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Tachycardia -- What are effective treatments?

SOC

Senior Member
Messages
7,849
I searched the forums, but the info seems mixed in other topics. Can we gather here, in a single thread, what people have found to be effective treatments for tachycardia?

My daughter had good luck with Florinef and K-Dur, but then her doctor took her off and won't put her back on. He has her on a beta-blocker instead now. He's not giving her any kind of explanation either. :rolleyes:

I don't have serious NMH/POTS, but do have tachycardia. I suspect I'd make another increment of improvement if I could get the tachycardia under control. Verapamil doesn't seem to be doing anything for me. I can't get a beta-blocker because of my asthma.
 

heapsreal

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SOC, ANy thoughts of going on valcyte again, my thinking is that Lerners theory of these viruses effecting the heart and its still an issue for you, maybe another stint on valcyte could help further???
Did u go on famvir? i think last time we communicated you were looking into this?
 

SOC

Senior Member
Messages
7,849
SOC, ANy thoughts of going on valcyte again, my thinking is that Lerners theory of these viruses effecting the heart and its still an issue for you, maybe another stint on valcyte could help further???
Did u go on famvir? i think last time we communicated you were looking into this?

Probably no more Valcyte for me -- for quite a while, at least. My liver had had enough. I'm still on Valtrex, though, which should be helping. Maybe my heart just needs more time to heal...?
 

ahimsa

ahimsa_pdx on twitter
Messages
1,921
I searched the forums, but the info seems mixed in other topics. Can we gather here, in a single thread, what people have found to be effective treatments for tachycardia.

I hope I'm not making things too complicated but wouldn't it depend on what is causing the tachycardia?

I have one kind of tachycardia which is caused by some kind of short circuit in my heart. (AV nodal reentrant tachycardia, a type of SVT, supraventricular tachycardia) My heart changes rhythm in a single heartbeat from normal to fast (190-200 beats per minute). And when it goes back to normal it also changes in a single heartbeat. In my case this is annoying (and exhausting) but not disabling. The Valsalva maneuver can help some people with this but please read all the warnings, and ask your doctor, etc.

I also have a completely different type of tachycardia that seems to be caused by the Orthostatic Intolerance. It was diagnosed as Neurally Mediated Hypotension (tilt table test in 1995 and 2003). But I also might have POTS as well (not sure). The heart rate increases in response to standing, heat, and even sitting upright for too long. What makes it better is resting, cooler temperatures, putting my feet up, lying down, etc.

Because the causes for my tachycardia are so different, what helps one problem usually does nothing for the other problem. To take one example, caffeine (a mild vasoconstrictor) can sometimes help the symptoms that I get from NMH. But too much caffeine is listed as one factor that may aggravate the other problem.

TL;DR -- If you think your tachycardia is related to autonomic dysfunction or orthostatic intolerance maybe these links will help:

http://www.medhelp.org/health_pages/Neurological-Disorders/Dysautonomia-Treatments/show/171?cid=196

http://www.research1st.com/2011/06/19/the-outs-and-ins-of-oi/

http://www.dinet.org/index.htm
 

SOC

Senior Member
Messages
7,849
I hope I'm not making things too complicated but wouldn't it depend on what is causing the tachycardia?

You are absolutely right. We need to consider all the different causes. :)

Thanks for the excellent links! They seem to cover the topic very well. I found the medhelp article to be particularly useful to me, but they're all good.

Sea -- thanks for mentioning Ivabradine. I'm going to look into that.

ETA: Is Ivabradine currently not available in the US?
 

SOC

Senior Member
Messages
7,849
Pristiq, believe it or not, works wonderfully on tachycardias. good luck!

Tachycardia is listed as a side effect of Pristique. Sounds like taking Pristique would be going in the wrong direction. o_O
 

SOC

Senior Member
Messages
7,849
Okay, maybe I do have POTS.

I did Dr Bell's Simple Test for OI, and even on a calcium channel blocker I test positive for POTS, although it takes 25-30mins to get there. And I feel awful the whole time -- sweating, shaking, leg muscles getting very tight. It's not pretty. :ill: So I guess POTS treatment is the next step. It never ends, does it? I may get to an adequately functioning state, but it will be like juggling plates to keep all the management techniques going. ** sigh**
 
Messages
8
Not necessarily. Just because it can cause tachycardia in a minority of people does not mean that it cannot relieve it in others. Everyone is different. I am on it and my ventricular tachycardia has never been better. It is actually not an unusual practice for electrophysiologists to prescribe SSRIs in patients with tachycardias that don't tolorate beta blockers well. In my case, I was fainting due to my tachycardia, a beta blocker side effect is also fainting. Everyone is different.
 

