Sinus Tachicardia

Hi,
I am new to this site and joined because I need advice. I live in Windhoek, Namibia, we do not have cardiologists here and have to get various referrals in order to get an appointment in with one in South Africa and it normally takes months to get such an appointment.

I have been suffering from sinus tachicardia since I was a child, but was only diagnosed properly about 10 years ago ... I am now 37 years old. I also have slighly low blood pressure as a rule, taking the beta blockers, causes my bloop pressure to drop and then I pass out so I cannot take it as I should ... twice daily ... I have been taking it only when I felt I needed it, but this has now become a problem as I constantly have chest pains.

I am now considering the sinus modification and possibly a pacemaker, but I don't know enough about it to make an informed decission

Can anyone please help

7 Comments

tachicardia

by Barbie - 2010-04-19 05:04:03

Hi Genie,

Thanx for the info and advice.

My HR sometimes goes as high as 180bpm and especially like to do it at night while I sleep ...

I've tried several different beta blockers, some had horrible side effects but I eventully settled for one that only lowered my bp.

I've read about sinus modification, which does not destroy the sinus node and therefor you don't neccessarily need a pacemaker, but Namibia and even SA being behind the times as we are, probably have'nt even heard of this procedure.

I will ask my dr about the Ivabradine, I'm sure we'll have something similar.

I will be going to SA again in the near future for another EP study and thereafter I guess we'll decide what treatment path/plan to follow.

I do quadbiking and motorsport etc, which probably does not help and I also found that having even a single beer (or any form of alcohol for that matter) triggers or makes the tachicardia worse and taking flu medicine, specifically cough medicine, totally freeks out my heart ... I'm tired of struggling with this and want a permanent solution only there does not seem to be one

Regards
Barbie

How Fast?

by Genie - 2010-04-19 05:04:25

Hi Barbie,

I too have sinus tachycardia. I had a pacemaker 3 weeks ago for heart block (also have slow rhythms), and since this it has been worse, but I also had it before the pacemaker. I am on beta blockers.

I presume you are talking about ablation: lots of people on the site can tell you about this, and the pros and cons. But I personally wouldn't go for this unless your heart was going very fast, or if the rhythm was irregular. You say this is sinus tachycardia. So how quick is it? Does it cause you to faint or pass out?

There are some other drug options out there. I have naturally low pressure so my cardiologist combined my beta blocker with a drug called ivabradine which also lowers your heart rate without lowering your blood pressure. This meant I could take a lower dose of the beta blocker. I'm not sure if this is available in Namibia (I am in the UK).

Best Wishes,
Genie

three don'ts

by golden_snitch - 2010-04-19 12:04:41

Hey,

as someone who has undergone several sinus node ablations for permanent sinus node reentry tachycardia, i would say: don't do it unless you have permanent tachycardia with a rate that is on average much higher than 100bpm! and don't do it before you haven't tried ivabradine. and especially don't do it if you do not have a very, very experienced EP specialist.

i had my sinus node ablations back in 1999 and 2000, and at that time there was no ivabradine available. my heart rate at rest was around 120-140bpm, even at night it didn't go lower than 100bpm. And whenever I moved just the slightest bit, like walking from the kitchen to my room (no stairs) my heart rate went up to as high as 180bpm. we tried betablockers but only a very high dosage brought the rate a little down, and since i have low blood pressure, too, this high betablocker dosage didn't do me any good. so i had the ablations, ended up with a pacer after the third attempt when my sinus node was destroyed completely. about nine months later i had episodes of sinus tachycardia again so they ablated again. they also ablated an av-nodal reentry-tachycardia, two ectopic atrial tachycardias, and atrial flutter in a total of six ablation procedures. four years after the sinus node ablations i had developed superior vena cava syndrome: the whole vein was blocked by scar tissue from the ablations; i needed open-heart surgery to correct that.

today, i still suffer from arrhythmia, and the latest event recorder showed that my sinus node is back once again. it's not nearly as bad as before, but on the recorder was an episode of sinus tachycardia at about 150bpm when i was going for a walk. so somehow it managed to grow back - "nature just finds its way" is what my EP said.

i have done lots of research on sinus tachycardia since i was diagnosed with it, and i have gotten to know a couple of patients with stories similar to mine. no sinus tachycardia patient i know needed just one ablation, no patient got out of the ablations without a pacer, and no patient didn't get any other arrhythmias, they all came up with more after the sinus node ablations. and here on this board there even is one other member who had superior vena cava syndrome after sinus node ablations, too. i have also talked to some EPs who told me that nowadays they don't do sinus node ablations very often; the outcomes in the past have just been too bad. my EP who is the top EP in Germany says he now does this type of ablation probably 1-3 times per year and only in very, very bad cases.

hope this helps. i'm sorry if i scared you but this really isn't an easy to do ablation.

best wishes
inga

thanx

by Barbie - 2010-04-20 03:04:42

Dear Inga

No you did not scare me at all, this is exactly what I wanted to hear, I don't know anyone in Namibia with this problem (although I'm sure there are many) and the doctors here don't seem to know much about it either. I had to find out all that I know by myself through research on the internet, can you believe it ... ? ! This is what I meant when I said I need to be able to make an informed decission ...

