Idiopathic Ventricular Tachycardia with extreme symptoms

[cookienkikin]

I'm a 24 yr old male. Echo, stress test, stress echo, holter, and event monitors have all been normal besides "PVC's and a 26 beat run of ventricular tachycardia at 127bpms that self terminated". I seen an EP today and he said that he thought it to be benign and called it Idiopathic Ventricular Tachycardia and I started asking questions and he said that just to be safe he wants to do an EP study next week. Can you explain an EP study? How safe are they to do? If he triggers a deadly arrythmia can they easily terminate it and keep me safe? What if he has to do an ablation, how safe is that? Just how benign is "Idiopathic Ventricular Tachycardia"? Can it develop into V-Fib? How bad is it to have a 26 beat run of v-tach?? Can you share your personal experiences and opinions? I also have been experiencing what feels like angina for about 2 yrs now and thats why I had the whole work up but all the test for that came back negative. ??
Do having bad symptoms make it more dangerous?

[cookienkikin]

could it be Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy? how would that be diagnosed? would that fit my symptoms of chest pain and the PVC's and VT and other symptoms that I feel? if a dangerous arrythmia (V-Fib) is triggered during EP study, how often is it converted back to normal and what are the chances of death resulting from this test? im REALLY concerned about could it be Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy!!

[cookienkikin]

I found this article at www.orlive.com

The patient is a middle aged male who was resuscitated from a VF cardiac arrest.  Extensive cardiac evaluation showed no coronary artery disease, normal left and right ventricular function, normal cardiac MRI, and no inducible arrhythmias at EP study.  Frequent PVCs were noted on cardiac monitoring.  An ICD was implanted and continued to record episodes of non-sustained polymorphic VT, culminating in a sustained episode terminated by a shock.  Catheter ablation was performed targeting the ventricular ectopy

How can they call "Idiopathic Ventricular Tachycardia" benign if these types of cases are occuring? Dr's say that PVC's are benign and "V-Tach" is benign in a structurally normal heart and with all the test this man had proved his heart was "structurally normal" yet he still suffered cardiac arrest due to V-Fibb.  Anyone have any inputs on this situation?

[kevk]

I have to agree with is something wrong. I would not worry so much and try not to compare your heart condition with what you read. I answered your post in another forum about your EP study.
For me everyone of my test came back abnormal ECG,Echo, Stress test and EP study. At the start I passed out all the time V-tach @ 315 bpm.
If you would have gone through a serious cardiac arrhythmia the doctors would have taken your drivers license. I could not drive for up to six months after every sustained run of v-tach or v-fib.
The bottom line is you can`t let this run your life try to relax

[is_something_wrong]

You should listen to my advice here, because it's important!

Are you tired of your PVCs (and the possibly V-tach)? Well, they are highly likely caused by your extreme worries and your mistrust in virtually every doctor you've ever met.

An example:
If I'm worried about PVCs / PACs / palpitations at night before sleep, then BAM, I can get 10 of them in less than 2 minutes, along with variable heart rate (tachy, normal, brady, tachy). If you are nervous about your heart, NOTHING is a worse trigger for palpitations than reading cardiology.

Electrophysiology is probably one of the most advanced topics in medicine, and if you don't understand it completely (you don't, and I don't - only cardiologists and especially electrophysiologists do - GP's do not!) you WILL end up scaring yourself and increasing your symptoms dramatically.

Why do "suddenly" PVCs show up? You think you never had a PVC until a certain time in your life? WRONG! You did, but they were less common, because you didn't care about them, you didn't worry about them and it never crossed your mind that the light flutter or thump or whatever you felt in your chest was cardiac related.

People obsessed with cleaning see dirt everywhere. We don't. And we don't spend our entire life cleaning our home again and again, though there can be small spots of dust here and there.

I wonder - how on earth did you come up with Brugada or LQTS? They both manifest with ultra-fast ventricular tachycardias (rate 300) with passing out. They are congenital diseases and you would have got the symptoms many years ago.

ARVD is ruled out with echocardiography. RVOT (right ventricular outflow tachy) is usually a benign condition.

My advice:

Immediately STOP reading cardiology
TRUST your doctors, at least the cardiologists.

I know it's not easy, and I worry about this stuff too. But you don't really have an alternative, if you're not going to ruin your life completely. You don't have a heart disease, your problem is worrying about heart disease. Do the EP study, get your questions answered and move on with your life.