SOC

Senior Member
Messages
7,849
Not necessarily. Just because it can cause tachycardia in a minority of people does not mean that it cannot relieve it in others. Everyone is different. I am on it and my ventricular tachycardia has never been better. It is actually not an unusual practice for electrophysiologists to prescribe SSRIs in patients with tachycardias that don't tolorate beta blockers well. In my case, I was fainting due to my tachycardia, a beta blocker side effect is also fainting. Everyone is different.

That's really interesting! I had heard that SSRIs, and SNRIs as well, can help with tachycardia. I'll have to do more research on that. Thanks!
 

taniaaust1

Senior Member
Messages
13,054
Location
Sth Australia
I havent been having tachycardia show up on my BP monitor of late (on standing).. since my Florinef has been increased. I have POTS thou.

Another thing to consider is if you have any hyperadrenalic stuff going on too at time, that too can cause tachycardia. The POTS i have isnt just low blood volume POTS but also seems to be hyperadrenalic POTS (but the adrenaline side of it may be a delayed on feet adrenaline reaction in my case).

Im due to see my specialist again tomorrow and are thinking about asking about trialing an adrenaline lowering med which I guess may stop even more the tachycardia I get while on feet.. and possibly it may help too the tachycardia I occassionally get in my sleep which wakes me. I can feel also the increased adrenaline which I get for no reason at all.

Anyway the answer for "me" so far with the tachycardia has been Florinef.
 

urbantravels

disjecta membra
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1,333
Location
Los Angeles, CA
I was on an SNRI for a couple years (Effexor/Venlafaxine) which at one point was at a very high dose; it did nothing for my POTS, which wasn't properly diagnosed until later. I have fairly extreme POTS but no NMH whatsoever, so the fluid balance stuff isn't quite as important for me and there's not much case to be made for Florinef. Beta blockers help me a lot with my tachycardia; I didn't even realize until I was on them for a while how much distress the constant pounding heart had been causing me.

There is a newer class of beta blockers called "cardioselective" beta blockers that are targeted to the cardiovascular receptors and have little effect on the airway receptors, so they are less likely to worsen asthma. They might be worth considering - VERY carefully, as this article says.

http://highbloodpressure.about.com/od/treatmentmonitoring/f/asthma-beta.htm
 

urbantravels

disjecta membra
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1,333
Location
Los Angeles, CA
Oh duh, I just went and looked at the list of cardioselective beta blockers and realized that Atenolol is one of them. That's what I take. I have also taken Metoprolol in the past for my borderline high blood pressure, pre-ME/CFS. I guess they aren't that new or cutting edge if Kaiser is handing them out.
 

SOC

Senior Member
Messages
7,849
I was on an SNRI for a couple years (Effexor/Venlafaxine) which at one point was at a very high dose; it did nothing for my POTS, which wasn't properly diagnosed until later. I have fairly extreme POTS but no NMH whatsoever, so the fluid balance stuff isn't quite as important for me and there's not much case to be made for Florinef. Beta blockers help me a lot with my tachycardia; I didn't even realize until I was on them for a while how much distress the constant pounding heart had been causing me.

There is a newer class of beta blockers called "cardioselective" beta blockers that are targeted to the cardiovascular receptors and have little effect on the airway receptors, so they are less likely to worsen asthma. They might be worth considering - VERY carefully, as this article says.

http://highbloodpressure.about.com/od/treatmentmonitoring/f/asthma-beta.htm

Thanks for that info, urbantravels. Since the verapamil doesn't seem to be doing a thing for me, I might be willing to take a chance on a cardioselective beta blocker since my asthma has always been very mild.
 
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4
Maybe you guys can help me too (please!). My 15-year-old daughter got a diagnosis of CFS/ME earlier this year, after 2 years of tests etc. You know the drill. Anyway, she has complained of heart palpitations often. But when I took her to the GP and to the hospital because of it last year, they took her BP and said there was nothing wrong. Now I have a BP monitor which also reads heart rate. She has a low BP (80/56) which they have started to treat with Florinef. Great, that increased it to about 95/65 (dose is one pill in the morning). But the heart palpitations and generally thudding heart seem to be getting worse. Here are some numbers and situations: lying on couch two days ago: HR 87; HR taken immediately she stands up - 117. Heart rate taken yesterday - seated 102, standing - gradually rising to 119 after a minute or two (then she had to sit down). Today, she gets out of bed in the morning and walks upstairs and sits down. HR 144. I find those numbers alarming. I take her to the GP. I ask him if she has POTS. No, he says, since she is tachycardic when sitting down as well. He won't put her on beta blockers, wants to wait for a halter test at the hospital. Is it worth waiting for? Am I better to go private and get a bunch of tests done? Tilt table? V02 max? I'm up for getting whichever tests done that sort this issue out. Her GP wants to believe her tachycardia is caused by anxiety. I KNOW that is not the case. What would you do?