Question Title: Exercise Induced Ventricular Tachycardia - Followup

When you responded to my first question you asked how I was diagnosed and what the tests showed. I went to the emergency room with a pulse of 185 3 hours after I had finished working out. This had been going on since November, but usually stopped on its own after a short time. This time however, it got progressively worse until we went to the hospital. They gave me a drug to get the heart down to a more reasonable pace. The first drug didn't work, but the second one did. The ER doctor and cardiologist agreed it looked like I had ventricular tachycardia. (I'm 33, my cholesterol's 135 and I exercise regularly...)The cardio cath showed no blockage. During the EPS, however she was unable to recreate the vtach until she gave me isoprol, which did the trick. We had determined that my heart never started pounding unless I was at least moving, and usually exercising.

What I'm trying to found it additional information about this situation. Will I take this medication for the rest of my life, what caused it. The doctor said he wants to do an MRI, but hasn't followed up. Should I press this? Am I really risk free now that I have the lopressor. I feel great, but would like to learn more. Thanks!

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Dear Maria

The MRI would be useful to diagnose a particular type of ventricular tachycardia that originates from an abnormally developed right ventricle. This type of VT does tend to occur with exertion. If your doctors suspect this diagnosis, then the MRI is important, because this disease can be associated with sudden or premature death.

Sometimes it is possible to ablate (eliminate) an abnormal focus for ventricular tachycardia; the doctor that you saw for the EPS might be able to tell you if you are a candidate for such a curative procedure. In addition, many patients with serious ventricular arrhythmias get an implanted defibrillator that gives them an electric shock to convert life-threatening VT to normal, before fainting (or death) occurs.

I would guess that the doctor that did your EPS is a cardiac electrophysiologist, a specialist in VT. If this is not the case, you should definitely be evaluated by an electrophysiologist at a major medical center, as your condition is potentially quite serious.

I cannot comment on the Lopressor in your specific case. It is often useful to prevent VT, but I am not convinced (based on the limited information provided) that it is sufficient therapy for you.

I hope this is useful. Good luck. Feel free to write back with further questions.

If you wish to be evaluated here at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a cardiologist at desk F15. Information provided in the Heart Forum is for general purposes only. Specific diagnoses and therapies can only be provided by your doctor.

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