NSVT and Exercise

Hi everyone I hope you are all well,


Just looking for some reassurance really, today I went to the hospital for my pre-op admission tests ready for my procedure next week. During the treadmill test in October I had a 7 beat run of non-sustained Ventricular Tachycardia. My surgeon/doctor has said this is not a big issue and something they will monitor. He said he is not worried by it but I have had a few short runs of NSVT on my pacemaker interrogations, lasting between 3/6 beats. Usually on exercise. 
 

The surgeon does not seem really bothered and has said that the way forward is to implant a dual chamber pacemaker and give me a 80mg dose of Nadolol everyday. He says this combination should work and preventing the NSVT. There was also a slight discussion at needing an ICD, but he does not think that is needed as he and his team are sure this dual chamber pacemaker- Nadolol combination will work. 
 

I have had pacemakers since 4 weeks old and am now 17. I have a perfect heart structururaly and functionally, and was given the pacemakers for complete heart block. 
 

I hope some people have some reassurance and maybe have experienced episodes of NSVT too?,

Thank you,

Hayden


3 Comments

NSVT is very common

by crustyg - 2021-01-12 18:01:57

But since most people don't have any device that would detect it, they aren't aware of it and don't worry about it.

I get very occasional episodes of NSVT, in my case always associated with hard physical effort.  The key part of NSVT is the NS at the front - Non-Sustained.  If you start getting a lot of episodes and/or they last longer and longer, that's the time to start worrying.

Best wishes.

NSVT (non sustained Ventricular Tachycardia)

by Gemita - 2021-01-12 18:26:22

Hello Hayden,

I believe we have discussed this before?  I too suffer from runs of NSVT and this finding is often of no real concern to my treating doctors, especially if the runs are of short duration and no heart/ischaemic disease is present.

Ideally we need an ECG and a good EP to confirm NSVT and to determine the cause and significance of runs of NSVT if they become more frequent.  For example on one occasion, I had a run of supraventricular tachycardia (an atrial tachy arrhythmia) with aberrant conduction wrongly reported by my pacemaker as NSVT.  A good EP will usually accurately read your ECG report, from whatever source and determine the type/significance of arrhythmia present.  Machines can get the reporting wrong sometimes.  I do not worry about any of this any more.  I go by how i feel.  That tells me if I need help or not and is more important than the finding of a short run of a tachy arrhythmia on an ECG strip.  Arrhythmia interpretation is a complex area Hayden that I do not understand but if my EP is not too concerned and I trust him well enough, then I try not to worry.

The definition of NSVT is an episode of ventricular tachycardia with a heart rate of 120 bpm or above, lasting for at least 3 heartbeats and persisting less than 30 seconds. Clearly anything above 30 second duration would be dangerous territory.  Your runs are of short duration Hayden and your doctors are clearly not concerned, so why should you be?

With a dual chamber pacemaker and a beta blocker, any short runs of NSVT should hopefully settle.  This is clearly what your doctors believe and tell you.  I would try to focus on the benefits of getting your new implant and starting a new life.  After all I believe you have been feeling so much better recently, so I wouldn't let a few short runs of NSVT upset you.  I am sure you will be fine under such excellent care at Great Ormond Street hospital and that the new pacemaker will help to stabilise your heart rhythms.  

Good luck Hayden

thank you for your help, as always

by PacerPrice - 2021-01-13 06:21:40

Thank you both,

Both of your answers, Gemita and Crusty, have been really helpful at providing some reassurance. Hearing that I had had a few of episodes of ventricular tachycardia really scared me as I have only ever heard about the dangerous side. And then to hear about the possibility of an icd if the dual chamber/ beta blocker doesn't work scared me even more. 
 

But to hear my doctor was not concerned and is confident this plan will work gave me some reassurance, and too hear that NSVT is common also gives me some confidence. My longest run was 7 beats, my EP called it ventricular tachycardia, but I know as it was no where near 30 seconds, they are always non-sustained. 
 

Thank you for your help, I really hope this new pacemaker helps out,

Hayden 

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