[cookienkikin]

i also found on my copy of the cardionet report it says sinus rhythm with IVCD (Intraventricular Conduction Delay) and on the Diagnosis part it says (ICD-9): 426.9 conduction disorder, unspecified. sinus rhythm with IVCD shows like 3 different times on the report.  and 3 different times had ventricular tachycardia 25 beats, rate 124BPM, all the v-tach reports had 25beat runs with the highest rate 125BPM.  does any of this offer any additional info for this v-tach maybe not being benign?  does the IVCD pose more risk to SCD or v-fib with since i had documented v-tach?  

[BionicBabe]

Cookie,

I don't think there is anything wrong with looking stuff up on the Internet...especially if you aren't getting all the answers you want from your doctor. Yes, listen to your doctor...but after the appointment is over and you go home and have to deal with those weird heart beats and wondering about your EP study...looking stuff up on the Internet at least feels proactive. I did the same thing when I was told I needed an EP study, a Cardiac Cath and a Cardiac MRI. Just try to relax if you can and not overreact...because it is easy to assume you have all the worst kinds of heart defects there are. If you had a normal echo...then that is a very good sign! Did you find out your ejection fraction?

[erijon]

No, right ventricular dysplasia is a genetic defect that can be seen as hypokinesis of the heart muscle and your echos have been normal. Brugada syndrome is also a genetic disorder that would have shown up on one of your many EKGs as would long QT.

You really need to stop looking things up on the Internet, listen to your doctor, he knows.

Jon

[cookienkikin]

do you know if its possible for me to have right ventricular dysplasia that causes right outflow ventricular tachycardia? or could it be brugada syndrome or long qt that wasnt caught on a test?  would the test that ive had, have caught any of these diseases? thanks
im just so scared of SCD and want to know whats going on. your opinion would be greatly appreciated

[erijon]

Again, here's the last answer you got from a doctor;

"V-tach at 127 is very unlikely to lead to v-fib in someone with normal echo and EKG, and is certainly benign, not deadly at all, not even dangerous.  Find out how many VPCs in a row occurred.  If only 3, certainly no problem.  Even 10 or 20 in a row at 127/min would not be dangerous.  Low blood potassium or magnesium can make PVCs more frequent and might lead to non-sustained vtach, which is what you had.  A lot of beer, several quarts, might lead to low potassium or magnesium, so I'd stick to one bottle of beer two or three times a day, or less if you don't mind.  I'm not alarmed.  I think you're safe."

And the time before;

"The most common cause of chest pain in a young person is cramping of the muscles in the chest wall.  If you can modify the pain, make it better or worse, by pressing on the area that hurts, then you have proven that the pain is coming from your chest wall.  Chest wall pain is a nuisance but no threat to life or health.  At age below 45, chest pain is very unlikely to come from clogging of the coronary arteries that supply blood to the heart.

Prinzmetal's angina is unlikely since you had a normal EKG while the pain was present.

Get your blood pressure measured while you're standing quietly for 1,3 and 5 minutes.  If it gets below 85, that's the cause of your fast heart rate and faint feeling.  If not below 90, you have postural orthostatic tachycardia, which is doctors' jargon for sudden increase in heart rate without explanation.  A nuisance but no threat to life or health.  You're at no risk for SCD."

And the time before;

"Michael, haven't I answered all these questions many times before now?  Coronary blockages and angina are unheard of at age 24.  No more tests will help.  It's almost  certainly chest wall pain, which is no threat to life or health."

And the time before;

"The most common cause of chest pain in a young person is cramping of the muscles in the chest wall.  This pain can radiate to jaw and arm.  At age below 45, chest pain is very unlikely to come from clogging of the coronary arteries that supply blood to the heart.  Your chest pain is not heart related or it would have shown up on one or more of the tests.  Heart pain is brought on by exercise and relieved promptly by rest.  CT angio is unlikely to show any coronary narrowing at your age and with your pain that can occur when you're resting, and exposes you to right much x-ray.  An angiogram is VERY unlikely to show narrowing in your heart."

All this from one website. I can also quote the answers from the doctors here as well as WebMD, all the same. You need to get over this, we are not as qualified as all these doctors, why would you ask us when you have received feedback from so many doctors?

Jon