I'd like some imput from someone on this has anyone suffered SVT ( Supraventricular Tachycardia ) If so did you what did the doctors do for you? Mine gave me ablation. It went away, Now with POTS you get rapid heart rate as well and it feels like SVT. I would like some comments please on what the difference is in the rapid beat. It is my own experience and records from doctors saying SVT's are abnormal ryth. in the heart causing a sudden jump in rate, with pots they tell me 165 bpm is not tach, or svt's it is just the heart rate accelerating to compensate a sudden drop in blood pressure, I have researched this tonight and all I can find is that ANY HEART RATE ABOVE 150 IS TACH. Well that being the case and T in tachycardia, spells it out that it is Tachycardia, what is the difference? any info apprieciated. THanks

I have superventricular tachycardia as well. And I have sinus tachycardia too. I have the superventricular tachy even when my blood pressure is normal. From what my cardiologist has said anything above 120 is sinus tachy anything above 150 is super tacy. I have had one ep study done back in 2004 but didnt have super then. I will be going in again here soon. I have my appointment on wed with the ep cardiologist and see what he says. For me I dont have hypotension anymore now I have hypertension with tachy so I dont know what is worse.

quote:

Originally posted by Misty:
I have superventricular tachycardia as well. And I have sinus tachycardia too. I have the superventricular tachy even when my blood pressure is normal. From what my cardiologist has said anything above 120 is sinus tachy anything above 150 is super tacy. I have had one ep study done back in 2004 but didnt have super then. I will be going in again here soon. I have my appointment on wed with the ep cardiologist and see what he says. For me I dont have hypotension anymore now I have hypertension with tachy so I dont know what is worse.

just curious how did you go from hyper to hypo?
see I had 165 heart rate cought on recorder at OSU and they told me that even though it is a high heart rate it was normal sius rythem and they could not put in a pacer cause it is caused by pots syndrome, said if it were true tach, I would have abnormal sinus rythem. thanks for commenting, I will wait to see what your doctor saids.

Shirley -
I just responded about this on your other post but just wanted to mention something here as well. Some Drs. are under the impression that you have to have a blood pressure drop with POTS. This is not true. If you poll many of us on this forum, some have it and some do not. I can go either way. POTS is defined (by Dr. Grubb who I understand is your Dr.) as an increase in heartrate of 30 beats or more within 10 minutes upon standing. This may or may not be associated with orthostatic hypotension. It is now also known that POTS symptoms can occur due to blood pooling while sitting as well.
Many people with POTS who have a tilt test do not actually pass out during the test but do have the extreme heartrate jumps when the table is tilted up.
I spoke a bit more about my experience with SVT and sinus tach on the other post. I'm a bit confused as to why your Dr. says that true tachycardia would have an abnormal sinus rhythm. It sounds to me as if you are dealing with a form of Inappropriate sinus tachycardia. That means your heart is still in rhythm but is beating very fast. It's still tachycardia......it can be very confusing and frustrating to sift through all the info. and each Dr. can have a different way of describing things. I hope you can get all the answers you're looking for.

How confusing! I had heard that the different rates made for tachy, SVT, etc, too. But when I saw my strips (from being monitored in the hosp) a resident noted SVT, well the cardio wrote in big letters NO, IST. It really depends from where (and sometimes what) it originates.

From what I understand is that IST is a normal sinus rhythm, it comes from the sinus node. SVT comes from above the ventricles...Here I looked up this article: http://www.emedicinehealth.com/supraventricular_tachycardia/article_em.htm

So, I am guessing the SVT maybe wouldn't have the P wave? Which if I recall correctly is the sinus node starting the next beat.

IST is "inappropriate" sinus tachy. It means if you go over 100bpm sitting that is inappropriate tachy. If it jumps say to 120-170bpm just upon standing or walking a few steps that is inappropriate (or that's what I was told in my case).

