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Defibrillator at 39???

Tim
For many years I have had episodes of heart flutters and what felt like quivering.  I went to a Cardiologist four years ago.  After wearing a holter, stress test, and echogram he said, "Sounds like atrial-fib, don't worry about it, it is not life-threatening!"  I lived with this condition for years.  I am a firefighter in Oklahoma and was fighting a house fire in December 2000 when I felt the quivering.  Since noone actually recorded this rhythm, I went to the paramedics on scene and had them hook me up to their monitor.  They said, "I was in V-Tach!", which quit on its own within minutes.  The emergency room doctor diagnosed the rhythm as SVT.  During an Electrophysiology study, V-Tach was induced and an ablation was not possible.  The next day they implanted a Medtronic defibrillator.  One week before my first post-operative check up, I had another episode which I received two shocks at 30 joles.  During this episode, I was conscience and felt ok as usual.  This was the same feeling I have had in the past.  When they read the ICD, I was in V-fib.  They placed me on Sotalol 80mg twice a day.  Since I have been taking the medication, I have not had any episodes.  Although, the heart flutters seem to be constant now.  I have worked out with free-weights and ran most of my life.  I would like to start working out again, but I am afraid!  I have never had an episode from weightlifting, but usually after running I would go into the rhythm.  Also, they thought I would be able to return to work as a firefighter.  I do not see any possible way to return to such a "safety sensitive" job.  What do you think?
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Avatar universal
I fantasise about taking beta blockers to fix my multiple PVC/PAC problems but I cannot take any due to bad asthma.  Do you know of any alternative drugs that are safe like atenolol?  Also, what exactly does v tach feel like...I am sure I have it but my Dr says it is impossible (we have never caught an episode on tape) I sometimes get runs of PVCs (or PACs - not sure) which only last maybe 6 beats or so - I have no symptoms except the pounding chest.  Does this sound like v tach?  My Dr said only people with infarcted heart muscle get this but my heart is OK (I think!).  I'd really appreciate anyone's input.

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Tim
Just as I thought, I was "singing before the rooster crowed."  

I was unloading trash at the dumpsite and felt my heart go into v-tach.  I rushed to my vehicle.  After receiving several shocks, I finally got the attention of some workers.  They dialed 911, and an ambulance arrived.  By this time, I do not know how many shocks I received, but it was well over 20.  Which did not turn the rhythm arround.  While on the scene, they pushed lidocane at least 3 times, which also did not return a normal rythm.  Finally, I returned to a normal sinus rythm.


After consulting with my cardiologist and electrophysiologist, they determined to put me back on Sotalol.  Even though this drug cause me to have 300,000 pvc's in a 2 month period.

I have an appoitment next week at which time I plan to discuss further options on medications.

Hankstar do you have any further suggestions?  Maybe a teaching hospital in Oklahoma or another drug.  My Dad has sugested Toprol which works for him.
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Tim
Well it has been one week today since I started amiodarone, and my pvc's ARE GONE!!  I may be singing a little early, but I certainly feel better on the new drug.  They are going to check my organ functions in three weeks to see how I am tolerating the drug.

Talk to ya then,

Tim
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Tim
Thank you for responding and the encouragement.  I was somewhat scared of the new drug, but feel a little better about it now.  As for feeling the pvc's, yes I am aware of EVERY ONE!!!  

The City of Enid has scheduled me an appointment for an opinion of my disability.  Furthermore, I will have to go through the  Firefighter Pension Board doctor for an opinion also.  Maybe between the three of them, I will be assured of my condition.

Talk to you soon.

Tim
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Tim
Just thought I would update all of you that have responded.  I had my three month post-op checkup, and no shocks!!!!  Thank God!  However, I had almost 300,000 pvc's which I feel were caused or aggravated by sotalol.  They changed medications to amiodarone which somewhat scares me.  I have read the forum on this drug and feel a little more secure now.  I would appreciate any comments or experiences you may have.

Thanks

Tim
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Avatar universal
I forgot to mention that I too am very energetic. It never happens to me then. It always happens at rest especially when I get a fright.

Fran
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Avatar universal
Hi

I have been reading this line of post with great interest. What you are describing seems very like what happens to me. I am having difficulties with getting a proper diagnosos. I have AF and take sotalol (hopefully for not to much longer). Any way, I too can't breath sometimes during an attack. Was told this was a seperate problem, along with my Dizziness(which they call Menieres Disease). They are all connected I know because it happens to me.

I sometimes faint and convulse. Before it happens I have what I can only describe as breathing through water. It is very very difficult to breath and I have to make a concerted effort. One night I was in bed and I kept waking up with what I thought was sleep apnoea. I would start rasping for breath then after a few times at this I passed out (heart rythm had been fluttering, quivering, missing beats - everything thats not normal but normal for me). Like you the Sotalol seems to give me these arrythmias more than before I was on it.

