Concern with Arrhythmia

[Paige]

Thank you for this forum.  It has been very informative.  I will apologize in advance for the length of this, but I know how hard it is to get on and wanted to make sure you knew my whole story.  I am a 38 year old female, overweight by about 30 pounds.  In October, 1999, had a situation where I was awakened by my heart racing.  It scared me, but I attributed it to too much caffeine that night and finally it subsided. (This was also a time when I began taking birth control after having been off of it for about 1 1/2 years). I had been told prior to that when I tried to give blood that my heart rate was too fast. GP said it was within normal range, 60-100 but suggested I lose weight.  I also went off birth control at the end of December. On January 12, 2000, I went to the ER as I was working and felt my heart all of a sudden begin racing.  They determined when I first went in that it was at 192bpm.  It came down on it's own to 108 in about five minutes, however they still administered a calcium channel blocker to get it down further before releasing me.  The Verapamil (120 or 160 mg?) didn't agree with me and my GP took me off of them.  I had an EKG and Echo during that time which showed nothing.  They were checking for MVP.  On March 10, 2000 began racing again at about 140bpm.  Went to GP and it went down to 70 bpm in about 20 minutes.  He went ahead and sent me to cardiologist for consult; he said that it looked like PSVT, nothing life threatening.  Put me on event monitor and gave me Lopressor 50 mg. to take it I had an event and it didn't convert withing 30 minutes or so.  He said that I could go to electrophysiologist to look at options, medicine or ablation.  I had an event which I was able to record about two weeks ago, event monitor showed 170bpm.  I took Lopressor which convered it to 70's range in about 20 minutes.  EKG which was taken at hospital during this event showed the following: Vent. rate: 142bpm, PR interval 152ms, QRS duration 88ms, QT/QTc 264/406ms, P-R-T axes 265 97 -45.  My questions are (any that you can answer):  What is going on with me?  Is it dangerous?  I would like to not be on medicine if possible.  In my situation, is catheter ablation a consideration? Thank you very much for your time.

[CARDIO CCF MD JMF]

Paige,

This is likely a supraventricular tachycardia and i recommend that this be evaluated by an electrophysiologist to further clarify. An electrophysiologist will be able to review your ecg and data more fully to determine the course of action.

[Barb]

Just curious Paige - do you get a lot of skipped heart beats as well or just the racing sensation?

[Paige]

Thanks for commenting Barb.  I have had a "third heartbeat" all of my life.  Lately, especially since all of this has happened, I get a lot more of them.  I was told that they were all benign.

[Additional Comment by Paige]

I should also mention that I am currently taking Lopressor, 25 mg, a day to keep the episodes of tachycardia from happening as I am in sales and on the road quite a bit.  As I mentioned to Barb, I also have PVCs which I was told were benign.  They can come in patterns of multiples or one every three or four beats.  The Lopressor has calmed these down quite a bit.  I have been on it for about two weeks.

[poly]

I was just diagnosed with innapropiate sinus tachycardia: My resting pulse is always around 105 bpm and it goes much higher with exercise and stress (it's been at 177 bpm once in the ER, and 144 when I was scared to death at the cardiologist consultation).  I have no symptoms though (unless I'm under too much stress; I feel short of breath and lightheaded).
I also suffer from panic attacks (don't know which causes which).
My cardiologist decided to put me on toprol-xl (50 mg) to slow my rate down.  I was very scared to take it since I had a very bad experience with atenolol (another beta blocker); I felt very depressed, tired, dizzy, weak, mental confussion, etc.  But thanks God I do not get any side effects with the toprol (today is my second day with it; I hope it stays that way).
From what I've read, sinus tachycardia is not life threatening and nothing needs to be done unless symptomatic (I don't know why my Dr. makes take this med., but at least it slows my pulse down to 85 bpm and I don't have the side effects).  Now I wonder if I'll have to take this for the rest of my life, may be I should get a second opinion or go to an electrophysiologist.

[Philip]

Does anyone know whether a blood pressure measuring instrument can indicate a "skip" in the heart beat?

My mum is 65 has had hypertension for years.  She has recently been put on cozaar, an angiotensin II receptor blocker, mainly because she has diabetes also.  She has recently dianosed to have low potassium (she has been on diuretic for years).  Lately her blood pressure measuring machine would stop suddenly when the figure on the screen drops.  We wonder whether it signifies no heart beat during that brief moment or the battery is low.

Would anyone know?  My mum says she cannot tell.

Gretaly appreciate your help

Thanks and much blessing

[jan to poly]

Dear Poly,
I, too, have inappropriate sinus tachy. I am on a beta blocker, atenolol.  I was told I have to take it because the tachy. occurs frequently which can lead to congestive heart failure or cardiomeghaly (?) if not treated.   I have just heard that beta blockers increase your risk of diabetes, so I need to talk with my electrophys. because my mother had diabetes and now my older brother and older sister have it.   :o(
Good luck.

[comment to jan]

Comment to jan - how often to you get the superventricular tacharacdia?  I was told not to worry and I get it about once per week if not more somtimes.  Please respond.