I hope I didn't add more confusion to the matter.

hugs

quote:

Originally posted by trebleclef:
Shirley -
I just responded about this on your other post but just wanted to mention something here as well. Some Drs. are under the impression that you have to have a blood pressure drop with POTS. This is not true. If you poll many of us on this forum, some have it and some do not. I can go either way. POTS is defined (by Dr. Grubb who I understand is your Dr.) as an increase in heartrate of 30 beats or more within 10 minutes upon standing. This may or may not be associated with orthostatic hypotension. It is now also known that POTS symptoms can occur due to blood pooling while sitting as well.
Many people with POTS who have a tilt test do not actually pass out during the test but do have the extreme heartrate jumps when the table is tilted up.
I spoke a bit more about my experience with SVT and sinus tach on the other post. I'm a bit confused as to why your Dr. says that true tachycardia would have an abnormal sinus rhythm. It sounds to me as if you are dealing with a form of Inappropriate sinus tachycardia. That means your heart is still in rhythm but is beating very fast. It's still tachycardia......it can be very confusing and frustrating to sift through all the info. and each Dr. can have a different way of describing things. I hope you can get all the answers you're looking for.

I am very confused on this topic as well a anyone, Yes Dr. Grub said there does NOT need to be a B/P Drop which I do get sometimes I get readings as low as 80/59. some may have been lower, none the less I don't know why I am finding in here that anything over 150 bpm is tach and they tell me it's not, and if it is due to pots, I have had very high beats sitting. I will definately clear this up, they say they used to put in pacers in the old days to help with this rapid heart beat, but it caused ohter problems he didn't go over and didn't recommend it for me at that time,furthermore he did say that some pts do end up getting pacers anyway but didn't go into specifics of who would benefit and/or had no choice for what ever the reasoning was to do it on some patients.

quote:

Originally posted by jan p:
How confusing! I had heard that the different rates made for tachy, SVT, etc, too. But when I saw my strips (from being monitored in the hosp) a resident noted SVT, well the cardio wrote in big letters NO, IST. It really depends from where (and sometimes what) it originates.

From what I understand is that IST is a normal sinus rhythm, it comes from the sinus node. SVT comes from above the ventricles...Here I looked up this article: http://www.emedicinehealth.com/supraventricular_tachycardia/article_em.htm

So, I am guessing the SVT maybe wouldn't have the P wave? Which if I recall correctly is the sinus node starting the next beat.

IST is "inappropriate" sinus tachy. It means if you go over 100bpm sitting that is inappropriate tachy. If it jumps say to 120-170bpm just upon standing or walking a few steps that is inappropriate (or that's what I was told in my case).

I hope I didn't add more confusion to the matter.

hugs

You couldn't be more right of the confusion on this tach issue, I have noted them talking about the p wave as well when reading my recordings. I am courious to find out what my cardiologist and POTS dr. say when I really nail it do to find the answer on my next visits. I will let you know and I will check out the link too. I will let you know. thanks for your reply

quote:

just curious how did you go from hyper to hypo?
see I had 165 heart rate cought on recorder at OSU and they told me that even though it is a high heart rate it was normal sius rythem and they could not put in a pacer cause it is caused by pots syndrome, said if it were true tach, I would have abnormal sinus rythem. thanks for commenting, I will wait to see what your doctor saids.

I went from hypotension to hypertension. The doctor seems to be baffled by it. My blood pressure started getting so high so they stopped my midodrine and florinef. Since they have done that my blood pressure has been running normal with taking my beta blockers. I am really not sure how this happened or what caused. But from my understanding with POTS you can have high/low blood pressure. You dont just have to have low to have POTS. I also have inappropriate sinus tachycardia as well. These are all the reasons and things that my cardiologist wants me to see the EP cardio for. He is completely lost at this point himself so wants to send me to someone else to find out what is going on. My body has done a change on them after 4 yrs of hypotension and they dont know what caused it.

