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Heart Disease (Expert Forum)
Are PVC's ever dangerous?
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve, Pacemaker, PAD, Stenosis, Stress Tests
Are PVC's ever dangerous?
by Lyn2, Dec 03, 2001 12:00AM
I have a couple of questions. The first is about placing a pacemaker. I had one put in a couple of years ago, because an ablation of my sinus node caused sick sinus syndrome. I was told after a 24hr monitor and telemetry in intensive care that my heart would repeatedly stop for 8 -10 sec. But it would always resume on its own. I was told I was lucky to be alive. Is it unusual for a heart rate to come back from a long pause like that on it's own? They seemed very surprised. Do you think it would be likely that I would have died shortly if I hadn't had a pacemaker put in?
My other question relates to now. I have a-fib with aberancy, a-flutter, PVC's and possibly V-tach, (waiting to find out). I take amiodarone, coumadin, cartia, midodrine, lasix, spironolactone. I am getting many many skipped beats. EP doc says 10's of thousands of PVC's. I also get runs of very fast beats during these episodes. I feel very weak and dizzy when this happens. I am wondering if because of all the scar tissue that has caused the SSS, if the PVC's can be more dangerous turning into a more sustained run of v-tach? Can this be treated? I have already done most all the antiarrythmics. I have asthma so I am slightly limited with some of them. Can these rhythms all be treated with an ablation, or would this just cause more scar tissue, and move the electrical instability to another part of the heart? I feel like no one knows what to do at this point. Do you have any ideas?
Thankyou so very much. You have always been so helpful. Oh, I am 33 and female.
My other question relates to now. I have a-fib with aberancy, a-flutter, PVC's and possibly V-tach, (waiting to find out). I take amiodarone, coumadin, cartia, midodrine, lasix, spironolactone. I am getting many many skipped beats. EP doc says 10's of thousands of PVC's. I also get runs of very fast beats during these episodes. I feel very weak and dizzy when this happens. I am wondering if because of all the scar tissue that has caused the SSS, if the PVC's can be more dangerous turning into a more sustained run of v-tach? Can this be treated? I have already done most all the antiarrythmics. I have asthma so I am slightly limited with some of them. Can these rhythms all be treated with an ablation, or would this just cause more scar tissue, and move the electrical instability to another part of the heart? I feel like no one knows what to do at this point. Do you have any ideas?
Thankyou so very much. You have always been so helpful. Oh, I am 33 and female.
Doctor's Answer
by CCF-M.D.-CRC, Dec 05, 2001 12:00AM
Dear cn,
Sick sinus syndrome or as it is now called sinus node dysfunction (SND) is a syndrome characterized by fast and slow heart beats. In your case the SND was secondary to a procedure but in the majority of cases the cause is intrinsic. While SND is not usually lethal and the sinus node ususally does "start back" after a pause SND may be very symptomatic. In general pauses of longer than 3 seconds or heart rates less than 40 are considered to be indications for a pacmemaker.
In regard to your second question the treatment would depend of exactly what rhythm disturbance you are having. In general I would favor a more aggressive approach with ablation in a young person, particularly if they had failed multiple medications. There are ablations for PVC, aflutter and afib. There should not be an increased risk for sustained VT due to your previous ablation procedure. At this point you may wish to consider a second opinion in regard to the next best step.
Sick sinus syndrome or as it is now called sinus node dysfunction (SND) is a syndrome characterized by fast and slow heart beats. In your case the SND was secondary to a procedure but in the majority of cases the cause is intrinsic. While SND is not usually lethal and the sinus node ususally does "start back" after a pause SND may be very symptomatic. In general pauses of longer than 3 seconds or heart rates less than 40 are considered to be indications for a pacmemaker.
In regard to your second question the treatment would depend of exactly what rhythm disturbance you are having. In general I would favor a more aggressive approach with ablation in a young person, particularly if they had failed multiple medications. There are ablations for PVC, aflutter and afib. There should not be an increased risk for sustained VT due to your previous ablation procedure. At this point you may wish to consider a second opinion in regard to the next best step.
I would suggest you go to the afibsupport group at yahoo,
groups.yahoo.com/group/afibsupport as there are
a lot of folks there with experience as patients with afib, etc. and maybe we can make suggestions about meds or ablation results (there are mixed opinions about ablation for afib, many think it is not ready for prime time, which ablation for aflutter seems to be more successful. But there is also a danger with procedures.)
I notice you are taking amiodarone. That can have really bad side effects - lung damage, thyroid damage, eye damage, so I hope you are being monitored for those lcosely.
I am puzzled as to why they have you on two diuretics vs one. Also, what is midodrine, I couldn't find that in a medicine lookup at drugstore.com
http://www.docguide.com/dg.nsf/PrintPrint/B489CD627ADD4A34852566480049B079
Drug Reduces Severity Of Sudden Drops In Blood Pressure
ST. PAUL, MN -- July 21, 1998 -- The drug midodrine can improve blood pressure in patients suffering from a disorder that causes blood pressure to plunge when a patient stands up, according to a study published in this month's issue of Neurology.
This study examined the use of midodrine in patients with the disorder, known as neurogenic orthostatic hypotension. Midodrine, the first drug approved by the United States Food and Drug Administration to treat orthostatic hypotension, constricts blood vessels and in turn increases blood pressure. This disorder can appear on its own or be associated with other disorders such as parkinsonism or diabetes.
"Some patients with this condition are afraid to leave home or even get out of bed in fear of fainting or passing out," said neurologist and study author Phillip Low, MD, of the Mayo Clinic in Rochester, MN. "By increasing blood pressure at times when patients need it, midodrine can help people lead a more normal life."
Thankyou for your comments. I am not all that happy about taking the amiodarone. I have liver problems and eye problems already. Apparently we are waiting til we cross a certain unacceptable side effects level (especially with the liver) before they take me off it. I wish there was something else, that is why I was asking about ablations. I just don't know what to do. To answer your question, I am taking 2 diuretics, spironolactone and lasix, because when I was taking lasix only it caused a real problem with my potassium, even with pot. supplements. So they put me on the spironolactone, but that doesn't work as well with acute fluid accumulations, which I get relatively often, so I take the lasix only when that happens. I take the spironolactone all the time. Thankyou you for the web site for people with a-fib. I intend to check it out.
Have a great day.