[jan]

On the 24 hr.holter I had it a total of 4+ hrs.

[To Jan (and others who know about Sinus]

Thank you for your reply!
I've read in this forum (where I have found most of the info about inappropriate sinus tachycardia) that this IST is not dangerous and that people that have it do not show an increased mortality rate.  It says that nothing needs to be done about it unless symptoms bother the patient (which is not my case).  As I said my resting pulse is "always" high, but the rythm is completely normal.  My cardiologist told me that if not treated this could cause problems in the long run (20 or 30 yrs more), but that is not what I've read in this site about IST.
I wish I could ask the doctors in this forum, but I'm never able to.  I wonder if I should go for a second opinion on this matter, or may be I should go to an electrophysiologist.
If you, or any other person, get more info on this please let me know.  (My problems with the beta blockers is that they lower my blood pressure, and it was already low; with 50 mg of Toprol-xl it is 85/70?!?!, and my cardiologist wants to increase the dossage of Toprol to lower my pulse from 85 bpm at rest to 70 bpm.  What's going to happen to my blood pressure then?)
Poly

[jan to poly]

Dear Poly,
It was on this website I found out about IST causing the chf and cardiomegaly, if the conditions were right (happening frequently enough).  I confronted my dr. and he said, " Yes, if it isn't treated, but we're treating yours".  Also, IST is common in younger people and usually not treated, in people my age (43) it is rare. The arrhythmia itself is not dangerous, because it is the normal rhythm.  Go to "Search" and enter in "Inappropriate Sinus Tachycardia" , that's where I found the info.  There may be more under "Arrhythmia" and who knows what else you might want to look under.  You say your dr. wants to put you on more to get your pulse rate lower, is your pulse actually regular?  Mine is now normal, but that can be anywhere between 60 - 100, it is always different from one minute to the next. I am still experiencing tachycardia up to 136 ( at least that's the highest I've caught it, but I wasn't aware when it was as high as 170 before, so who knows)so, we will be adding or changing my meds next visit.

[jan,ps to poly]

My IST just happens, it doesn't occur because of stress or exercise.  It happens when I am at rest, like reading or sewing, or watching tv.  (It can, of course happen at times of stress and exercise, too, but just because I am stressed or exercising doesn't necessarily mean it would). When your cardio. said it could cause problems in the long run, he probably meant the chf or cardiomegaly. I guess after awhile it wears the heart out if it isn't treated. (I hope I am not frightening you). I see an electrophysiologist because I read on this site that they deal with the rhythms of the heart and the dr. who did my tilt table test happened to be one, so I made him my cardio.  I share your concern about your blood pressure possibly going to low.  Mine is fine, but on days of stress I am supposed to double the atenolol, what would happen then?  Also, on the holter it showed at one point my heart went to 58 bpm, what about that?  I write down all these questions and ask my dr. (next visit I will ask these) you should, too. Also, if you can get an ep (electrophys.), then do so.

[Poly to Jan]

Thank you Jan for all the information! I'll look for an electrophysiologist for peace of mind (I'm not sure though if my insurance covers that because they're not listed in the directory they gave me; are they a subspecialty of cardiology?)
I'm 25 yrs old, and my pulse is completely normal (just fast).  But now that I've been taking the Toprol-xl, I noticed that I do feel better; I sleep better, I'm not anxious (I have suffered from anxiety for a long time), I don't feel exhausted when I exercise, etc.  It's been 5 days on the Toprol and each day my pulse seems to get better (yesterday, at rest it was 78 bpm, for the first time in my life!!!; it used to be ALWAYS above 100), and my blood pressure is still low (I feel fine though).  I don't think I need to increase the dossage of the medication as my cardiologist suggested, but I'll ask the electrophysiologist to make sure.

[jan to poly]

Yes, electrophys. is a sub of cardio.  and they don't list as such.  Like I said I found mine because a cardio. sent me to him for a tilt table test.  I guess a way to find one is to ask your dr. to refer you to one.  There is a website that will eventually be listing electrophys., but at this time they don't (if they did I would try to find the site for you...) I have talked with others on this forum that have said they have not seen them listed as such either.  I have a young friend, 22, who was having svt's pretty bad and here it was because she wasn't making the time to eat more than one meal a day (because of college and working)!  She started eating better and she is doing fine now.  I wish it was that easy for me.

[harold h.]

I had TypeII polio when I was 17 and am experiencing some PPS. I have been diagnosed with Achalasia and Atrial Fibrillation.  I have also had chicken pox and typical herpes cold sores.  Since all of these are entroviruses and the polio typically destroys or severely causes nerves in the medulla is it possible that the damage to the  the vagus nerve has in some way impaired the sphincter at the base of the esophagus thereby causing the achalasia.  Since damage to the vagus nerve could possibly impair the acetylcholine  production, is it possible that an anti-cholinesterese medication (mestinon) could alleviate these symptom.  

