Any nurses have SVT or IST?

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Specializes in rehabilitation, home health, LTC.

Hi there,

I had an episode of possible SVT in September while I was working----I went to the ER with a rate of 150's and up at times. The doctors thought after vagal maneuvers I was in A flutter. My K+ was also very low at 2.4 for unknown reasons. After Adenosine and cardioversion...nothing worked. Apparently I was in "sinus tach" the whole time. I was then placed on IV amiodarone and sent to ICU overnight. Since then I have been taking Toprol XL 100mg a day for this rapis rate of unknown orgin. I have seen an EP doc. and even they said it's sinus tach....but in the 150's??? and for so long?? have any of you experienced cardiac issues? There is a thing called Inappropriate sinus tachycardia...supposedly it is seen in female healthcare workers...HMMMMMM???:nurse:

If anyone else has SVT or IST please let me know your story and how you deal at work. :redbeathe

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Specializes in SICU/CVICU.

I haven't been diagnosed yet, but my EP is pretty sure it's ISP. I have big time problems with it pretty much every day. My heart rate gets in the 140s-160s on a daily basis. I'm only taking 50mg of Toprol XL though. I get really dizzy and short of breath. I am still waiting to see my options of how to deal with it because right now it is very difficult. I have a lot of trouble in my 12 hour clinicals and sometimes I just have to squat down on the floor to catch my breath. I have never gone to the ER because of it.

Is there anything besides beta blockers that helps? Mine help some, but I still have problems with it. How do you deal with it?

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Specializes in rehabilitation, home health, LTC.

Hi there,

I am on 100mg of Toprol Xl. I was on 50 and still had breakthrough tachycardia. It took awhile to adjust to the beta blockers, but now I am fine. I was really tired at first. You need to drink more fluids and check your BP frequently if your dizzy often. I can tell once I feel dizzy to increase my fluids. Have you worn a Holter? or an event monitor? I have had episodes while in telemetry and they told me it's "only sinus tach" kids of odd to me to get sinus tach for no reason up to 150's just sitting still and not have it be SVT.

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Specializes in SICU/CVICU.
travelnurse28 said:
Hi there,

I am on 100mg of Toprol Xl. I was on 50 and still had breakthrough tachycardia. It took awhile to adjust to the beta blockers, but now I am fine. I was really tired at first. You need to drink more fluids and check your BP frequently if your dizzy often. I can tell once I feel dizzy to increase my fluids. Have you worn a Holter? or an event monitor? I have had episodes while in telemetry and they told me it's "only sinus tach" kids of odd to me to get sinus tach for no reason up to 150's just sitting still and not have it be SVT.

I am thinking 100mg is going to be better for me as well. My EP told me to drink 3L of water a day and increase my salt intake, but that honestly hasn't helped at all. I have worn an event monior and Holter monitor. 99 % of what was captured was NSR. I notice mine the most when I'm standing, but it still goes on when I'm sitting or laying down. My EP said it definitely wasn't SVT.

Did they make you do a 24 hour urine? I know they are checking for catecholamines and a few other things.

I think it's so strange that IST is common with female health care workers. I wonder why that is. I read something that said that nurses are more likely not to dismiss their symptoms. My PCP was very dismissive of my problems, so I kept pushing forward to a cardiologist and electrophysiologist. I'm glad I did because my PCP thought I was just very deconditioned (which isn't true because I'm in good shape).

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Specializes in rehabilitation, home health, LTC.

I did have to do 24 hr urine...I also had chatecholamines drawn as well as TSH--and renin, aldosterone...they were all normal. They thought it could be a pheochromocytoma...but I had not HTN so probably not. It wasn't that. 9Thank God) who knows what caused my sudden symptoms. I just hope it doesn't come back! Toprol seems to help. I'm afaid to go off of it honestly!

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Specializes in NICU Level III.

