<s>[INST] Hi. I am 40 years old man. I was diagnosed PSVT 10 years back. In 2006 when i Had attack of PSVt It was reverted with 6mg adenosine and i was suggested to take Calaptin 80mg thrice a week along with olmozest 20 mg. Every thing was normal till last month. now even after taking the medicines very regularly I am having attacks of tachycardia usually in the morning. the heart beat goes uo to 100 Plus and get back to norma after caarotid massage/ blowing of air with nose closed. Can u suggest me the reasons of having tachycarid even after taking calaptin 80 thrice aday and olmezest 20 mg. Dr. Ravi Toteja [/INST] Hi,It simply means drug is inadequate for you and you need to be added on additional drug like Metoprolol. More definitive and permanent solution is electrophysiological studies and ablation which will treat arrhythmia permanently with success rate of 90-95%. So visit your nearby cardiologist who does electrophysiological studies. Or else you can ask your doctor for metoprolol xr.Hope I have answered your query. Let me know if I can assist you further. Regards,Dr. Sagar Makode </s>