i, too, have spent way too much of my time and energy being confused about all this, but here is my two-cents.
i have also been diagnosed with inappropriate sinus tachycardia. sinus tachycardia is a normal physiological response to things that get our heart rates up - working out, getting "spooked," etc. sinus tachycardia is basically a rapid heart beat, but normal rhythm. inappropriate sinus tachycardia is called so because our hearts respond like we are in situations that would ordinarily cause increases in heart rate - but we're not. so my heart rate will kick up to over 200 bpm while i'm sitting watching tv. that is NOT appropriate. or, i believe that inappropriate sinus tachycardia can also be the case when we have exaggerated heart rate responses to things that would normally get heart rates up, like exercise or caffeine. so, for example, when i exercise, normally, as a healthy person, my heart rate would have been around 160 max. now, a little exertion can cause it to soar to well into the 200s. same with caffeine. a couple cups of coffee a couple years ago would kick my heart rate up to maybe around 100-110, which is TACHYCARDIA, but this is a normal physiological response to a stimulant like caffeine. however, now, a cup of so-called decaffeinated coffee from starbucks (which still has a little caffeine in it) can get my heart rate going in the 170s. so, the point is, this is also inappropriate sinus tachycardia.
from what i understand, however, my heart rate's rhythm is normal. it doesn't change. i don't know much about SVT, but i am quite sure that is considered a change in rhythm from the sinus node, as jan said. my inappropriate sinus tachycardia is caused by abnormal norepinephrine/hormone issues, not my heart. i believe SVT is a heart issue (though benign, from what i understand).
i highlighted the word tachycardia above because tachycardia is defined as a heart rate above 100. again though, tachycardia is NORMAL in response to certain things, like exercise and caffeine. everyone experiences tachycardia. it becomes abnormal or worrisome though when it is an inappropriate response. my resting heart rate is often tachycardic, and that's not normal!

hope this makes some sense. it took me some time to understand all of this, and, i still don't.

Hi, I'm going to give this a shot. I know it is very difficult to understand the intricate details of our heart. It is truly amazing! I have been out of EMS for quite a while, so I admit, I had to refresh my memory on this a little myself!

What you have to remember first and foremost is that the NUMBER of beats per minute does not in and of itself constitute what rhythm your heart is in. You can't look at the number 150 and say, oh, I'm in SVT, or PSVT as it is sometimes called. A diagnosis of a heart rhythm is made by looking at what the heart is doing on the monitor, not just by how many times it is beating per minute. There are several factors that one must take into consideration to determine this.

Sinus Tachycardia is a regular, normal rhythm of the heart. It is just beating faster than it normally should go. The electrical impulse of the heart is originating where it should and the heart is not in danger. The doctor looks at specific markings on the EKG to decide where the electrical impulse is originating. Even though it may make US with DYS feel dizzy and not well, it can still be tachycardia at 150 and the heart itself is fine. Usually anything over 90-100 is considered Sinus Tachycardia.

PSVT is an abnormal rhythm of the heart and is not generated in the normal area of the heart. Again, it is not so much the rate but the markings on the EKG that tells the doctor where the electrical impulse is originating. In PSVT, the heart is beating so fast the heart muscle cannot relax between contractions. When the chambers of the heart do not relax, they can not contract strongly to fill with enough blood. Since the blood flow is not sufficient, sometimes patients become symptomatic (lightheaded, dizzy, feel faint, etc.) and it must be treated. Sometimes the patient is not symptomatic so they may let them ride it out and see if it converts back to a normal rhythm.

I hope this helps some.

ETA: I didn't address IST but I think GracieTiger ^^ did an excellent job!!

