I’m about to be investigated for SVT (supra ventricular tachycardia) due to som odd episodes of suddenly raised heart rate (and a couple of other symptoms). SVT is a but of a bucket term for a number of possibilities, but generally can be described as a raised, but regular heart rate, suddenly occurring and suddenly stopping, without appropriate stimulus (eg heart rate of 120, no exercise etc).
My (new) GP says its generally quite benign, but they’ll do a holter test (like an ECG you wear for 24 hours) to check. Any experiences ?
It just seems like I’ve had a cascade of medical issues when before PsA there was none, so I also wonder if anyone is aware of a connection?
The Paroxysmal supraventricular tachycardia form of SVT does have a connection to PsA. I am assuming they are doing a Holter in order to make sure it is SVT and not palpitations. While your Doc is most certainly correct that it is usually benign, I would push for a Echocardiogram anyway. (Personally I would suggest EVERY PsA Person have one periodically. SVT as many of us know starts in the A-V node but with folks with chronic inflammation it seems to occur more often in the atrium. I mention this for couple of reasons.
The first reason is the atrial form more often leads to Heart Failure (a disease not actual heart failure) Serious enough on its own the exhaustion is killer.
The atrial version is most often treated. The more common AV node stuff is "'watched" The problem is for most the Beta Blockers they use to treat it do so by blocking epinephrine. Great idea except it makes pain control more difficult. Not only that I have never seen a cardioolgist who didn't have a love affair with the pharmacy. They do great work but the use a lot of very powerful meds.
Most anesthesiologists I've seen start to get a very nervous twitch when the hear SVT. PsA patients usually spend some quality time with a surgeon at some point.
I guess the bottom line is I would take this thing seriously not because it of itself is dangerous but because of the potential of other things that could happen. If and when you are diagnosed you need a clear idea of your heart function and I would push for a cure RF Ablation not a treatment especially given your globe trotting ways. The heart meds are just nasty, we take enough as it is. Incidentally your ultimate consult should be with an electrician - ie electrophysiologist. Internists and some GPs try to take care of this stuff.
As far as experience with holter monitors, they didn't TELL me I couldn't go flyfishing with it. The rice trick may work with cell phones but not with holter monitors. One little slip... If it was THAT expensvie they should have had it insured. Also make sure the red event button is isolated. it can get pressed alot accidentaly during some activities.
I also suffer from rapid heartbeats, sometimes waking me from sleep. It is very scary. My cardiologist did many tests including a heart cath, found nothing, other then high blood pressure and no reasons for this condition. I amcurrently on a beta blocker, my PsA is running rampid. I had been on Arava for 8 weeks but developed horrible burning in feet. After a round of predniesone my Psa is worse. I have an appointment tomorrow , see what is next.
I started getting atrial fibrillation several years. Once diagnosed I was given Sotalol,an antiarrhythmic drug. Definitely related to Psa.Caused light headedness, brain vagueness, tiredness. breathlessness.
With PsA relatively under control it became infrequent but initially it was scarey and I was in hospital several times, once having my heart restarted to stop it. Later as I came to understand it I realised it usually stopped after about 30 hours so I took extra sotalol to slow it down and injected a blood thinner to reduce the high risk of a stroke. Only to hospital if it continued after this which it didn't.
At the end of last year I became overweight and was exercising less because of another problem and as Psa got worse AF became very frequent. Since losing weight and exercising more ,including bike riding with short bursts of vigorous effort ,it has again gone away. And my PsA flares, sugar levels, BP, cholesterol and liver enzyme levels are way down.
All actions planned with the agreement of the Doc!
I had a suspicion I probably shouldn’t take it on my barrier reef snorkeling and fishing charter…
I also thought more exercise might help. The GP was pretty ambivalent about that, but once I’ve had the investigation and decided if any treatment is required, it won’t hurt - I’d been meaning to add cardio to my weights anyway.
Thanks for the suggestion about the specialist, as well as the possibility of ablation. If there’s anything to see on the holter, I’ll ask for a referral to an electrician.
And Cooker, I know exactly how you feel. Nothing quite like being woken up from a Sunday afternoon nap by a thumping heart and a heart rate of 150, is there!
And so to update, I went to get my holter monitor done…
I had other things on my mind when I handed it in - nearly ended up in emergency (with my 4yo, husband on surfing trip!) the night before because of mystery illness - fever, immense abdominal pain, shakes, not far off septaceamia.
