My son has SVT Questions

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My 20 year old son was just diagnosed with SVT. He wore an event monitor for a month. It doesn't seem to be too severe as his only symptoms are a feeling of chest discomfort and the rapid heart beat. It has never lasted long.

I am waiting for the cardiologist to call me any words of wisdom, questions to ask him. I am an OB nurse so this is out of my realm!

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Specializes in Hemodialysis, Home Health.

I recently underwent a cardiac ablation for SVTs. I had them for several years, and while not near as bad as my sister (who has had them for over a decade), mine were interfering with my work,. I was having to go up the hill to our local hospital ER to be converted, and this was getting to be problematic, as I am often in charge, and the only RN at our unit several days a week.

I opted for the ablation, as I am not fond of taking medications due to their numerous side effects.. much less those I would have to take the rest of my life. Nor had I ever been successful in converting myself by vagal maneuvers, etc.

I have not had an episode of SVTs since.. the ablation was in March.

While I do often notice short "runs".. they are as if the SVTs are "wanting" to kick in.. but never last more than a few seconds. The extra circuitry has been ablated, so they have no where to go to continue their run.

SVTs can be quite scary, but mostly they are annoying. They did cause me to become lightheaded and dizzy if they continued for more than an hour, and my fingers would begin to tingle... the heart is beating so rapidly, it is not able to pump adequate oxygen to the brain.

I would wait to hear back from your son's cardiologist.. he may be scheduled for further tests, etc. to rule out other concerns.

If it is SVTs and no more, I would not be overly concerned at this point, your son with the help of his doc will have to decide how and when he wants to intervene and resolve this to best suit his needs and preference.

Wish him the best ! :)

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Specializes in ICUs, Tele, etc..

what are his questions about svt's

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Sorry it should have been I have questions. When is it bad enough to treat. If untreated are there any consequences or is it just an annoyance if not severe.

Medication vs ablation

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Specializes in ICUs, Tele, etc..

Hi i guess since most cases of psvt in young people are harmless and sometimes occur once in awhile leading to symptoms, maybe learning how to ''stop'' they cycle would be a good idea. I get psvt once in awhile and get a lil short of breath and i feel my heart found fast, real fast. Doing vagal maneuvers and there's different kind would help alot and save alot of trips to the emergency room. I guess it just depends on how frequent it is, and how fast it converts back...now in the question of ablation or medication i guess it would depend on someone, if they're going to be able to comply with medication then using digoxin or beta blockers would be good, but most kids won't really comply so i guess it's better to just get the interventional route. good luck

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Thanks for the replies, still waiting for the cardiologist to call!! :o

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Specializes in acute care.

If it's not severe, it may not warrant going for the ablation--the procedure does carry some risks, especially if the accessory pathway is in or near the AV node (as is often the case with PSVT--AV nodal reentry tachycardia is a common form)--if the AV node accidentally gets fried, the person ends up needing a pacemaker. However, ablation is a great option for someone whose arrhythmia is causing problems, and has the advantage of (hopefully) permanently solving the problem so no medications are needed. How long do his episodes generally last, and how often do they happen? Do they stop on their own, or do vagal maneuvers break the SVT? You said during an episode he feels his heart racing and has chest discomfort; any other symptoms--dizziness, SOB, near syncope? Has he noticed anything that tends to bring on episodes (certain activities, caffeine etc.)? Let us know what you find out.

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The cardiologist called and he recommended going to see about an ablation which surprised me because it has never been severe enough to cause syncope or SOB. The MD did say that it was happening very frequently according to his event monitor and lasting for significant amounts of time. Stress, physical activity (many times not very much) bring it on. He has been off of caffeine for six months due to GERD. Would there be any long term effects of not treating??

How does the AV node get fried and how common is that?

I really thought it wouldn't need to be treated because it has never been severe.

We go to the electrophysiologist on Tuesday.

Any intelligent questions I should ask?

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Specializes in acute care.
PegRNBSN said:
The cardiologist called and he recommended going to see about an ablation which surprised me because it has never been severe enough to cause syncope or SOB. The MD did say that it was happening very frequently according to his event monitor and lasting for significant amounts of time. Stress, physical activity (many times not very much) bring it on. He has been off of caffeine for six months due to GERD. Would there be any long term effects of not treating??

How does the AV node get fried and how common is that?

I really thought it wouldn't need to be treated because it has never been severe.

We go to the electrophysiologist on Tuesday.

Any intelligent questions I should ask?

Before I continue giving out info, I should just let you know that I am not a nurse yet (planning on doing direct entry NP Program), just have a BS in biology. All the info I'm telling you just comes from me being a nerd who does entirely too much reading about such things as arrhythmias! :wink2: And as always, ask the experts involved in your son's care if you have concerns. As far as long-term effects of not treating, I think it's more the concern about syncope etc. happening from it; also it is possible with tachycardia that is sustained for a long time, for the heart muscle to be weakened but this is unusual. Plus, I can imagine that it would get annoying to tach out like this on a frequent basis. In addition, if physical activity is bringing this on it's not exactly conducive to exercising like one should! It does make sense if it's happening frequently and lasting a long time, to go see about the ablation. As far as how the AV node gets fried, the way the ablation is done is that they go in with a special catheter and first map the electrical activity in the heart and find out where the arrhythmia originates (by seeing where they can induce it). Then once they find the offending area, they "zap" it with a burst of radiofrequency energy, and that interrupts the electrical conduction through the abnormal pathway by destroying a very small area of cells and creating a scar. If the problem area is in or near the AV node, it is possible for the AV node to be burned, causing heart block. I looked up info on how common this is and the paper I read (from 2002) said a pacemaker is needed in only 1/200 cases overall (includes ablation for v-tach in these statistics as well). It might be helpful for you to ask exactly what type of SVT he has and how amenable it is to being cured by ablation--most SVT's are but there is variation. You could also ask about the advantages of doing the ablation vs. not treating (obviously the disadvantage of using meds is that there can be side effects and possible compliance issues). Hope this helps!

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Specializes in acute care.

So...what did you find out from the EP?

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Yes, I want to know what happened, too.

SVT ablations come in many flavors. The most common is AVNRT or AV nodal reentrant tachycardia where there are essentially two pathways an impulse can take down the av node. Basically, the impulse goes around in circles and rapidly conducts to the ventricles, hence the high heart rate. This is the most common type of ablation as well. The EP just ablates the extra pathway. It's the most common ablation, and it's relatively safe. There is a slight (my docs always quote 1%) chance that the av node can be knocked out, requiring a pacemaker implant. Some of the more progressive centers are using cryo for these ablations, and they (supposedly) have never inadvertently destroyed the av node with cryo.

There are other types of SVT and SVT ablations out there. Give us some particulars!

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The EP told us that the extra pathway was the most probable cause of his SVT. He told my son he would recommend an ablation and would probably use cryo in his case. He said if he thought there was any danger of being too close to the AV node he does not do the ablation.

He basically told my son it was up to him if he wanted it treated or not. If he could stand living with it he could do nothing. He did tell him it was more likely to get worse than better or stay the same.

He left the office thinking he didn't want to have anything done, but that night he went running and had an episode that lasted 20 minutes. Although he knew it wasn't life threatening, he gets so anxious and I think curbs his activity that he now wants to have it done.

We are going to schedule it over his semester break so he has some time to reconsider if needed

Thanks for the info and concern!

Peg

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