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Dr. Andrew Rynne

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What causes nighttime PSVT while on Adenosine?

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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 6551 Questions

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Posted on Thu, 23 Nov 2017 in Hypertension and Heart Disease
Question: I've had PSVT since I was 18 yo. I am now 72 and episodes are becoming more frequent but less severe and less sustained. Have had needed cardioversion with Adenosine 4 times. All tests were normal but can't find a trigger. Can r/o excess caffeine or stimulants or excercise. Usually occurs at night and will wake me from sleep. Any suggestions?
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Answered by Dr. Ilir Sharka 2 hours later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

Regarding your concern, I would explain that it is true that those episodes of arrhythmia are triggered by physical activities and coffee intake.

Other possible causes to consider would be : cardiac ischemia, thyroid dysfunction, anemia, electrolyte imbalance, QT prolongation syndrome, etc.

As your symptoms keep occurring during the night, this could be related to gastroesophageal reflux or sleep apnea.
For this reason, I would first recommend trying an antiacid or PPI ( omeprazole, etc.). It would help improve your situation in case of acid reflux.

Otherwise, I wound recommend performing a polysomnogram, to investigate for sleep apnea.

You should discuss with your doctor on the above issues.

Hope to have been helpful!

Kind regards,

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