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Heart Disease (Expert Forum)
AIVR and NSVT
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AIVR and NSVT
by wmac, Nov 19, 2006 12:00AM
Hello and thanks for taking my question in advance. I justread that one of the docs answer the other day about AIVR and that Its unusal for someone to have that unless they have CAD. What about the people like myself who have it, I have had all the test and and all the docs and ep docs say my heart is normal and normal ef. But I do have mvp some echo's show that its present with leakage some show mild leakage it varies from time to time. I also have nsvt. Longest episode being 26 beat long h/r 186 . I had a loop recorder implanted so it was documented, along with many other episodes. I also have pacs, pvcs, svt, and of course AIVR and nsvt. I also have had two eps and both times it was not induceable so they say not worry but they did induce v-fib with first eps. With that being said, do I need to worrry if AIVR only usually occurs with people with sick hearts is there something they are missing. I usually have nsvt run at least once a month if not more. I am not on any meds tried toprol xl took three small doses and the third day is when I had my worse nsvt run and I blame the meds so I wont try it again. Also isnt AIVR the same as vt just slower? I wore the king of hearts just a couple of weeks ago for six weeks and the assisant called and said I had a bunch of pvcs in a row but too slow for nsvt so im assuming it was AIVR. The cardio never did call should I call to be sure or not worry. I usually have all my episodes when sitting and relaxing thats why I think the meds werent good for me cause it slows the h/r. What do you think. Thanks for your time &Happy Holidays wmac
Doctor's Answer
by CCF-M.D.-MJM, Nov 19, 2006 12:00AM
Hello,
I understand your concerns. The tough thing about AIVR is that we don't know what causes it. I imagine the reason you are so concerned is because we cannot give you a straight answer of what it is and why it happens. Unfortunately, I cannot answers these questions as well.
Do I need to worrry if AIVR only usually occurs with people with sick hearts is there something they are missing.
It is true that AIVR is usually a rhythmm seen with people after heart attacks and is considered a reperfusion rhtyhm -- seen after the artery is open. This is not always the case. This clearly does not apply to you and you should try not to worry about it. The mechanism of you AIVR is likely impossible to explain definitively.
Also isnt AIVR the same as vt just slower?
In the very simplest of terms yes. Ventricular tachycardia is ventricular rhythm greater than 100 beats per minute and AIVR is a ventricular rhythm that is slower than 100 beats per minute. Mechanistically they can be very different. Ventricular tachycardia is usually a rhythm that is dependent on scar for its circuit. AIVR is caused by an area with rapid firing greater than the sinus rhythm and therefore suppressing sinus rhythm. Ventricular tachycardia can be a dangerous rhythm. AIVR is not generally considered dangerous.
I usually have all my episodes when sitting and relaxing thats why I think the meds werent good for me cause it slows the h/r. What do you think.
It is possible that there is an area in your ventricle that acts as its own pacemaker. When you relax your heart rate goes down and the AIVR is no longer suppressed by sinus rhythm and is able to fire. It may not do this all the time but only when the conditions are right. The beta blocker may slow your sinus rate but not the AIVR rate and allow it to come out more. During an ep study the emphasis is usually trying to speed up the heart or improve conduction. It is possible that your AIVR only comes out in the opposite conditions.
I understand your concerns but try not to allow this to scare you. The best approach is probably to learn how to coexist with this when it happens. You will be able to do this only after you convince yourself that you aren't going to die from this -- and I don't think you believe this yet. You will not die from AIVR.
I hope this answers your questions. Good luck and thanks for posting.
I understand your concerns. The tough thing about AIVR is that we don't know what causes it. I imagine the reason you are so concerned is because we cannot give you a straight answer of what it is and why it happens. Unfortunately, I cannot answers these questions as well.
Do I need to worrry if AIVR only usually occurs with people with sick hearts is there something they are missing.
It is true that AIVR is usually a rhythmm seen with people after heart attacks and is considered a reperfusion rhtyhm -- seen after the artery is open. This is not always the case. This clearly does not apply to you and you should try not to worry about it. The mechanism of you AIVR is likely impossible to explain definitively.
Also isnt AIVR the same as vt just slower?
In the very simplest of terms yes. Ventricular tachycardia is ventricular rhythm greater than 100 beats per minute and AIVR is a ventricular rhythm that is slower than 100 beats per minute. Mechanistically they can be very different. Ventricular tachycardia is usually a rhythm that is dependent on scar for its circuit. AIVR is caused by an area with rapid firing greater than the sinus rhythm and therefore suppressing sinus rhythm. Ventricular tachycardia can be a dangerous rhythm. AIVR is not generally considered dangerous.
I usually have all my episodes when sitting and relaxing thats why I think the meds werent good for me cause it slows the h/r. What do you think.
It is possible that there is an area in your ventricle that acts as its own pacemaker. When you relax your heart rate goes down and the AIVR is no longer suppressed by sinus rhythm and is able to fire. It may not do this all the time but only when the conditions are right. The beta blocker may slow your sinus rate but not the AIVR rate and allow it to come out more. During an ep study the emphasis is usually trying to speed up the heart or improve conduction. It is possible that your AIVR only comes out in the opposite conditions.
I understand your concerns but try not to allow this to scare you. The best approach is probably to learn how to coexist with this when it happens. You will be able to do this only after you convince yourself that you aren't going to die from this -- and I don't think you believe this yet. You will not die from AIVR.
I hope this answers your questions. Good luck and thanks for posting.
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