Irregular Heart Rate. Done Echo, Ekgs, Holter, Stress Test Done. What Could Be The Reason?

Hi XXXXXXX,

Thank you for writing in.

I am a cardiologist and read your well written description with diligence.

There are hardly any better things in life than seeing your child grow. Congratulations. Yes, there are associated anxieties too.

To answer one of your questions whether I have seen any such thing I can honestly say yes, about a dozen in my career of 25 years.

As per the details provided, I want you to remember these facts:
1. As 26 year old lady, heart rate generated on its own (also called target heart rate) while doing stress test is 194. It is calculated as 220 minus age in Years.
2. Going through your normal echocardiography Doppler, Holter and stress test; all is been normal. It is seems that you have "Sinus Tachycardia".
3. This is further supported by fact that though the onset of rapid heart rate is 'rapid in minutes' before it slows down. That is opposed to a similar condition which can be possibly disease that is Paroxysmal Supraventricular Ventricular Tachycardia (PSVT). Typically, here the heart rate jumps like a bolt from blue and after a short duration it settles down to normal heart rate as abruptly as it started. It does not slowly come down.
PSVT is also relatively benign condition, but may need treatment. At times the later is associated with urge to urinate after tachycardia settles down.
4. Structurally normal heart - as revealed by echocardiogram, no irregular heart beat, normal sleeping heart rate around 50 and normal rise of rate with exertion - as revealed by stress test, no significant abnormality - as revealed by Holter are further reassuring signs of investigations. These prove the benign and temporary nature of the phenomenon.

Yes, there was cause for concern before you were investigated; But never a cause of panic especially now.

Hope I was able to address your concern and reassure you. If you have any follow-up query I shall be pleased to answer.

With Best Wishes
Dr Anil Grover
Cardiologist

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Hello,

Thanks for your pertinent question.

When one stands the blood supply to upper part of body, decreases. It includes blood supply to carotid receptors to sense your blood pressure. It is sensed as if your heart output has gone down and by a natural reflex these receptors send signals to brain which in turn increases your heart rate. As we grow, in most of us this phenomenon is stabalized and one does no longer feel it happen. In your case, your pulse generating center of heart that is sinus node is a little more sensitive than others this produces not only aggravated response but you perceive it as palpitation. That is perfectly normal and happens in some.

With best wishes,

Dr Anil Grover
Cardiologist

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Hello,

Let us review the procedure (RF ablation) and side effects. It is painless, more than needle prick and momentary heavy sensation in chest, there is nothing more as far as patient's discomfort is concerned.

A finite percentage of patients land up with need for a permanent pacemaker post procedure for some time if there is a complication...that is the only serious complication

I have come across in one patient apart from in two patients my failure to abolish arrhythmia. The patient needed pacemaker support for few weeks fortunately.

You can specifically discuss complications with your doctor. In my view, it is perfectly safe and benefits outweigh the risk of complications and long term medical treatment. Of course, final decision is always that of the patient. Therefore, my suggestion is take your time, discuss, and finally decide. Your being 5 months post partum should not come in a way it is an outpatient procedure and you will be away for few hours from your child.

With Best Wishes.


Dr Anil Grover
Cardiologist

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