Arrhythmias Support Group

Cardiac arrhythmia is a group of conditions in which the muscle contraction of the heart is irregular or is faster or slower than normal. Some arrhythmias are life-threatening medical emergencies that can cause cardiac arrest and sudden death. Others cause aggravating symptoms, such as an awareness of a different heart beat, or palpitation, which can be annoying.

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Heart, Blood & Circulation
/ Arrhythmias Support Group

Inappropriate Sinus Tachycardia

AgentSmith
AgentSmith

I have posted a couple other times. I just got back from my appt with my cardiologist after wearing the event monitor for a month. My symptoms are fatigue, shortness of breath, dizziness, palpitations, fast heart beat... 


I had events that they called me about 4 times. Once was just walking/hiking outside. Later the same day, cleaning up my yard. Another time I was just climbing my stairs to the attic. And once I was working out on an elliptical. When working out, I have noticed my heart rate (via heart rate monitor) would immediately shoot up into the red zone even though I have a slow resting heart rate (57-65). It'd shoot immediately up to 160 while doing the slowest workout imaginable. It would stay in the red zone the entire time I worked out. Once I was done working out, it'd immediately drop back down to 100. 


He just diagnosed me with Inappropriate Sinus Tachycardia. The one time, my heart rate was 180bpm. He wants me to take Metoprolol. But I just looked it up and what I read says that beta blockers don't really work for this issue. And the side effects for Metoprolol sound like the exact problems I already have that I'm trying to alleviate. It also says not to take it if you have a slow heart rate. My resting heart rate is usually low, 57-65. 


Does this sound normal? Does anyone know about IST? I'm not a fan of meds at all and try to avoid them at all cost. I don't take anything aside from vitamins. I generally have really bad reactions to meds so I'm hesitant to take anything.

RoboPop
RoboPop
First, a resting heart rate of 57 - 65 bpm is not low, in fact that is normal. Normal resting rates are considered between 60 and 100bpm. 57 isn't low enough to be of concern.

Yeah one of the ironies is that almost all heart meds can, and I stress the word can, cause symptoms that mimic heart disease. However they can help significantly and few people actually experience those side effects. I've been on Metoprolol for 10 years and the only issue I had was it made me tired. When I mentioned it to my Cardiologist, he looked at me and said take it at bed time dummy. I did and that made all the difference. No, 'm still a dummy, but I'm not dargging my behind around.

Look you can self diagnose, and determine what you should and shouldn't do on your own or using Google, but if you're going to do that may I suggest you get some medical malpractice insurance. That way when things don't come out well with the self treatment, at least you'll be able to sue yourself for malpractice. Yeah this is tongue in cheek, but you have got to realize doctors go to school for a long time and are far more expert than you in this. Follow the treatment plan and take the meds he prescribes and see what happens.

Just my opinion
AgentSmith
AgentSmith
A resting heart rate of 57-65 is at the very low end of the normal spectrum, which is why I say it's low. In fact, I don't meet the diagnostic criteria for IST based on that. IST is diagnosed when someone has a resting heart rate over 100, which I obviously don't. People with IST have a sleeping heart rate of 90 or more. What I likely have is POTS, and they don't recommend beta blockers to someone with POTS (or IST for that matter). I've already done the research and read that several times. I'm perfectly capable of understanding medical issues. I've been able to accurately figure out mine and my dog's medical issues thus far and even shocked the doctors when my theories were later confirmed. In fact, it was my theory that lead me to a cardiologist to discover all this. A lot of people nowadays are having to diagnose themselves and then ask the doctor to verify through testing because doctors just aren't taking the time to look into things thoroughly enough. So if you want to figure it out, you have to do it on your these days. There's nothing wrong with being proactive. And it's not uncommon for drs to just throw medication at people for anything and everything. So anyway, it was a bad call on his part. I am seeing a POTS specialist next month.
luv2teachspeech
luv2teachspeech
I have IST among other heart issues. The beta blocker is an appropriate treatment for it and a good idea IMO. I have been on metoprolol (genetric for Toprol) for about two months. There are some side effects, but most likely managable for most healthy people. I would try it, but maybe start at a lower dose like 25 mg. I would not be worried about the beta blocker-- very common and widely used. Now a drug to worry about is the antiarrythmic drugs- those are SCARY. Glad you aren't having rhythm problems!
Also, have you been checked for POTS? The sinus tachycardia is very common with POTS. I have POTS (secondary to Lyme disease) and there are some good tricks I have learned to help the heart rate go down.
AgentSmith
AgentSmith
Luv, I responded to your comment on the other post. I too believe it to be POTS, not IST, and am seeing a POTS specialist next week. In my case, I don't believe beta blockers would be good because my resting heart rate already goes into the 50s and would be too low on beta blockers. The people in my POTS support groups seem to agree with that. I will see what the POTS specialist says next week.
jabberwocky85
jabberwocky85
I know this is an old post, but have you discussed a tilt table test with your cardiologist? If you have POTS, that should reveal it pretty quickly. If the cardiologist isn't an electrophysiologist, try to get an appointment with one--they tend to have a better understanding of IST. Beta blockers seem to work for some people with this condition, but not usually enough to alleviate symptoms significantly. My doctor put me on Ivabradine, and coupled with a beta blocker, it did work, sort of, but made my resting heartrate too low, while my active heart rate still went too high, though it took a little longer to do so, and it had some pretty shitty side effects, so I ended up coming off it. I'm like you--my resting heartrate is normal, but even just something like walking to the mailbox or climbing a flight of stairs will send my heartrate dangerously high, along with all the crazy side=effects. It's such a crazy condition, and there doesn't seem to be a whole lot that can be done other than managing the symptoms as much as possible.
AgentSmith
AgentSmith
Jabbr, yes, I saw a POTS specialist cardiologist and then had another full work up scheduled this month with a POTS specialist electrophysiologist at cleveland clinic but it was rescheduled for october. That includes the tilt table test. The previous pots specialist confirmed that it's not IST, as I predicted, but pots or something like pots (orthostatic hypotension, unlikely). I've joined some POTS groups on FB and have been increasing my salt and water intake.
Feelingtachy
Feelingtachy
Hi I'm new to this group but I was reading about your experience with originally being diagnosed with IST and now they're thinking it's POTS. I have been seeing an electrophysiologist for more than a year, received my diagnosis over two years ago, and was hoping to have ablation but he has decided that he does not want to go that route despite the plethora of medications we have tried with no success. He tells me to increase my salt as well and to drink lots of water which I already do. Have you found anything that helps get you through the bad days with more comfort and less fatigue? I'm beginning to become overtaken by my symptoms and I'm a single mother trying to hold down a full time job and I fear I am near to giving up.