First time with VT now what?

[BigBoy2u]

40 y/o male one time weighed 425lbs. Gastric bypass surgery in 2001 and currently 255lbs used to be diabetic with a history of Anxiety.  Left shoulder pain so my PCP sent me in for a treadmill test in October 2003 (shoulder pain is caused by joint pain now). I do not exercise much and mostly hold a desk job, at 188 bpm I went into VT. I had self-converted back and my rate was 240 VT lasted about 15-20 seconds I think. Angiogram was completely open no blocks or buildup was found, All blood work was fine. Sonogram was fine. EP study and the VT was not inducible.  A cardiac MRI to rule out ARVD.  Holter Monitor for 24 hours.  There are no structural defects, no arrhythmias other than PVC

[mikeweegel]

Hi Everyone,
Hope you're all still there. I had a very scary day yesterday with rapid heart beat and lots of skips while having them. (I'm 29 year old female) I went to ER and has signs of sinus tach on the EKG and a BP of 170/100, but the irregular beats weren't picked up because they stopped by the time I was hooked up to the machine. What I'm terrified about is that I have undiagnosed v-tach rather than diagnosed sinus tach (because the skipped beats weren't picked up). I've heard that v-tach is a medical emergency. After about 20 mins in the hospital bed my heart rate dropped to 95 and my BP to 120/90. I woke up this morning to a raging heartbeat again and skipped beats among them. How do I know this isn't going to turn into a medical emergency just because the machine hasn't picked up on it? I feel very emotionally drained and scared today. At the moment my heart rate feels normal but I so so tired. Does anyone know about this sort of thing?

[BigBoy2u]

Thanks for your input however, I used to have levels that where in the mid 200's and a A1C that was over 8.  Since my gastric bypass surgery my levels have been below normal.  My after meal levels when last checked were 120 and fasting was in the low 70's my A1C 2 weeks ago was 5.1.  My Dr says I am not longer diabetic and the huge amounts of sugar's I consumed wsa more than my boby could handle.  Most severly overweight people that have had gastric bypass have seen a complete return to normal of the glucose levels in a matter of weeks this is a documented fact.  Now I am not able to say this is a cure or I am cured...but normal levels with no medications or diet restrictions at all for the last 3 years would tell me I no longer have diabetes.

[hbp702]

No such thing as "used to be diabetic".

Once diabetic, always diabetic. I am assuming you are type 2, since type 1 doesn't appear to "go away". Type 2 does appear to "go away", if you reduce insulin resistance, reduce glycemic load and/or exercise to the point where your remaining beta cells can maintain normal glucose levels for the time being.

However, it never actually goes away.

You have many, many beta cells that are dead and are not coming back.

If this was not true, you would not be diabetic. Beta cell loss is a necessary precondition for diabetes, even type 2. It is believed by some that beta cell death occurs even during the IGT stage of the progression to diabetes.

And unfortunately statistics and studies show that beta cell destruction cannot be stopped, only slowed, so you will get worse.

However you can slow the loss and there are new therapies on the horizon that may change this (do a search on amyloid and diabetes on the net).

You still need to consider diabetes a risk factor right now. And still take care of your eyes, feet, etc! Once diabetic, damage has been done to nearly every part of the body and that damage is relentlessly progressive. Stay hopeful, this may change, but you want to limit or eliminate the amount of irreversible damage.

Diabetes not only kills, it maims you first and takes away your quality of life.

I am not a doctor, just a male hypertensive IGT patient with androgen and estrogen imbalances. Who is more scared of diabetes than Al Qaeda or anything else I can think of.

[flipflop]

BM,
Thanks for the correction, you are right excuse my "fuzzy" math, if my comments is as off as my math, I wouldn't give them the time of the day.

one tenth of one percent is a very very low risk is what I was trying to get accross, a slip of the fingers can get you trouble sometime.

Nice to see you on the forum again.

take care,

  flip(Lyn)

[bigmick]

Flip,

At the risk of being pedantic, I would respectfully point out that the ratio is 0.1% as opposed to 0.001%. (300,000,000 divided by 300,000 is 1000 and  100% divided by 1000 = 0.1 (%)).

Other than the maths (-:  great posts flip.

Cheers,

BM

[Dr. Erik]

You have NSVT. Non-Sustained Ventricular Tachycardia. Your heart is normal structurally. All other tests are normal. After having the Gastric Bypass you are unable to absorb certain nutrients as well as before the surgery. You may need to take supplements so your electrolytes don't get out of whack, which can cause arrhythmias. You are not in danger of dying from your NSVT,
as the Cardio Doctor will tell you. You will live a normal life span providing that you keep your obesity in check. You should stay on the Beta Blocker. It should prevent the NSVT from reoccuring or at least keep it from bothering you too much. Good luck.