So after handing in monitor and dropping angel at day care went to doc, dengue, ok cool. Promptly forgot about holter monitor.
Went in holidays to indonesia. Lots of fun. Must get photos for you all!
Opened mail, and in the three weeks I was gone, got $6,000 in bills, and a letter telling me the doc wants to see me about the holter.
Presumably this is one of those lifestyle conversations (apart from my festive ways with alcohol, I don’t really have issues, but anyway), or at worst an offer of something therapeutic if its still concerning me.
I reckon I’d have noticed (via many challenges to both my stress and heart) in the last few weeks if anything truly needed follow up…
But dodge it, I’ll be thinking about it till Saturday!
PS. I turned 39 a couple of days ago… I reckon my heart has some loving to do yet!
This is of interest to me and I'm wondering if your heart "episodes"are similar to mine. I never thought what happened to me was PsA related, but beginning to wonder! Four times in the past 15 years I've had a couple ambulance trips to the ER due to weird and alarming episodes. What happens is an extreme heart beat suddenly wakes me up. Extreme meaning, and this is as accurate as I can describe it, my heartbeat is like a cannon going off in my chest. I don't feel like the rate is faster-it just feels like it's beating so hard that it will explode. I've always said if heart palpitations are like a machine gun going off in the chest, that's not what my heartbeat feels like. Is yours a really hard, but slow pounding? Anyway, the first time it happened, the ER cardiologist said my EKG had changes and told me I had a heart attack. I was in my early 40s, not overweight and not a smoker. A stress test days later was stopped abruptly because the cardiologist monitoring it thought the readings were indicative of a heart attack. She convinced me to then have an angiogram, which,surprisingly showed absolutely no blockages or damage. At that point, the docs said there was nothing to be concerned about. At 50, I started having high BP, beta blockers didn't work so I'm on a calcium channel blocker which works great. I'd like your feedback and hopefully some others' thoughts, tntlamb? My internist recently suggested I see an electrophysiologist, but I haven't made the appointment yet.
Benign EKG changes are not uncommon. One thing we have to understand about EKG is that it is conducted and interpreted by a human. So, anomalies occur, and depending on who is reading your test, further testing may be needed. I had a patient recently who went through something very similar: changes on the EKG, stress test that resulted in a cardiologist getting nervous and the test ending, then an angiogram with possible angioplasty, that was just a look-see.
BP drugs: as with bios, BP drugs are fickle. What works for one, might not work for others.
the heart can do all sorts of whacky things that we may not like, because we can FEEL it! PVCs, runs of tachycardia (you are actually less likely to notice that one), flutters (not good), flips and flops. Usually, these are diagnosed with a Holter monitor. Unless they see it on an EKG strip, it’s really hard to tell what is going on. As always, when it comes to your heart, it’s better to get it checked out. On the bright side, it’s almost always benign.
Thanks, grumpycat. That's almost exactly what happened to me. The changes in my EKG were an extra bump in the line on every beat (that's what they showed me and told me). They said thats what an ekg looks like following a heart attack They even told me to keep an explanation with me in case I was in an accident and paramedics ran an EKG on me because looking at it they would think I was having a heart attack. Several EKGs over a few years were abnormal, but my most recent one was normal, with no extra bumps.
GrumpyCat said:
1) Benign EKG changes are not uncommon. One thing we have to understand about EKG is that it is conducted and interpreted by a human. So, anomalies occur, and depending on who is reading your test, further testing may be needed. I had a patient recently who went through something very similar: changes on the EKG, stress test that resulted in a cardiologist getting nervous and the test ending, then an angiogram with possible angioplasty, that was just a look-see. 2) BP drugs: as with bios, BP drugs are fickle. What works for one, might not work for others. 3) the heart can do all sorts of whacky things that we may not like, because we can FEEL it! PVCs, runs of tachycardia (you are actually less likely to notice that one), flutters (not good), flips and flops. Usually, these are diagnosed with a Holter monitor. Unless they see it on an EKG strip, it's really hard to tell what is going on. As always, when it comes to your heart, it's better to get it checked out. On the bright side, it's almost always benign.
The bumps show the electrical patterns of the heart cycle. Each series of bumps ( in a normal EKG)represents one whole beat from relaxing at the beginning, the cycle of the heart contracting to force blood through, and then resting again at the end. Kind of cool to know.