Thank you so very much for taking the time to tell me your story. I will discuss the ivabradine treatment with the cardiologist once I manage to get an appointment with him in Cape Town. Till then I'll keep taking the beta blockers as previously ... only when I really need to.

Regards
Barbie

Inappropriate sinus tachycardia?

by mego13 - 2010-04-22 07:04:58

Hey Barbie! I just wanted to write and tell you I went through the same thing! My cardiologist tried several different medicines (10 to be exact), before even doing what they call an ep study. This is where they realized I have inappropriate sinus tachycardia and tried ablations. I was kept on the meds, but also have a normally low bp, so it would just keep dropping it lower and I would feel terrible.

My 1st ablation procedure, I was in there for 6.5 hours, and I'm not trying to tell you this to scare you, but the ablations hurt bc I had to be awake and because my bp is so low naturally, they did not give me more seditive when it was wearing off, just pain meds that only lasted about 15 mins or so. Long story short, the ablations only dropped my heart rate about 10 beats per minute, was put on another beta blocker and a med to increase my blood pressure, but this didn't help any, my resting heart rate stayed 110 and above and would still shoot up to 190 and above with little exertion! When I went for my check up, I told my doc and we scheduled another ablation procedure.

During this ablation, which was just on 4/12/10, lasted another 6 hours and doc actually got my heart rate to spike to 226 andslowly decline in the last 20 minutes. He thought he may have got it to drop just enough so we didn't have to do another ablation or need the pacemaker, but he put a temporary pacemaker in my leg where he did the ablations just in case. Apparently that night, my heart rate dropped enough to kick in the temporary pacemaker and put me in a junctional rhythm, so the next day, my doctor gave me a pacemaker. To tell you the truth, I would not change a thing! My resting heart rate has been 70 beats per minute and although it has only been a week since i got it, I have felt 100 times better than before, only had a couple issues feeling the pacing, but they turned down the energy 2 different times and all has been amazing!

It can be a difficult decision, but once the meds did not work, and I researched my condition, I knew I had to do the ablation with the possibility of having to have a pacemaker and I'm so happy that I did! My days have been so good, I can get up at 5:30, work until 5pm and still have tons of energy when I was getting extremely exhausted by 2pm! Hope this helps in your decision making process!

Good luck!
Megan

exercise

by mego13 - 2010-04-23 01:04:08

yes, they say i can start back to my normal exercise regimen in 6-8 weeks - to give my heart time to heal and to make sure the wires are set (build up scar tissue around them). i am so ready to get back to exercising - i've been an athlete my whole life and was doing intense training before, so this not exercising is killing me, especially since i am only 25!

i was actually having chest pains a lot - and although i was only going through the rapid HR, near fainting, etc for a year, believe me, for a little while, i thought it was all in my head - this was before the ep study.

good luck with your appointment - keep us updated before and after though!

megan

IST

by Barbie - 2010-04-23 03:04:42

Hi Megan,
Oh thank you so much for this ifno ... I have an appointment on 24 June in Cape Town to see a new Cardiologist, get an EP study and possibly ablation and pacemaker.
I am not scared of 6+ hours procedure and pain as a rule does not scare me to much either, if it can sort out my problem permanently I'll gladly go through it.
I totally get what you're saying ... the being tired all the time is horrible. Most people just don't know what it feels like to get up tired, go through the day tired and go to bed tired and tomorrow and every other day it's the same thing ... I have two teenage boys and hardly have any energy to do fun stuff with them, and no matter how much I sleep I stay tired, I would do almost anything to get through a day without feeling so deadly tired. When I get home in the afternoon (round about 17h00) I have to go lie down for just a while in order to have the strength to do my motherly duties (cook etc)
What bothers me most is that lately, even if I do take my meds (beta blockers) I still have chest pains most of the time ... that can't be right?
I believe I can have an active lifestyle with a pacemaker, like excersize and ride my quadbike etc...is that correct? I need to be able to these things, especially ride my bike ...
Well it's just lovely being able to talk to people with the same problem, I have been feeling so stupid to talk about it because no one understood my situation and no-one could talk with me about it or give me advice,in fact it just scares the living daylights out of my friends.
Hope your problem is permantly solved. Have a lovely day.
Regards
Barbie


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So, my advice is to go about your daily routine and forget that you have a pacemaker implanted in your body.