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Heart Disease (Expert Forum)
Ventricular Fibrillation in nonsichemic cardiomyopathy
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Ventricular Fibrillation in nonsichemic cardiomyopathy
by DottyCece, Apr 02, 2007 12:00AM
I have an extensive cardiac history. I started with uncontrolled Atrial Fibrillation and severe mital valve regurgitation about four years ago. I had the valve replaced but there were problems with how the valve was seated. I developed CHF and in eleven months after the first surgery had to have the valve re-done. During that time I had persistent Atrial Fib Flutter that required 10 cardioversions, an attempted atrial flutter ablation that failed and did have a pacemaker for sick sinus syndrome. After the second surgery, I did well for about two months and then developed signs of CHF which grew worse over three months. On ECHO, I had an EF of 30%. I then had an AV node ablation and was pacemaker dependent. After a few more months I did get a bi-ventricular pacemaker and a ICD. On EP students it was found that I had easily induced V-fib. I did do a holter monitor and there were nonsustained v-tach on that which is how I ended up with the ICD. Anyway, over the next year and a half I made significant improvement. My EF increased to 50% and my symptoms improved remarkably. I am on coreg, lisinopril diuretics, electrolytes etc. Recently, I had two episodes of V-fibrillation that required shocks. My question is why would this happen now when my function has imporved significantly. In my mind, I never thought this would happen. It is scary. I do have lots of PVCs, bigeminal at times. Should I be on an antiarrhythmic? I really prefer to not be shocked which is absolutely no fun. I appreciate any insight you could give me.
Doctor's Answer
by Forum-M.D.-MJM, Apr 02, 2007 12:00AM
Hi Dotty,
I am glad to hear that your heart function and symptoms improved.
My question is why would this happen now when my function has imporved significantly.
Anytime there is scar in the heart, there is increased risk for ventricular tachycardia or fibrillation. Your heart function improved but there is probably still some scar. It is fortuante that you had the defibrillator.
In my mind, I never thought this would happen. It is scary. I do have lots of PVCs, bigeminal at times. Should I be on an antiarrhythmic?
If you had a single appropriate shock, I would wait it out. The options are standard heart failure therapy, adding an anti arrhythmic, and a VT ablation (if it was VT not a VF). For a single event, I think the risk of side effects is high enough on anti arrhythmic drugs that I would prefer to wait. If you have mroe events, then I would consider medications. You should already be on a beta blocker and if not, you should start one. Consider the antiarrhythmic medications only if you have to.
I hope his helps, thanks for posting.
I am glad to hear that your heart function and symptoms improved.
My question is why would this happen now when my function has imporved significantly.
Anytime there is scar in the heart, there is increased risk for ventricular tachycardia or fibrillation. Your heart function improved but there is probably still some scar. It is fortuante that you had the defibrillator.
In my mind, I never thought this would happen. It is scary. I do have lots of PVCs, bigeminal at times. Should I be on an antiarrhythmic?
If you had a single appropriate shock, I would wait it out. The options are standard heart failure therapy, adding an anti arrhythmic, and a VT ablation (if it was VT not a VF). For a single event, I think the risk of side effects is high enough on anti arrhythmic drugs that I would prefer to wait. If you have mroe events, then I would consider medications. You should already be on a beta blocker and if not, you should start one. Consider the antiarrhythmic medications only if you have to.
I hope his helps, thanks for posting.
Has your EP suggested antiarrythmics to reduce the chance for these type of events? I'm hoping this is just minor setback and that in no time you will be back to feeling much better. Perhaps the CC doctors will be able to offer some suggestions. Please take care! We're here for you.
Connie
Hope things settle for you soon
I was on Dig for 3 years.
Anyways, Thank-you again, I usually try not to worry about my EF, except for it dropping, I know that 45% is pretty good.
amy
The scars would take how long to cause the event of VF or VT happens? What happen they're so many wpw/svt babies or young children had their pathway ablated without ICD?
When the cardio that day told me the ablation scar could show as a heart infarction. I was cried and upset for a while. I want my heart have a full function like everyone else.
I don't think you should worry if you had succesfull ablation.