Is radiofrequency ablation the right treatment for sinus tachycardia?

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Posted on Wed, 15 Jun 2016 in Hypertension and Heart Disease
Question: Hi i want ask to cardiologist because im really boring with my actual situation...for example tonight i just go out to have a beer like most people of my age, after 2 beers and my meals i want to go out to an other place and i check my hear beat...just walking in the street after 2 beers and meal im around 150 and i feel tired...how thats possible???is it possible to make radiofrequency ablation for a strong sinus tachycardia cause im boring of it im boring ot have to take medication i have bad idea, im only é_ years and feel like im done already...
doctor
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Thank you for asking on HCM!

I understand your concern and would explain that radiofrequency ablation is not a routine procedure for sinus tachycardia.

It is important to investigate for the possible cause of tachycardia first:

- anxiety
- thyroid dysfunction
- electrolyte imbalances
- post prandial hypotension leading to reflectory tachycardia
- a heart disorder

I would recommend consulting with your attending physician and performing some tests:

- a cardiac ultrasound to examine the cardiac structure
- an ambulatory 24-48 hours ECG monitoring to examine your heart rhythm trends during a prolonged time and exclude possible cardiac arrhythmia
- blood lab tests (complete blood count for anemia, thyroid hormone levels, blood electrolytes).

A fibrogastroscopy may be necessary to exclude possible hiatal hernia or reflux which could lead to a similar clinical scenario.

You should discuss with your doctor on the above tests.

Hope to have been helpful!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 1 hour later
I hade done cardiac ultrasound 6 months ago, EKG stress test and EKG like a month, i can exclude heart problem?
doctor
Answered by Dr. Ilir Sharka 12 minutes later
Brief Answer:
My answer as follows:

Detailed Answer:
Hello again!

The cardiac ultrasound and ECG stress test can exclude possible cardiac structural disorders and possible coronary artery disease.

I would recommend performing an ambulatory 24-48 hours ECG monitoring to examine your heart rhythm trends for a more prolonged time (much more than just resting ECG), in order to exclude possible cardiac arrhythmia.

It is necessary performing the above mentioned blood lab tests in order to exclude other possible causes of possible cardiac arrhythmia.

Hope to have been helpful!

Greetings!

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 7 hours later
I have maked hotler 6 months ago, can it change??i had only sinus tachycardia
and CBC i have maked it couple of weeks ago, everything was ok except some uric acid...dont know where to search...i have done stomach lung, heart, try to different medicine atenolol, omeprzole, also some anti dispress medicine even extra medicine like chiropractor, acupunctor still pain in my chest and still tachycardia for nothing
doctor
Answered by Dr. Ilir Sharka 12 hours later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

Thank you for the additional information!

Regarding your ambulatory 24-48 hours ECG monitoring, I would explain that we do not expect any changes in such a short period.

Coming to this point, I would conclude that your symptoms are not cardiac related.

Anxiety could play a big role in your symptomatology.

I would recommend consulting with a specialist of the field. Even if you have tried an antidepressant, you should discuss with your psychiatrist on the possibility of switching to other therapies. Yoga and meditation may also help in your situation.


I would also avoid triggering factors like:

- caffeine intake
- alcohol intake
- large meals. I would recommend eating more frequently during the day in small meals.

Hope to have clarified your uncertainties.

Best wishes,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 12 minutes later
Doctor,
My last questions are:

1/ I take atenolol since now 6 months at 12,5mg , do you think i could upgrade it to 25 mg, and take it two times per day like at 12:00 like i usually take and an other dose around 20:00

2/I dont want to appear like a party boy, but i would like to enjoy my life again , like most of my friends do like going out a bit , chill around 2 or 3 beers at night and i think with that second dose i could afford to make it, but is it dangerous for me to do it if i take that second dose.

3/I often have pain in my left side of my chest and also my shoulder, especially when i make effort but as you have told me its not cardiac related so how i could avoid it??
Antidepressants dont work well on me, i feel dizzu and i cannot work properly but when i take diazepam at 1mg it usually relax me, so how i can take that medicine if i want to have a normal life, at what time it will be preferable for me to take.

4/Can the fact than sometimes my breath is stuck and i feel lie i cannot breath good related to anxiety

Thank you so much for your kind help

Mr XXXXXXX XXXX
doctor
Answered by Dr. Ilir Sharka 5 hours later
Brief Answer:
My opinion:

Detailed Answer:
Dear XXXXXXX

Here are my answers to your questions:

1. Yes you can take atenolol 12.5mg twice daily. I would recommend every 12 hours (08.00-20.00) to try to control better your heart rate.

2. Regarding a couple of bears, you can try to have them and see what happens. As I explained alcohol can trigger anxiety as it is a stimulant of the central nervous system, thus leading the increased heart rate.

3. Regarding the chest pain, I would recommend taking alprazolam 0.25mg 1-2 tablets during these episodes, instead of diazepam. This is an anxiolytic drug and can be used safely during these episodes. Anyway, these drugs should be used rarely and not regularly for a prolonged time as they can lead to addiction and tolerance.
I would also recommend taking ibuprofen and acetaminophen during these episodes. These antiinflammatory drugs, can help reduce inflammation and pain, when pain is related to musculoskeletal system. I would recommend making this try during these episodes.

4. Difficulty breathing, dizziness, shortness of breath are typical signs of anxiety.

I would recommend discussing with a psychiatrist on other treatment options to help you manage better your anxiety (there are different types of antidepressants that can be effective).

Hope to have clarified your uncertainties!

Greetings!

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 17 hours later
Hi doctor,
Here is opinion of others doctors, do you think also i should perform all my cardiac exams again?

Based on the description of your symptoms, though anxiety is a possible cause but its less likely in my view. The reason being that the pain is worsened with exertion. Worsening chest pain with exertion, signifies an ischemic cause. The EKG should be repeated with troponins , CK MB and LDH levels. ETT can also be repeated. If its clear then the tachycardia or palpitations should be addressed reaching an adequate beta blockade effect. Atenolol dosing should be adjusted to have the heart rate at around 60. The age of 28 makes it less likely to be a cardiac cause so if the above workup is negative on repeating then alternative diagnosis such as costochondritis , generalized anxiety disorder and GERD should also be taken into consideration.

Thanks
doctor
Answered by Dr. Ilir Sharka 13 minutes later
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

I carefully read the opinion of my other college and would explain that I agree with him that a cardiac cause is less likely at your age.

I think all these tests would result normal, that is why I would not recommend performing them. It would be a waste of time and money.

I agree also on the other possible causes you should consider:

-chostochondritis
- GERD
- generalized anxiety disorder.


If ibuprofen and omeprazole or antiacids do not relieve your symptoms, you should consider generalized anxiety disorder as the main cause of your symptomatology (because the other two causes would be excluded).

Hope to have clarified some of your uncertainties.

Best wishes,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Dr. Ilir Sharka

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Practicing since :2001

Answered : 7252 Questions

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