Misty -

I believe the high blood pressure is a symptom of tje hyperadrengic form of POTS. Maybe this is what is going on???

joy - great response!
i have a question, which may be completely stupid - if one is having an episode of SVT, one's pulse would be fast too? is it possible for someone's heart to be beating really rapidly, but for the pulse to not reflect this?
i ask because i think i have read somewhere that it is possible, i think with VTach, for a person to not be able to feel their pulse in their neck anymore (which is really bad), because the heart cannot pump the blood. so i'm wondering if this also means that the heart cannot pump enough blood to cause the pulse to speed up, though the heart is?
this is very complicated. it's not something i worry about having, just curious.

quote:

Originally posted by Misty:

quote:

just curious how did you go from hyper to hypo?
see I had 165 heart rate cought on recorder at OSU and they told me that even though it is a high heart rate it was normal sius rythem and they could not put in a pacer cause it is caused by pots syndrome, said if it were true tach, I would have abnormal sinus rythem. thanks for commenting, I will wait to see what your doctor saids.

I went from hypotension to hypertension. The doctor seems to be baffled by it. My blood pressure started getting so high so they stopped my midodrine and florinef. Since they have done that my blood pressure has been running normal with taking my beta blockers. I am really not sure how this happened or what caused. But from my understanding with POTS you can have high/low blood pressure. You dont just have to have low to have POTS. I also have inappropriate sinus tachycardia as well. These are all the reasons and things that my cardiologist wants me to see the EP cardio for. He is completely lost at this point himself so wants to send me to someone else to find out what is going on. My body has done a change on them after 4 yrs of hypotension and they dont know what caused it.

Misty is there a chance that you are getting better, cause you are now off the two meds, and doing okay on beta? I know it is true you can have high or low b/p. but to have it low for so long than going to high, is weird, do you or rather did you feel different when it went up? I am courious cause my B/P has gone up before and I feel really bad, which is also weird cause when I say it went up it mearly went to normal compared to the extreamly low readings, and to me when that happens it's as bad as when It first started going low. just feel horrible, I hope this is a good thing for you.

Actually while it is sitting normal I am doing great for the most part. But when I go into hypertension I get the same effects as I did when it would be low. I get clamy, lightheaded, and a migraine. So all in all high is no better than low. I have even still had my blackouts while bp is high. So I am still getting the same effects as if it were low. Its weird. But I dont think I am getting any better. Now I have gasteritis,peptic ulcer, and IBS with constipation. So all in all I am still miserable. The cardiologist thinks my heart is working an overload to much since I am so fatigue all the time and sleeping 12-14 hrs a day. This is why they need to send me to the ep cardiologist. My reg cardio said I may have to have a pace maker put in given the changing in my heart rate. Also I have a atrial flutter now and Premature contractions. So there are still problems going on with my heart which is making them concerned with the high blood pressure now.

quote:

Originally posted by GracieTiger:
joy - great response!
i have a question, which may be completely stupid - if one is having an episode of SVT, one's pulse would be fast too? is it possible for someone's heart to be beating really rapidly, but for the pulse to not reflect this?
i ask because i think i have read somewhere that it is possible, i think with VTach, for a person to not be able to feel their pulse in their neck anymore (which is really bad), because the heart cannot pump the blood. so i'm wondering if this also means that the heart cannot pump enough blood to cause the pulse to speed up, though the heart is?
this is very complicated. it's not something i worry about having, just curious.

GracieTiger, there are no stupid questions and this is a very good one! You are correct. We were always taught to treat the patient, not the monitor! You can have a rhythm on the monitor but it may not be producing a pulse at all. Once your heart starts beating really, really fast, or sometimes if it is beating too slow, it may not be adequately filling with blood and contracting properly. At this point, it can not produce a strong pulse or sometimes it will not produce a pulse at all. Sometimes you can feel it at the carotid artery (neck) but not at the radial artery (wrist). Once you can not feel it at the wrist, you can pretty much assume the blood pressure is less than 90 systolic. This is serious and the patient needs intervention fast!

In the case of V-tach, it is very serious regardless. It has two different algorithms depending on whether or not the patient has a pulse. If the patient does not have a pulse, it is treated like V-Fib (the heart is basically just quivering, not contracting). They are defibrillated immediately if it is pulseless.