All my tests have never shown up anything abnormal except for the AF. I have tried to diagnose myself. I have a healthy heart, I was told. I have come to the conclusion myself that it has something to do with the vegus nerve. My theory is that when my nervous system gets over stimulated causing the electrical stimulation in my heart and the very fast flutters etc take over my vegus nerve kicks in and slows the heart right down. Hence why I come out of it. I don't know if my heart stops but I have had near death experiences with it when I am out. (In a long dark tunnel knowing I have to come back or I will be dead) The only thing is that I have been told my QT is slightly long. This can be caused by the sotalol. But I feel the same as before. There are cases of people having V fib or is it Tach that causes syncope when the heart does stop. I have read this in medical papers. These people can naturally come out of it. However it usually becomes fatal. This is why it is important to not stop looking for answers.

Also, I know that before it happens I need some precipitating factor. It seems since I have kept my self well hydrated and upped my salt. I make my self drink a health salt drink (I have a healthy heart I reckoned it would not be bad for me)and lots of plain water that the episodes have lessened. Your episodes when you don't pass out could be what I have read as presyncopal. I get this. I am a strong fighter and you may be too. I feel sometimes it is mind over matter.

Good luck Let me know what you think. Your search could help my search too.

Fran
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Avatar universal
I sure hope that  I am not too late to comment on this subject. It was very interesting to read all the posts here. I want to tell you my story and this is ongoing for me as I write this. I am 36 F and have been having these attacks for years. It was found 3 years ago that I have cardiomyopathy. I have experienced the bumps and flips of a nerve in my heart that kept me in constant sharp pain. I went to an EP and we did a study. I was diagnosed with PSVT and chose to have it ablated. Now, I want to make it clear that I never caught the "big" attack on my recorder. I had a right ven. outflow ablation in Nov.- 2 weeks after it I had 2 of the "big" ones two nights in a row. Finally i had another one, while washing dishes in the morning. Some of them are very brief and just take my breath away and make my head feel queazy, for lack of a better word. The longer, more severe ones make me feel like death is at my door. My chest gets an empy kind of a feeling in it that soon travels to my head. I become very disoriented and pale, and my breathing is shallow. I feel like i cant breathe but my husband has assured me that i am  LOL  it is shallow and weak. I know I am not getting the oxygin to my brain. When I "come to" my heart races and i feel like i have to run somewhere. My EP has me wearing another monitor to try to catch this thing!! This past saturday i had a brief run of it. Not the big one i want my dr to see but i knew it would be enough for him to know what was going on. I saw him today and i have confirmed wide complex v-tach, non sustained. Now get this.....I am to wear this thing for another 8 weeks to see if i become sustained. Now here is what i believe is fact about v-tach and v-fib. v-tach takes many forms but the most dangerous one is UNSTABLE. Unstable v-tach is to be treated as v-fib because it can rapidly turn into v-fib. The only thing i know to tell the difference between stable and unstable is the symptoms you have with it. With me, i have s.o.b., chest pain and labored breathing for days sometimes a week after my episode. I also swell slightly (edmeia) and my left arm aches terribly. Right after a big episode i get to feeling like i'm gonna lose my cookies and the fatiuge takes over every muscule in my body and i just sleep, sometimes for days. Before my ablation it looked like PSVT. It is sometimes difficult to tell the difference when you have so many pvc's and such. Now that they are gone, it has uncovered the true nature of my episodes and possibly the reason or result of my heart failure. An EP study is a good idea for anyone with these symptoms. That doesnt mean you go into a cath lab the first day. The first thing they do is monitor your heart and they must document a reason to send you to the lab. But even then, it is your choice. The only downside of an ablation that i know of is that it may not be something that can be ablated, also that if the area of your heart that is causing the misfire is in the sinus node or natural pace maker, you may come out with a pacer, that will be up to you too. Mine is firing off several times a week now and when i started 9 years ago they were not very often. As they became more frequent and disrupted my life so much, i had to do something to fix it. At this point, i think i would welcome a defibulater. I know people with defibs and i also believe that when they fire, they have saved your life.
  Good luck to all of you and if you are interested in my personal journey, check in here and i will let you know what he says when i show him a susstained v-tach. Hopefully not in the ER <lol>  : )
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JR
heres the scoop on V-fib...
hankstar is right to an extent. V-fib usually is fatal (about 98%) if not converted no NSR within 4 or 5 min....it can spontaneously convert to NSR by itself, but it just dosent happen very often. like he said, in a lot of cases, patients who "majically" convert from VF were not in true VF to start with, probably another atrial arrythmia that can be hard to distinguish by someone who is not highly trained......
(NO IM NOT A DOCTOR, BUT I PLAY ONE ON TV)
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Avatar universal
It is possible to have short runs of VF - I have the strips to prove it.  It can 'break' on its own, just as VT, SVT do.  Yes, even the best have been fooled - but who are we to tell someone that they weren't in VF if we haven't seen the strips?  