Secondarily, could these entroviruses have caused damage to the av node or the sinus node, thereby causing electrical disturbances that manifests itself in a-fib or flutter?

Thanks

[DiDiDEG]

Hi, I've been looking in here to see if anyone knows about my symptoms. I am going to see my doctor but am sure it will take weeks to see a heart specialist. I am a very busy person and sometimes am stressed because of it. At times of most stress (as far as I can make out) when resting (ie reading, TV, bed etc) my heart will stop for one beat and then resume. This will continue for periods of time. It almost feels like a kick and then a missed beat. I experience no pain or shortness of breath and then it will go away for weeks at a time. Should I be worrying? I do not have an elevated heart beat and previous tests, a few years ago showed nothing.

[A friend]

DiDiDeg, these are PVC's or PAC's.  Look it under "Archives".  There are many, many postings because many suffer from this.

[Carla Hogan]

For the arrythemia forum board

I am a 45 y/o female with a history of PVC becoming much worse this past year; I experience sometimes 8-10 a minute. I have been treated with Lopresor and now switched to Naladol.

I have had a negative Holter, event montor and thallium stress test.  A recent ultrasound showed adrenal lesion but the dye CAT scan showed a normal adrenal gland but some calcification on the aorta; the radiologist said this was unusual for a person under 50.

I have remained concerned that the PVCs are a symptom of CAD because of unusual fatigue and PVC intensity.  Would it be useful to have the electron beam CT scan done??? Do these symptoms and findings suggest that an angiogram should be performed??

Thank you for whatever guidance you can give.

[Deb]

Hi

For anyone looking for a Electrophysiologist, can go to www.naspe.com  and look up in the section they have for finding a doctor in your area.

[kjm]

Hello,
I was suprised to find so many people with the same symptoms that I have been experiencing. The Dr. has checked my thyroid and it is normal. The racing of my heart usually happens when I am resting so to my mind there is no reason for it--and it has gone as high as 190 bpm. My Dr. doesn't seem to concerned, so she may suspect that it is the same thing most on this site are talking about. I suppose the best thing I can do is commit to walking every day (I work at a desk in a very stress filled job)and eating properly--more greens, even though my favorite are the pastas and creams!
Good luck to all. If my Dr. finds anything outstanding I will let you all know.
kjm

[mbm]

To Mother of Pregnant Daughter:
My heart really goes out to your daughter.  I have suffered with tacchycardia since the age of 20.  I have three children and during the preganacies and postpartum periods with each child, I would have spells where my heart would soar to 200 bpm for a few hours.  My probs continued with each pregnancy until I fully weaned each child.  With my third baby, my heart rate rose (to 200 bpm) during labor.  The last thing I felt like during that was delivering a baby!  I'm CONVINCED that hormones are the precipitating factor.  All my blood tests (incl thyroid, holtors, stress tests, ekgs have come back normal.  I'm having an ep study later this month.  Good luck to your daughter.
MBM

[link correction]

www.naspe.org

[Deb]

Hi,

I am so sorry about the wrong link! :o)

Thanks to who ever caught the mistake!  It is www.naspe.org!

[krista]

Paige,

I was born with supraventricular tachycardia, also known as WPW Syndrome.  I started have rapid heart rates at about age 13 (I am now 24) and required constant medication to control them.  At that time, only open heart surgery could solve the problem.  After technology improved, I had a catheter ablation performed in 1993 to remove the extra fiber causing the tachycardia.  It was a very quick procedure, requiring about 2-3 hours with only an overnite stay in the hospital.  Depending on the frequency of your bouts, which sound rather frequent, I would recommend this procedure.  It is much better than continually taking medications.  By this time, you have probably consulted a cardiologist.  I hope your condition improves.

[JimV]

Paige;
I had four episodes of SVT in about ten years, the last three being all in one year.  After tons of tests my cardiologist referred me to an electrophysiologist who recommended the catheter ablation.  I did a lot of research and then decided on the ablation.  I underwent the procedure last January, put on 10 mg atenolol (which was just discontinued) and also two 81 mg Ecotrin each day.  Am now doing GREAT!
Your BEST "doctor" is your own body and it sounds like it is telling you something.  Listen to it and, as you are doing, do the research.  You will then make the right decision.
Good Luck!

[Linda]

I agree with MBM, there is a DEFINITE link between hormones and some individuals SVT's. I had my first SVT of 238 a day after my son was born. I remember having them toward the end of the pregnancy and ignoring them. I wish someone would do research on this issue in the long run it would save the medical community an awful lot of money! I have mentioned it to my gynecologist. I still have the SVT's but there is no question that they initially began during my pregnancy. I have talked to countless women that have had the same experience over the past 8 years. I have been through all types of heart tests and when I have an attack and it doesn't come down and I have to go to the emergency room they ask me if I drank too much caffeine (I don't do caffeine, smoke or use alcohol or drugs. Does anyone know if their is some type of test that can be done to see my hormone levels? I may ask my gynecologist. Ovarian cysts also run in my family as well. If anyone has any information please send me an email at ***@**** - Thank you.