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What Causes Heart Palpitations At Night After An Increase In Heart Rate?

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Posted on Thu, 1 Oct 2015
Question: Hi Dr, my aunt aged 47, day ago started getting palpitations at night, she was taken to Jayadeva hospital XXXXXXX she was given some treatment and brought under control, the doctors there said her heart rate had gone high and that was the reason for her palpitations and uneasiness, they have given her one month medication but have also asked her to get operated as soon as possible to bring the problem to a permanent cure, i have attached the reports, please advise us.
doctor
Answered by Dr. Rajesh Teli (3 hours later)
Brief Answer:
she needs Electrophysical (EP) study

Detailed Answer:
hello,
I am Dr.Rajesh Teli,MD.
I have gone through your query. Thanks for using HCM.
your aunt had got a condition called SVT. This condition results from kind of short circuit in electrical conduction system of heart.Usually there is some extra pathway leading to circus like entry of current in heart leading to fast heart rate around 200 bpm.
It is usually controlled by single shot of injection of verapamil or adenosine.If this has happened for the first time then you can follow wait and watch policy.The medicine which you are prescribed may prevent flow of current in extra pathway and prevent repeated palpitations.I have many patients who have hardly one or two episodes of SVT in a year ,requiring emergency injection to revert the rhythm to normal.
If she gets repeated spells inspite of regular medicine you may need to get EPS i.e. Electrophysiological study.This will find out the exact site of extra pathway permitting flow of current.Having found that one may ablate that pathway with Laser.This is know as RFA- radio frequency ablation.This is kind of permanent solution.
But you can certainly wait with regular medicines .If the spells of SVT recur inspite of adequate medicines then she should undergo EP study and RFA.
My best wishes
Dr.Rajesh Teli,MD.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Rajesh Teli (1 hour later)
Thanks for the opinion Dr, should she continue the medicine or go for the Electrophysical (EP) study now, we are a little bit concerned, is this a serious condition, what is the cost for the RFA generally.
doctor
Answered by Dr. Rajesh Teli (6 hours later)
Brief Answer:
you should get EPS if cost is not matter of concern.

Detailed Answer:
hello,
Cost of EPS is around 15 to 20,000 INR.Total cost inclusive of RFA would be around sixty five thousand.Many of my patients opt to wait and in most of the time there is no crisis.Because even with ongoing SVT one can reach hospital and get it terminated by injection.So if cost is an issue you can wait.However you should discuss this with your treating doctor before you make this decision.
My best wishes
Dr.Teli.
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Rajesh Teli

Cardiologist

Practicing since :1983

Answered : 663 Questions

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What Causes Heart Palpitations At Night After An Increase In Heart Rate?

Brief Answer: she needs Electrophysical (EP) study Detailed Answer: hello, I am Dr.Rajesh Teli,MD. I have gone through your query. Thanks for using HCM. your aunt had got a condition called SVT. This condition results from kind of short circuit in electrical conduction system of heart.Usually there is some extra pathway leading to circus like entry of current in heart leading to fast heart rate around 200 bpm. It is usually controlled by single shot of injection of verapamil or adenosine.If this has happened for the first time then you can follow wait and watch policy.The medicine which you are prescribed may prevent flow of current in extra pathway and prevent repeated palpitations.I have many patients who have hardly one or two episodes of SVT in a year ,requiring emergency injection to revert the rhythm to normal. If she gets repeated spells inspite of regular medicine you may need to get EPS i.e. Electrophysiological study.This will find out the exact site of extra pathway permitting flow of current.Having found that one may ablate that pathway with Laser.This is know as RFA- radio frequency ablation.This is kind of permanent solution. But you can certainly wait with regular medicines .If the spells of SVT recur inspite of adequate medicines then she should undergo EP study and RFA. My best wishes Dr.Rajesh Teli,MD.