If you feel uncomfortable with the diagnosis I would definitely recommend seeing another electrophysiologist - please do not take OUR word for it - thats just not smart.

Wishing you the best of luck - and no zaps :o)

Jennifer
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Avatar universal
You can stay 'awake' during VF.  I have an ICD for Long QT syndrome, and have been shocked out of VF 6 times (at a rate of 300)- I have never lost conciousness during it.  I got dizzy but never passed out.  It depends on the 'react' time of your ICD.  My ICD fires in about 15 seconds - enough time so that I don't pass out.  I fall down when I'm shocked but I never pass out.  

I know others who this happens to also.  You could have been in VF and not passed out - it is possible.  Many people who are otherwise physically fit/ not withstanding clogged arteries - can stay concious during a short run of VF.  I would take your doctors word for it - if they say you were in VF you probably were...only they are reading the strips.

Good Luck!

Jennifer
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Tim
Although I have a swimming pool, I have not been swimming this year with my ICD.  I do not think it has happen while swimming, but will keep you informed this summer.  Usually my rhythm happens when I am totally exhausted from exercise (running) or on the golf course when I am drinking, smoking, and having a good time.  I know thats bad, but hey you only go around once!
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Avatar universal
Is atrioventricular tachycardia different then atrial tachycardia?

The doc had drawn some diagrams for me, so that's why I remembered the av-nodal area was in between the upper and lower chambers and is where there is a strip of muscled that improperly conducts rhythm through this junction. And it creates a short circuit of some sort.

The doctor said today that it's nearly impossible for non-cardiologists to tell, in some cases, v-tach, from a-tach. And in my case, only the paramedics saw the tachycardia. He said even some cardiologists couldn't distinguish and that's why he was often referred to. So I thought, since he seemed skeptical of the a-tach thing (5%), and distinguished them as different from wolf-parkinson's white and this av nodal thing, and that he wanted to EP soon, seemed concerned, that perhaps his worry was v-tach.

Got my holter on now, and I'll keep posting to let you all know what's found and when, over the next few weeks. I hope someone out there finds this helpful, for I've learned a lot in the past few weeks about arrythmias that I didn't know about.
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Avatar universal
I had my appt. with the ep. He was much more knowledgeable then the other cardiologist whom I'd seen, and the other cardio has LOST my records, nice, fortunately my PAT was dx'd in the ER.

This doc felt that I had a problem, given my symptoms, 60% as a-v nodal (something problem), 35% Wolf-Parksinson's White, and 5% actual PAT. He felt the problem was more severe then just PAT and wants to do a EP study, but through my neck, as my veins there are very accessible, due to muscle mass removed over them during a radical neck dissection. OUch! This sounds painful!

First he wants to re-halter me as a standard, tomorrow. And he also wants to re-tilt table test me, because he side he has done 20 X more tilts then the other doctor, who gave me the more controversial nitroglycerin (which I spit out anyways)..., and then he wants it done with isuprel, big medication phobia here, esp. with IV medication. That will be in a week or two. If that is negative, which they know right off, then you schedule for an EP study. Now if the EP study is negative, I have no clue what direction to go in.
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Avatar universal
Keep us updated.  Did the doctor say it could be serious?
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Avatar universal
I had my appt. with the ep. He was much more knowledgeable then the other cardiologist whom I'd seen, and the other cardio has LOST my records, nice, fortunately my PAT was dx'd in the ER.

This doc felt that I had a problem, given my symptoms, 60% as a-v nodal (something problem), 35% Wolf-Parksinson's White, and 5% actual PAT. He felt the problem was more severe then just PAT and wants to do a EP study, but through my neck, as my veins there are very accessible, due to muscle mass removed over them during a radical neck dissection. OUch! This sounds painful!

First he wants to re-halter me as a standard, tomorrow. And he also wants to re-tilt table test me, because he side he has done 20 X more tilts then the other doctor, who gave me the more controversial nitroglycerin (which I spit out anyways)..., and then he wants it done with isuprel, big medication phobia here, esp. with IV medication. That will be in a week or two. If that is negative, which they know right off, then you schedule for an EP study. Now if the EP study is negative, I have no clue what direction to go in.
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Avatar universal
What does a-v nodal mean?  (in regards to Savannah?
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Tim:
It's a real shock when this happens to you isn't it? especially when you're a fit healthy person.  Running on the treadmill brings on worse arrythmias than weights and cycling, but generally it can happen any old time in my case.  apparently I have so many PACs that excersing causes them to degenerate into a fib.  But WORST of all is swimming! I haven't been in the water for years because of the wierdo heartbeats I get as soon as I jump in.  Have you ever noticed this?

