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Is SVT And Panic Disorder Directly Connected?

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Posted on Wed, 2 Sep 2015
Question: Is SVT & panic directly connected? My diagnosis of svt was made then i have been having panic attacks with the main symptom of sudden rapid heart rate (150+).
I am on sotalol & sertraline
doctor
Answered by Dr. Ilir Sharka (50 minutes later)
Brief Answer:
SVT and panic disorder are bidirectionally connected

Detailed Answer:
Hello!

Thank you for your question on HCM!

Yes, that is true.

SVT and panic are bidirectionally related. Panic attacks and anxiety disorders are generally considered a triggering factor for arrhythmia in predisposed persons.

From the other side, SVT expresses itself in a very stressful condition for the body, leading to anxiety and psychological stress generations.

Regarding sertraline therapy, I would like to say that this is one of the safest SSRI drugs, regarding arrhythmia related adverse effects.

Nevertheless, I recommend performing periodically a resting ECG, to assure that no medication side effect is occurring.

Hope to have been of help!

I am at your disposal for further questions, whenever you need.

Best wishes,
Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (2 hours later)
Thank you.
My other question is: is the high heart rate during a panic attack considered to be an arrhythmic svt? I realise that my first episode of svt then made me extremely anxious about it happening again which then caused the panic attacks.
I have short butst of what feels like fast fluttering/ fast beats at rest when i am not anxious. I assume this is break through arrrhythmia? I have also had periods of days/weeks with very frequent VE's. These rear when am am tired/anxious.
The worst episode i had was when i stupidly forgot to take sotalol for 2 days & had svt rate 170 which when into fast AF rate 190 ( confirmed on ECG in ambulance). Scared the hell out of me!
I am fine with exercise. I ride my horse and do not have any adverse symptoms.
doctor
Answered by Dr. Ilir Sharka (24 minutes later)
Brief Answer:
An electrophysiological study may be necessary.

Detailed Answer:

Hi again!

The primary precaution to avoid SVT is an appropriate continuing antiarrhythmic therapy.

A cardiac ultrasound is necessary to rule out any structural heart disorders.

If SVT is frequent despite the correct therapy, an electrophysiological study is recommended for investigating the possibility of cardiac ablation (which would definitely address your arrhythmia issue).

Anxiety is the other important target, when discussing arrhythmia prevention, because a better control of panic attacks would decrease the possibility of triggering SVT episodes.

An ambulatory ECG monitoring would be necessary to confirm the anxiety implication on arrhythmia appearance.

Regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (9 minutes later)
Than you.
I had a cardiac echo last year which was normal. Had electrophysiogical study in 1990 which did not show an accessory pathway. I have never been offered ablation. My attacks are not too frequent as long as I am on the ssri & sotalol. I do wonder whether it would be worth asking my GP for cardiology review as I do not like being dependant on the meds.
I find exercise helps my anxiety levels.
Previous ssri of paroxetine seemed to exaccerbate the svt episodes.
doctor
Answered by Dr. Ilir Sharka (26 minutes later)
Brief Answer:
A cardiology review may be helpful.

Detailed Answer:

As no other alternative has been offered after investigating your arrhythmia, seems that meds are a reasonable option to help you with arrhythmia and anxiety.

A cardiology review may be necessary to check your actual cardiac status, as well as to review the effectiveness of sotalol, and discuss if there is a need to change antiarrhythmic therapy to a more effective alternative.

Meanwhile, sertraline seems to have a safe profile in regards to arrhythmia triggering risk.

Regarding influence of exercise on anxiety level, you are right!

A more physically active daily profile may help you to cope better with your anxiety. Probably a scheduled fitness program would yield better results.

Wish you a good health!

Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.

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

Cardiologist

Practicing since :2001

Answered : 9542 Questions

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Is SVT And Panic Disorder Directly Connected?

Brief Answer: SVT and panic disorder are bidirectionally connected Detailed Answer: Hello! Thank you for your question on HCM! Yes, that is true. SVT and panic are bidirectionally related. Panic attacks and anxiety disorders are generally considered a triggering factor for arrhythmia in predisposed persons. From the other side, SVT expresses itself in a very stressful condition for the body, leading to anxiety and psychological stress generations. Regarding sertraline therapy, I would like to say that this is one of the safest SSRI drugs, regarding arrhythmia related adverse effects. Nevertheless, I recommend performing periodically a resting ECG, to assure that no medication side effect is occurring. Hope to have been of help! I am at your disposal for further questions, whenever you need. Best wishes, Dr. Iliri