Grandma J said:
Thanks, grumpycat. That’s almost exactly what happened to me. The changes in my EKG were an extra bump in the line on every beat (that’s what they showed me and told me). They said thats what an ekg looks like following a heart attack They even told me to keep an explanation with me in case I was in an accident and paramedics ran an EKG on me because looking at it they would think I was having a heart attack. Several EKGs over a few years were abnormal, but my most recent one was normal, with no extra bumps.
GrumpyCat said:
1) Benign EKG changes are not uncommon. One thing we have to understand about EKG is that it is conducted and interpreted by a human. So, anomalies occur, and depending on who is reading your test, further testing may be needed. I had a patient recently who went through something very similar: changes on the EKG, stress test that resulted in a cardiologist getting nervous and the test ending, then an angiogram with possible angioplasty, that was just a look-see. 2) BP drugs: as with bios, BP drugs are fickle. What works for one, might not work for others. 3) the heart can do all sorts of whacky things that we may not like, because we can FEEL it! PVCs, runs of tachycardia (you are actually less likely to notice that one), flutters (not good), flips and flops. Usually, these are diagnosed with a Holter monitor. Unless they see it on an EKG strip, it’s really hard to tell what is going on. As always, when it comes to your heart, it’s better to get it checked out. On the bright side, it’s almost always benign.
Well, Jen, if coming home to $6K in bills didn't make your heart blow up, you're probably not in too bad of shape. I wonder how wearing the Holter while enjoying dengue affected the results.
I'm curious about Lamb's 4/3/14 comment about beta blockers and pain control. I've been on them for several years. With Graves' disease, they keep my heart rate down in the double digits.
I have a "normal" arrhythmia also. It was identified years ago. When someone new listens to my heart they always ask if I have ever been told I had an arrhythmia and I reassure them I have. When I was young I was told I had a "normal" or benign arrhythmia and a murmur or extra sound at the end of the beat but that has disappeared in the last 50 years! No one mentions it any more. I have often wondered if it has anything to do with PsA but I don't really know. It makes sense to me it might with chronic inflammation. Jen I will keep my fingers crossed for you.
Epinephrine is what controls the immune system to keep it in check It also how the body controls pain. Both critical parts of PsA. Take a medication to supress it, you run a serious risk of increasing PsA symptoms. If it can be avoided so much the better. Just about any of the meds we take are designed to slow the immune system, something the bodies natural epinephrine does naturally. I wasn't talking about Graves disease. An electrophysiologist is the doctor you see for arrythmias. A cardiologist the GP of hearts is not. Fortunatley Jens doc is referring her
Thanks Lamb - it seems the protocol here (as in Aus) is to stuff about with any number of medications that have significant side effects and dubious efficacy for the issue in question.
Familiar story - NHS and Australian Medicare. But as you know, I’m a private patient - that doesn’t exist the same way here as elsewhere - it means that you need to research your disease, treatment, and then argue like a witch, even though you are willing to pay for it.
It’s still possible that there was nothing on the holter, and the callback
Was an attempt to refer to a psych or similar (though anxiety was clearly pretty mild during the episodes - I woke up the first time with a 150 heart rate - and besides measuring it, tbh, it took another four episodes before I mentioned it.
Life is funny sometimes hey? The holter was fine - few missed heartbeats which is normal. The callback was because my final test results from when I was sick as a dog and had dengue… Came back with salmonella as well!
That was from a test 4 weeks ago - since then I’ve taken two shots of Humira, so yay for my immune system to knock down the salmonella by itself, whilst on biologics!
I am so relieved to have come upon this discussion. I've had PsA for 3 yrs and symptoms are better, but recently have had problems with arrthymia and a valve mumur. I've seen a cardiologist and I'm scheduled for a Holter test (no fly fishing and I'll remember to bring it back!) and a stress test. I swim with a masters team and feel like I'm in pretty good shape but for the past few months I too have been waking up with my heart pounding, fast but not 150, just beating very hard. It's scary and I really don't want more meds (taking methotrexate which we're slowing lowering the dose).
My heart pounded really hard like that, falbala, I swear it felt like it was about to explode! It turned out to be nothing. My high bp is controlled with amlodipine, a calcium channel blocker. I hope everything is OK for you.
