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V-tach and A-tach same person
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MedHelp Member's Question

V-tach and A-tach same person

by gr13579, Jun 20, 2005 12:00AM
I am a 34 yr old Man

I have had two pacemakers.

I also had two WPW's ablated.

I have just foung out I have V-Tachy and A-tachy

They are running 1:1

I cannot find any info on this condition

its either one or the other but not both

Can anyone help me?!?

I called the AHA and I stumped the lady,

she couldn't find any info on it either

she just sent me info on clinical trials

I am very worried I passed out last week and was taken to the ER  they had no answers for me either.

Thank you  







Doctor's Answer

by CCF-M.D.-MJM, Jun 20, 2005 12:00AM
Hello,



Sounds like you are pretty frustrated.  Electrophysiology is pretty complicated.  Albeit rare, it is possible to have an atrial tachycardia and ventricular tachycardia -- but this is pretty rare, especially in some your age.



Unfortunately, without having the ECG rhythms strips and the pacemaker interrogations, I don't think I can tell you exactly what is going.  I can't quite tell from the way your post is worded -- do you have to seperate pacemakers now?  I have only seen this a few times.  Multple devices in one person opens you up for complicated device - device related interactions.



You should probably gather all your records and head to a good teaching hospital with a good electrophysiology department and obtain a second opinion.



If there is truly a 1:1 relationship ( on atrial contraction for each ventricular contraction), I don't think these are independent arrhythmias.  I am also concerned by your recent syncope (passing out) and think you need an answer as to what is going on.



Good luck with your quest -- let us know when you have an answer.
Member Comments (25)

by PikaPika88, Jun 20, 2005 12:00AM
To: gr13579
Hi, have the doctor given you any beta blocker to take yet? Why your 2 pacemakers didn't take action at all?  I want to see the doctor's comment too. I'm very sure you would find out the answer shortly.  Good luck and take care.

by Pete-Man, Jun 20, 2005 12:00AM
To: gr13579
Hello,



I just wanted to be sure I understood your post correctly.  You mean that either you have atrial tachycardia or ventricular tachycardia but not both of them at the same time, right?  I recently posted on here because I have different types of arrhythmias including atrial and now possibly ventricular tachycardia also.  I wonder if v-tach and atrial tach can both occur in someone with an otherwise "normal" heart.



I will look forward to the response you get and I wish you the best of luck.



by gr13579, Jun 20, 2005 12:00AM
Yes I have both at the same time

after I passed out and they interigated my pacemaker

they found I had both v-tach and a-tach happening at the same time running 1:1

the reason I had had two pacemakers is one of them malfunctioned



by gr13579, Jun 20, 2005 12:00AM
OH YA I have been on bata blockers

with horrible side affects

by gr13579, Jun 20, 2005 12:00AM
Sorry I keep reposting. My story is so

complex and has been going on for 6 years

the doctor told me my plumbing great. It is my electrical system that is going haywire

after countless stress test nuclear stress test

blood work and everything else they say my heart is healthy

the electrical system is shot.

by tickertock, Jun 20, 2005 12:00AM
To: gr13579


Go to http://www.ipej.org/0402/pirat.htm





This will explain in rare cases of an SVT that can initiate a VT and vice versa, mainly AVNRT triggering RVOT VT and RVOT triggering AVNRT, very complex , but interesting. Good luck.

by gr13579, Jun 20, 2005 12:00AM
To: tickertock
could the woman have had WPW

The article was very helpful

It seems like my condition before I had both of my WPW's

ablated  

AND even now could WPW come back and not show up on EKG's

by tickertock, Jun 20, 2005 12:00AM
To: gr13579


I really don't know to be honest, also I am not a medical doctor, what i do gather from the article the woman had dual Av nodal physiology that is a form of AVNRT (atrioventricular nodal reentrant tachycardia and also a spot in her right ventricular outflow tract(RVOT) that triggered VT. WPW is a form AVRT ( atrioventricular reentrant tachycardia), notice nodal is left out , it simply means that there is a direct connection bewteen the atria and ventricle, in WPW when atrial fibrillation is occuring because of the bypass tract(some bypass tracts are concealed and dont show up on ECG) it can conduct 1:1 to ventricles resulting extremely fast dangerous heartrate that could possibly turn into Ventricular fibrillation and cause sudden death , this is a very rare occurence and complication of WPW from my understanding . AVNRT is reentrant loop within or near the AV node that causes a fast heart rate by causing a circular rentry around the Av node and is not connected directly from atria to ventricle like WPW though the mechanisms are similiar from understanding.



I really can't answer or comment about your ECG and WPW as I am not a medical doctor,the information and comments above is my opinion and understanding of the difference between the 2 SVTs and I could be completely wrong also. Good luck and hope you get some answers soon.

by wmac, Jun 20, 2005 12:00AM
To: gr13579
Hello, I just read your comment. Did you say that you have A-tachy meaning supraventricular tachycardia and ventricular tachycardia?? Well I also  have both as well. I had a ep study in January  and at that point didnt know I had the svt thought I  only had v-tach. my ep study demosnstrated only dual AV nodal pathway physiology without inducable AVNRT. They coundnt induce the vtach either. I just found out about a month and a half ago that I also have svt. So needless to say they did not ablate anything. I have never passed out. I go back down to the university of Utah this thurs. for another echo and im going to beg for another ep study with hopes of being fixed. Oh they couldnt induce svt either during the ep study. good luck and whatever you find out let me know.

wmca

by wmac, Jun 20, 2005 12:00AM
Its odd that they both happened at the same time. The day before I got my loop recorder taken out I felt something strange, I literally felt the top part of my heart do one thing and the bottom of my heart do something else at the same time. But of course my luck my recorder was full so I couldnt record it. Is that what yours feels like when it does it.

wmac

by Bromley, Jun 20, 2005 12:00AM
Hi. Its my understanding that SVT refers to a class of arrhythmias that originate in tissue above the ventricles. Not sure,  but this category (SVT that is) might include AVNRT and atrial tachycardia.

by tickertock, Jun 21, 2005 12:00AM


Any arrhythmia that originates above the ventricles or at the AV junction is an SVT, they are many of them. Common sinus tachycardia, paroxysmal atrial tachycardia(PAT), inappropriate sinus tachycardia