Victoria:
thanks for your comment.  I have had every test you can imagine, including thyroid tests....all normal except for a tilt table test which was positive.

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Avatar universal
I JUST TURNED 40 IN FEBRUARY.
I FIRST NOTICE A FAST HEART RATE FOR NO REASON, IN OCT. 1993.
FROM THAT FIRST DAY I WOULD GET THESE EPISODES EVERY DAY .
ESPECIALLY AFTER EATING, BUT USUALLY FOR NO REASON. THEN IN SEPT.
1996, I BENT DOWN TO PICK UP SOMETHING, AND WHAT I FELT WHICH SCARED THE HEK OUT OF ME, WAS I FELT A FLUTTER, THEN I WENT TO FEEL MY PULSE, AND I CAN HARDLY FEEL ANYTHING, REAL SLOW IT WAS GOING, THEN WHAT I USUALLY DO IS COUGH OR DO SOMETHING WITH A QUICK MOTION, AND MY HEART GOES FROM THE SLOW RATE, TO A VERY FAST RATE, THEN BACK DOWN TO NORMAL, AND THEN THE EVENT IS OVER WITH. SOMETIMES WITH EVENT, WHEN MY HEART GOES TO THE FAST RATE FROM THE SLOW, I FEEL LIKE A HOT FLUSHED FEELING IN MY FACE AND ALL OVER SOMETIMES, AND SOMETIMES THAT PASSING OUT FEELING OR EVERTHIN G IS STANDING STILL FEELING. THIS EVENT USED TO HAPPENS
EVERY COUPLE OF MONTHS OR SO, NOW AT LEAST ONCE OR TWICE A MONTH.
I NOTICED ALSO AROUND THE TIME OF OVULATION OR MY MENSES. THEN IN FEB. 1998 THIS DAY MY HEART WOULD NOT SLOW DOWN LIKE IT USUSALLY DOES . JUST GOING FROM THE CHAIR TO THE COUCH IT WOULD BEAT FAST.
I FINALLY WENT TO THE ER THAT NITE, AND THEN A WEEK AFTER TO A CARDIOLOGIST FOR THE FIRST TIME. HAD A BLOOD WORK, CARDIOGRAM, ECHO, TOLD PICTURE PERFECT HEART, BUT STILL HAVE THE SINUS TACH, THE WEIRD EVENT ALSO I GUESS I ALSO GET THOSE EXTRA BEATS, IT IS LIKE A HARD BEAT OR SOMETHING, YOU FEEL IT AND ITS OVER WITH IN A BLINK OF AN EYE. SO THESE THREE SEPERATE ARRYTHMIAS I FEEL I FINALLY STARTED TORPOL 100 MG. IN SEPT. 1999. I STILL HAVE ALL THREE ARRYTHMIAS, BUT THE MEDICNE HAS HELPED. THE EVENT I GET WHER MY HEART GOES FROM NORMAL TO SUPER SLOW, THE SUPER FAST THEN NORMAL STILL HAPPENS ONCE OR TWICE A MONTH, BUT WITH THE TOPROL, WHEN IT GOES FROM THE SLOW RATE TO THE FAST RATE, THE FAST RATE IS NO WHERES AS FAST, AS IT WAS BEFORE THE TOPROL.
I HAVE NEVER BEEN TOLD BY MY CARDIOLOGIST WHAT THIS OR CALLED.
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Oops, I meant to say Capital letters, not bold ones.
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Please stop typing in bold letters.  They are very difficult to read.  Thank you.
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. IT IS THE VENTRICLES PAUSING TO CHANGE GEAR AND TO START BEATING VERY RAPIDLY FROM A SPOT IN THE ATRIUM TAKING OVER THE HEART'S REAL PACER THE SINUS NODE.

Hankstar-can this create that awful pause?  Can you explain this a little more?  If this was the case, it wouldn't be a-fib like my doc thought?

Jodie
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Savannah,
Please let us know how your appointment went!
Jodie
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Tim
I can not wait to get back to the gym, however I have not been released to do so.  My whole life is at a stand still, and I have to retire as a firefighter.  Guess our healthy hearts are nice to have, but I too would trade.  I feel every little bump, and it scares the hell out of me.  Although, I have never had any episodes from weight training, running seems to trigger v-tach pretty much everytime.  Good luck!!!

Getting fat in Oklahoma

Tim
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