About a couple of months ago I would occassionally get episodes of rapid heartbeats during my rides. It was bad enough that I would have stop for a few minutes to let my heart rate return to normal. This started happening more regularly, so I went to see a cardiologist. I was diagnosed with paroxysmal supraventricular tachycardia, or PSVT.

The doc tells me that there are three treatment options:

1. Do nothing. For the most part I've been keeping the episodes under control by keeping my heart rate below 150 (oh, I'm age 37, BTW). But even then the doc said the episodes may start becoming more frequent over time.

2. Medication. Either beta blockers or calcium channel blockers. My first doc gave me beta blockers (atenolol, 25 mg). The side effects were pretty bad, including impact on exercise performance since the drug limits heart rate. I dumped this doc, since he just gave me these pills without warning me of the side effects or telling me there were other treatment options.

3. Catheter Abalation. A procedure that eliminates the short circuit that causes the rapid heartbeat.

http://www.advocatehealth.com/system...e/cathabl.html

I'm leaning towards (3), anybody have experience with such a procedure?

Check out this thread in the Fifty+ Forum: http://www.bikeforums.net/showthread...9&page=1&pp=25

DnvrFox has been going through something similar and catheter ablation is discussed in the thread.

Thursday afternoon I underwent a catheter ablation procedure. I returned home from the hospital Friday afternoon:

http://www.sjm.com/procedures/proced...heter+Ablation
http://circ.ahajournals.org/cgi/cont...ll/106/25/e203

The procedure went well with no complications. I was hobbling around due to the groin incision on Friday, but I was told I could return to activity on Sunday.

I did a 40 mile bike ride today (Sunday) and felt great, no problems. It appears I may be cured, but will have to verify with the doctor on Friday. Only issues now are bruises at the incision points, quite normal.

Wow, and I am still working on 20 mile rides! I am impressed.

A few years ago I had a similar problem and went with option #3. I wasn't riding at the time but have had no problems at all since. Had the procedure on a Thursday and drove myself home (w/o the Doctor's knowledge) on Friday. I recently have taken up cycling to get into shape and some hills have pushed me so hard that if I were going to have a problem it should have happened right then. Good luck.

Way to go, Brian! I'm glad to hear all went well! :)

SO the way i understand it, it's a problem with the electrical system of the heart?

The good thing is that you got it treated.. it's obviously very treatable and seems to have good results.

Actually it's a hole in the heart that causes the "short circuit". They stick the probe up a vein from your groin and shoot a jolt of electricity, causing a small burn which cauderizes the hole.

euggh..... but it's probably not as painful as it sounds, either that or it's MORE painful.

Hey folks, Longhorn showed me this thread. I'll be having the sam procedure done soon myself. Glad to hear it went well for you all. I hope I have the same success.

edit: 26yr male diagnosed with W.P.W.

That may be true for PSVT (I don't know about PSVT), but definitely NOT true for AFib PVI Ablation, which is entirely a different procedure.

I had my followup with the doc today. He said all appears well and told me to come back in three months.

The form of SVT that I have (had?) is AV nodal reentry tachycardia. In this case, it was some tissue that was conducting the short circuit. The "burns" he did to the tissue stop it from conducting.

I've been getting my heart rate up to 190 on rides with no problems ... not bad for a 37 year old, I guess!

It's been a year since I had the catheter ablation for AVNRT. The doc said there was a 1-5% chance that the tachycardia (rapid heartbeat) could return after the procedure. Lo and behold, within the last couple of months I started feeling the tachycardia on occasion - mostly when getting up quickly from a lying position, or occasionally during hard riding.

So the doc put me on a monitor for a month to record the episodes during my riding. The monitor records automatically during an abnormal heart rate - I didn't feel any episodes during the time I had the monitor, but the monitor recorded a few times anyway. It recorded a heart rate about 250-300 bpm while riding! There's no reason to believe anything is wrong with the monitor, as the techs did a resting baseline recording every time I called in the post-ride recordings.

Based on the wave pattern, the doc said the tachycardia isn't life threatening, but suggested that I control it with medication or have another ablation done. I don't want to go the medication route (there's other threads on beta blockers), and I'm skeptical as to the benefit of another ablation, since during the last ablation the doc was somewhat limited in how much tissue he could burn without risking leaving me with a pacemaker (I had the "atypical" version of AVNRT, which is a little harder to cure than the "typical" version).

So, even though it's against the doc's advice, I'm strongly considering the "do nothing" option. Even with the occasional recurrence, I'm still feeling much better than before the ablation a year ago. From what I could gather from the doc, the worst that could happen is that I could feel lightheaded and possibly pass out due to rapid heartbeat - but that seems like a long shot based on my previous episodes.

Has anyone else been in this situation?

No i have not but an earlier post suggested a calcium blocker to help control the irregularity, I use verapamil and have no problems but this is used fror my high B/P. certain B/P meds do hurt performance but calcium channel blockers do not.,

I have a similar problem but control it with Calcium channel blockers since I have mild high blood pressure.

Given my blood pressure issue (which is basically part of my family genetic makeup) , I need to be on meds no matter what, hence I did not have the ablation done.

My neighbor tried Beta Blockers and it seriously messed up his riding, he has since switched to Calcium channel blockers and is back riding again.

I have been on them about 9 months now and can hit 175 MHR again (51 years old) without fear of redlining my heart rate. No side affects and feel great.

Good luck.

From what limited information I know (so you should probably want to check this out with your doctor and most of where I get this from comes from preventing high blood pressure problems - that aren't even on me - so it could again be completely different) there are a number of different medications that act in different ways. Basically you have a chain of events, or a pathway of chemical reaction occuring that makes your heard beat faster and harder. Different events can act on different parts of this pathway and so can have different side-effects.

Personally, I would stay away from the very first doctor you saw - every doctor should always tell you the risks and side - effects of everything. That doctor is just an eejiit.

Basically it can happen to anyone, no matter how fit. Have a read about a guy named Greg Welch, retired triathlete and formally one of the fittest people on the planet. Probably didn't have the same thing as you but similarish.

I've recently been diagnosed with PSVT. Checked graphs for outdoor and indoor training rides last couple of years and found HR spikes every few rides. They might occur 1-3x per ride when they occurred. Interestingly, it was usually shortly after a hill or increased speed/cadence when HR should be lowering.

Had an accelerated cardio stress test on treadmill and it showed up shortly after recovery phase began. I never felt any physical symptoms when my HR moved up. I'm 57 and HR would go from 145-160 range up to 190-210 for about 30 seconds. I was given the same 3 options in that order. I just started on a calcium channel blocker as I also have slightly high blood pressure. Waiting to see a cardiac specialist as well.

Will be doing a 160 km ride followed by a 100km next day this weekend so we'll see what effect this has.

You might want to start a new thread on this subject in the Fifty Plus forum.
Why? 1. This thread has been asleep for six years.
2. Higher chance on getting some feedback from we older pharts.

Done. I'm new to this so thanks for the suggestion