[Cleveland Clinic]

bigboy,

1. Most thinigs really have been considered. The presence of a normal ejection fraction, no coronary disease and non inducible VT on an EP study places you at lower rsik for sudden cardiac death. The beta blocker in itself is a good antiarrythmic drug.

2 75 is not that large of a dose for atenolol.

3 no. but i would imagine your conditioning played a role. As your still overweight.

4. It is unclear if your risk is slightly higher for SCD, given you've had 1 episode. On a beta blocker, your overall risk is going to approach that of unity.

5. The real risk is going to have your heart elevated to the level you had it before. Anxiety is not going to get it there alone. On the beta blocker, your heart rate will be blunted overall, so even exercise shouldn't.

Truthfully, The best thing for you would be a controlled cardiac rehabilitation program. There they can monitor your activity, heart rate, and overall progress in a controlled environment. The rehabilitation program at the Cleveland Clinic has a physician on duty during the sessions. As you make progress in further weight loss and conditioning, your overall risk will continue to fall.

good luck

[flipflop]

I just thought I'd throw this out there, despite the distressing symptoms of palpitations, PVCs, PACs,PSVTs, SVTs, NSVTs and VTs, the risk of sudden cardiac death from a significant arrhythmia is very low, even in those with mild heart disease.

i know statistics can be misleading, but take for example it is estimated that 300,000(3 hundred thousand) persons die yearly in U.S. of sudden cardiac death attributed to arrhythmias. It is my understanding that the U.S. has a population of about 300,000,000 (3 hundred million people).

therefore your chance of suffering sudden cardiac death due to an arrhythmia is about 0.001%., if my math is correct that is a very very low percentage.

Most of these person are found to have severe undiagnosed coronary heartdisease, a small percentage with hypertrophic cardiomyopathy or dilated cardiomyopathy and long qt syndrome. and a very minute percentage with WPW syndrome.

the true percentage is probably a bit higher, but not significantly.

  This is probably why persons that have arrhythmias once given all the necessary tests to rule significant causes as to their palpitations are probably told it is best to try and tolerate them rather than seek invasive treatment which carries a much higher risks than the arrhythmia itself, that is not say that many don't derive benefits and relief from invasive procedures such as EP studies and ablations for their arrhythmias, but the possible cure carries a much higher risk than most of the arrhythmias themselves.

  I can also understand the intolerable symptoms of arrhythmias and palpitations and why some including myself would take the risk even though small if they could be "cured" of their palpitations, even though there is really no guarantee of a "cure" either.

flip(lyn)

[flipflop]

Sound like the atenolol is really effective insuppressing your exercised induced VT.  Are you still advised to do moderate amounts of exercise such as brisk walkig to keep fit, but avoid the vigorous workouts just in case... i imagine moderate exercise would be recommended and encouraged for you, even thogh advised to avoid the vigorous exercise or workouts. Would I be correct in assuming this?

I have exercise induced PVCs myself and I take up to 75 mg of atenolol daily myself and I exercise daily on a machine to the equivalent of jogging about 2-3 miles everyday, no PVCs whatsoever during the exercise. I do this to keep fit, exercise is important, even in severe cases of heart failure , it is important to exercise if possible and can actually improve the quality of life.

[cfds]

Hankstar! Welcome back!!!!!!!!!!

[BigBoy2u]

Thanks for the reply.  The EP doc was not able to induce the VT again and he said he really tried...lol, but I was on beta blockers at that time so it might have effected the outcome.  So no ablation for me.

[flipflop]

from my understand and i am not a doctor, with all the test you had showing a normal heart with no blockages, you probably are at no greater risk than the average population for SCD, if you are, the risks are very minute.

Atenolol is great beta blocker for reducing exercised induced VT.

A woman that had exercise induced VT coming from the RVOT(Right ventricular outflow tact) was given 75mg atenolol and it abolished her VT within a short time.

You might even be a candidate for VT ablation , if it is exercised induce and coming from the RVOT, often called RVOT (VT), it is usually exercised induced.

Godd luck

flip(Lyn)

[flipflop]

Are you confusing me with hankstar? Well I would take that as compliment, but let's not start that controversy again.

If you think I'm Hankstar you can e-mail freely at

lyndon_21***@****

P.S. I don't even notice hankstar's name under any comments on the forum, even though some of his comments are still here.

      In the maintime , I will take your assumption as compliment.

flip(Lyn)