I'm pretty sure I have IST even though I've done several EKGs, exercise stress test, echo, blood work, holter monitoring..and whatever else and it was inconclusive. My resting heart rate when I'm awake is usually in the 110s-120s. When I work out, it shoots up to 180s within the first minute. It used to go over 200 but I haven't seen that in a while. During my EST, the cardiologist said I'm fine as long as it doesn't go over 200..and it went to 199 during the test. Hmmm. Right. The only symptom I don't really have is fatigue from it and exercise intolerance (unless I'm running then I poop out FAST). It's intermittent though.. it used to be that high all the time but the past year or so it seems to stay in the 90s and go up to 180 w/ cardio exercise. I definitely still get palpitations and when I stand up, I get light headed a lot. It's odd...I'm on nothing for it.

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Oh my! I have it too! I had an EP study and it was "inconclusive" stayed in sinus tach whole time. I am on beta blockers. I did not like Topral! It made mine worse for some reason. I am on acebutolol 400 mg a day. Also, POTS is another reason for tachycardia ecspecially when a person is on feet alot. I also wake up with the heart racing in the middle of the night about 1.5 hrs after I fall asleep(keep finger on 911 on my cell phone). I hate it. Even though I'm a nurse, it still scares me. I even had it at the gym one day but that time it felt like SVT. It is common in healthcare workers mainly nurses and paramedics (EMTs). Its not easy working and having the heart go crazy like that. I have had issues with it since I was 16 but its worse as I get older. I wanted an ablation but the EPS said there wasnt anything to ablate unless he took off whole node and then I would be pacemaker dependent :(

He said that can make arrythmias worse and new one pop up. Scary stuff.

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NeoNurseTX said:
I'm pretty sure I have IST even though I've done several EKGs, exercise stress test, echo, blood work, holter monitoring..and whatever else and it was inconclusive. My resting heart rate when I'm awake is usually in the 110s-120s. When I work out, it shoots up to 180s within the first minute. It used to go over 200 but I haven't seen that in a while. During my EST, the cardiologist said I'm fine as long as it doesn't go over 200..and it went to 199 during the test. Hmmm. Right. The only symptom I don't really have is fatigue from it and exercise intolerance (unless I'm running then I poop out FAST). It's intermittent though.. it used to be that high all the time but the past year or so it seems to stay in the 90s and go up to 180 w/ cardio exercise. I definitely still get palpitations and when I stand up, I get light headed a lot. It's odd...I'm on nothing for it.

Your symptoms are similar to mine. I'm over a year post-ablation for WPW. They haven't found anything abnormal either. I'm concerned that a silent pathway may becoming active since they ablated the other accessory pathway. I have to schedule an appointment with my EP soon so hopefully I'll get some answers. I'm also having chest discomfort with palpitations and shortness of breath. Had cardiac enzymes drawn (for some reason just one set) in the ER and they came back clear. My cardiologist scheduled me for a stress test with cardiac enzymes. They also told me to increase my sodium and fluids to help with my orthostatic hypotension. I hope you get some answers soon, as well.

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I was just recently diagnosed with IST. My heart rate was in the 160s at times (after wearing a holter monitor). I'm now on Coreg 3.125mg BID. But i still experience palpitations and have had a few episodes of my heart rate over 110, usually while at work, so I think an increase in mg's is needed soon. It is very scary even if we are nurses.

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I've had IST for at least 14 years. I also have the autonomia. Atenolol 25mg BID keeps it under control. If I have a run of fast rhythm drinking a glass of ice water fast has always worked to bring it down, and even then sometimes I need to take an additional 25mg of the atenolol. It's interesting that it is most common in female healthcare workers, my cardiologist says...

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Just "officially" diagnosed with IST by my EP doctor. Of course since I am a nurse I did some homework beforehand and thought that might be what I had. I am already on 100 mg of Toprol each day for a previous heart dysrhythmia that was partially taken care of by an ablation. Surprised to read this condition is common in female nurses. I wonder if they are doing any research on this phenomenon?

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Specializes in Women's Health.

My daughter had SVT. She had always wanted to be a nurse, had no issues with things making her sick. When she entered her program she also started working as a PCT. She started fainting at work, not because of the work, but her heart. One cardiologist told her she was too tall and thin. hahaha She then became a paralegal. The attorny's son is a cardiologist. He diagnosed her SVT. She had an ablation and now is an RN BSN. No further problems, but she avoids caffeine. Good luck!!!! :yeah:

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