As of late, I find myself in the role of the patient.
About six weeks ago, I noticed some short bursts of palpitations and lightheadedness. Then during a weight training workout, I felt my pulse racing for about a minute before it would stop. I had only four hours of sleep the night before, it was 5 am at the gym, and I figured it was just due to fatigue.
A week and a half later, it occurred again while lifting. I looked down at my Polar heart rate monitor -- 180 beats per minute. That can't be right. My first instinct was to keep on exercising and hope it would stop, but trying to do squats with a racing heart doesn't work so well. I tried carotid sinus massage, pressing on the neck to try to stop the racing heart rhythm. Then I laid down, and by bearing down I was able to break the endless loop, watching my heart rate monitor flash from 180 suddenly to 73 beats per minute.
Being a cardiologist, I knew that this was likely a supraventricular tachycardia -- in other words, an abnormal circuit in the heart that can cause the heart to race. I obtained a portable heart rate monitor that I could carry with me wherever I went -- on long runs and bike rides, or in my lab coat pocket. If the palpitations recurred, I could capture the electrical impulses so that the rhythm could be diagnosed and appropriately treated.
Two and a half weeks went by without any palpitations. I hoped that meant that I was cured, but that was quite unlikely. Then, after a challenging bike climb, it occurred again. I pulled out my trusty event monitor to record the rhythm and sent in the recording.
My suspicions were correct. I have supraventricular tachycardia, also known as SVT. And the episodes are becoming more frequent, and at times are lasting longer, up to 25 minutes at a time!
There are two ways to treat this. The first option is medication. That would decrease the frequency of the attacks. However, it would cause my heart to be slower all the time and would limit my capacity to swim, bike, or run, and in all likelihood would not cure me. The second option is an invasive procedure called an ablation, which involves feeding a catheter from the large vein in the upper leg up to the heart, localizing the abnormal rhythm, and burning through that abnormal electrical circuit. The cure rate with the latter option is 90-95%.
I'm opting for the latter, more invasive procedure. I need a cure. If I had SVT while running or bicycling, it would be disruptive, and I'd have to stop. Worse yet, if I had SVT while swimming in open water, that could be downright dangerous.
Until my ablation procedure is done, I cannot race. Which absolutely kills me, because I was looking forward to my first race of the season this weekend.
I am nervous -- even though the complication risk is very low, normally I'm the one performing the procedure, and now I will be the patient on the table. I think this will give me a different appreciation for my patients' experiences.
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