9 Mos. Post-Ablation Short SVTs

Hello Fibbers:

I had my Natale Index ablation for afbb and aflutter in late March 2017. I've been fb and flutter free I think ever since. Some slightly painful PVCs; hardly any PACs. But lately I've had a few evening runs of SVT; 5 seconds or so. I think it's SVT and not flutter because for many years, since my 20s, I had occasional SVTs and it feels like "that" -- especially given the shortness of the runs. (I'm 55 now, by the way.) Are these runs of tachycardia a concern? Or is it just the same thing I've had most of my life, unrelated to the ablated areas?

I had what I believed at the time to be SVT runs up to a year (maybe even more) after my ablation. They're gone now. I suspect it just may be some transient effects of the scar tissue still forming up in the left atrium. I wouldn't get too worried about it unless it increases, in which case call your cardiologist and get it monitored.

I don't know how anyone could tell the difference between SVT and flutter by how it feels. They would feel pretty much the same. In fact, it's not always easy to distinguish between flutter and SVT even with an ECG (I've been given adenosine twice in order to figure out which I had).

In fact, flutter actually is SVT. SVT means supraventricular tachycardia, so any tachycardia originating in the atria is considered an SVT. There are three categories of SVTs:

• Atrial fibrillation
• Atrial flutter & atrial tachycardia.
• Paroxysmal supraventricular tachycardia (PSVT)

The last entry, PSVT, is what people usually mean when they say someone has SVT. SVT is further broken down into atrio-ventricular nodal reentrant tachycardia (AVNRT) and atrio-ventricular reciprocating tachycardia (AVRT).

I doubt that the feeling is any different. My runs were so short (and unpredictable) that I never caught one on Kardia. They were very sudden onsets (no PACs before) of a rapid but regular heartbeat that was much stronger than normal and could be felt. They scared the you-know-what out of me but they never lasted probably more than 5 or 10 seconds.

Maybe it's contextual but I think I feel the difference. My SVTs (yes, PSVT I think is what I'm trying to describe) were always short and I would "feel" them. My flutter was not so easy to feel. I would learn my heart rate was quite elevated and would not have noticed it.

I would never try to tell someone they don't know their own body, so you're probably right. In any case, to answer your original question, I doubt they're reason for concern but you should talk to your contact at TCAI and tell them about it.

Keep in mind too GB that with runs of under 30 sec duration technically do not qualify as a sustained arrhythmia of any sort ... just saying. If it increases In duration beyound 30 seconds or with much increased frequency of occurance then check in with your Nurse practioner/navigator at St Davids. Thus too may well subside with a little time especially with yoyrclingest reported episode being under 10 seconds. A good rule of thumb is if you can’t catch it on an Alivecor even with a speedy effort , it’s generally not worth worrying about.

Cheers!
Shannon

Thanks, Shannon. Finally avocado season and a box coming your way!