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A ticking time bomb. Supraventricular tachycardia (SVT)

Posted: July 2012

“I felt like a ticking time bomb,” my patient told me.  Rachel was born with an extra electrical connection. From the tender age of nine, she knew her heart was different – it had an extra electrical connection – a connection that sometimes produced over 200 beats per minute.

Periodically, her heart would race for no particular reason.  She could be sitting down, relaxing, and without any warning, her heart rate would shoot up to a frightening 200 beats a minute. Then, it would return to normal rate.

Her condition is called Supraventricular tachycardia (SVT). It is an abnormal heart rhythm caused by a rapid heart rate from an electrical impulse. The heart’s pumping action is regulated by an electrical conduction system that coordinates the contraction of the various chambers of the heart.

Normally at rest, the heart “beats” or contracts approximately 60 to 100 times per minute, depending on a person’s age and activity level. Each contraction is stimulated by an electrical impulse and pushes blood through the heart.

Arrhythmias, like SVT, cause the heart to pump less effectively as a result of abnormalities of the electrical signal. The heart can pumps too slow, too fast, or irregularly.

Instead of a carefree lifestyle like most of her friends experienced, Rachel was making trips to the hospital due to continuous symptoms of SVT. She was taking medications, but they didn’t fix the problem.

Typical symptoms include palpitations, lightheadedness, dizziness, loss of consciousness, chest pain and shortness of breath.

Rachel lived her teenage years – waiting for the next SVT event. Even so, her condition didn’t prevent her from falling in love, getting married and becoming pregnant. Unfortunately, her SVT got worse.

Into the seventh month of her second pregnancy at age 30, Rachel said her heart rate increased beyond 200 beats per minute for over one hour. He husband drove her to a nearby ER, where I was called to see her.

After the baby was delivered, I spoke with Rachel about the option of catheter ablation to cure her of the arrhythmia.

Catheter ablation is a nonsurgical procedure used to treat abnormal heart rhythms. Once the cause and location of the arrhythmia is determined, a special catheter is threaded through veins in the leg to the heart. The abnormal circuit is mapped out and destroyed.

In view of the unsuccessful procedures she had in the past, she was eager to have this resolved once and for all. Fortunately, we were able to do exactly that and eliminate the problem entirely so she can live her life without fear. She is able to enjoy her children, go to the playground, even start horseback riding again.

The good news is that today, we can offer cures for many types of arrhythmias, thanks to the advanced technology which helps us map the problem areas of the heart and guide procedures to correct them with greater safety than ever before.

Karthik Ramaswamy, MD, is board-certified in cardiovascular medicine and clinical cardiac electrophysiology and is director of the Electrophysiology Laboratory at Missouri Baptist Medical Center.

He received his medical degree from the University of Miami School of Medicine and completed an internship/residency in internal medicine, fellowship in cardiology, and fellowship in clinical cardiac electrophysiology at the University of Texas Southwestern Medical Center. He is a member of BJC Medical Group.

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