NSVT - While walking/activity - Need reassurance

[brian72]

Doctor,

Thank you for answering our questions.  Your help is invaluable. 33/m, 5'6 180 down from 215. Cholesterol 232 total, 163 ldl, 41 hdl, 140 tri.  Stressfull event led to increase in palpitations, had them since early 20

[CCF-M.D.-MJM]

Hi Brian,

1: Assuming it was NSVT (I know theres no way of knowing without capturing it), is it dangerous? Felt like 10-15 beats.

NSVT in a normal heart like yours is NOT dangerous.  There is no way to know by symptoms where the arrhythmia is coming from without a monitor.


2: It was while walking the dog up an incline and happened at the top of my steps and another time walking to my car, would this be considered exercise induced NSVT? I read thats dangerous and a possible indicator of future CAD. I wasn't really exercising, just walking the dog and walking to my car. Now I'm scared to do much physically, let alone exercise.

That isn't much exercise.  If you are really concerned and it is affecting your life, tell your doctor and ask for an exercise stress test.  You can do a maximal stress test and watch for the arrhythmia.  It sounds to me like you are thinking about this too much.  If you have a normal stress test and normal heart, I don't think you have anything to worry about.  You didn't mention any significant family history of CAD or early heart attacks.

3: I was under stress at the time, could you get runs of PVC's from stress during activity or could those factors lead to short episodes of NSVT?

I stopped drinking coffee during finals week in college for a reason.  Yes, stress can increase the frequency of PVCs.  I think you are making too many jumps with your anxieties here.  1. You don't even know if you had NSVT, SVT is much more common in your age group and feels exactly the same in most people.  2. Even if you did have NSVT, it is not life threatening in people with structurally nornal hearts.

4: If it was NSVT, any idea why it hasn't happened since? Could NSVT be caused by adrenaline surges while walking?
If you reduce stress can NSVT subside?

Stress can cause more PVCs, PACs, SVT and NSVT.

5: If CAD were ruled out, what else would cause NSVT?

That is the million dollar question and it is very difficult to explain and prove, but even more difficult to understand. It can be from local reentry, increased automaticity (increased local potentials in a cluster fo cells) or triggered activity.  Most doctors don't understand this stuff though, it is very complicated.

I hope this answers your questions.  Thanks for posting.

[nurse2]

I HAVE HAD PVC,PAC, SVT FOR OVER 10 YEARS,WORKED UP WITH EKG, ECHO,HOLTER AND EVENT MONITOR. I WAS TOLD I WAS NOT A CANDIDATE FOR ABLATION. RECENTLY MY ARRYTHMIA HAS BECOME WORSE AND I WENT TO SEE A EPS SPECIALIST. HE TOLD ME HE WANTED TO TRY TAMBOCOR FIRST RATHER THAN EPS- I HAVE BEEN TAKING IT FOR 3 DAYS NOW AND I AM PETRIFIED OF THE DRUG AND I AM AFRAID OF GOING TO THE GYM AND GETTING MY HEART RATE UP. I DONT KNIW WHATS WORSE THE ARRYTHMIA OR THE TAMBOCOR. HELP---- IHAVE ALSO HAVE BEEN ON TOPROL XL,INDERAL,DIGOXIN,LOPRESSOR. I HAVE TO ADMIT THAT SINCE STARTING THE TAMBOCOR I DO FEEL BETTER- ANY WORDS OF REASSURANCE FROM ANYONE!!!!!!!!

[nurse2]

I ALSO FORGOT TO  MENTION THAT I HAD A STRESS ECHO THAT WAS NEG FOR ISCHEMIA, SHOWED A HEALTHY HEART WITH MVP AND TR. I ALSO HAD AN EKG THAT DEMONSTRATED A RT BBB- WHICH WAS EXPLAINED TO ME IS ELECTRICAL- AFTER ALL THESE YEARS OF ARRYTHMIA AND BETA BLOCKERS W/O RELIEF- THE ONE DRUG THAT HAS FINALLY HELPED I'M AFRAID TO TAKE GO FIGURE.

[tickertock]

like I said before when I had the NSVt documented I didn't feel it, I've had so many different fluttering and frightening feelings since , I really don't know what it could have been because it wasn't caught, the one feeling thats terrible is bigeminal PVCs which i caught and documented, which when really close is a feeling i think could be confused with many PVCs in row. Hope this helps.

[brian72]

thanks for the reassurance! it does help to hear it from others... I did have a nuclear stress test, cardio says I did well on it... I remember your description of NSVT as lub dub dub and so on... I did have 6 episodes of SVT recorded on holter and the doctor says it can feel exactly the same to most people... I've felt my SVT and it just feels fast with no pauses... the episodes I had last july felt like it was out of rhythm, I've seen you describe NSVT being that way also

[Momto3]

Hope the doctor's answer has helped to ease the anxiety.  I think an exercise stress test is an excellent idea if you continue to worry about the palps.

Remember not to focus on bits and pieces of the study.  Rather, look at it as just one source of information.  As you know, we can find a study which supports any notion.  This one SUGGESTS that there COULD BE a link between NSVT and CAD.  I think it's important to recognize that walking was not a true test of your heart's pumping capability.  That's where the stress test could help put your mind at ease.  Don't worry....

Have a great day!

[brian72]

thanks for your input ticker, along with what the doctor has said it has certainly helped...  I wouldn't have thought SVT feels exactly the same as NSVT as the doctor stated... my holter actually showed 6 SVT episodes... he also added I should ask for an exercise stress test, I thought a nuclear stress test (which I stated I had) was always with exercise... thanks again

[brian72]

thanks for sharing ticker, it certainly helps...  have you had NSVT episodes during activity?

momto3: thats actually the study that has me worried lol, its the same link I posted but I put up the wrong one... this is the part that scares me:

The occurrence of premature ventricular depolarisation during exercise in apparently healthy subjects has not been associated with an increase in cardiovascular mortality and was considered to be a normal response to exertion.24

[Momto3]

Congratulations on the weight loss...You've given you're heart a great gift : )

Sorry about the added stress in your life...certainly a potential trigger for palps.  

Great news on the test results!!  I don't know if this will help or not.  But, although I've had a history of zillions of palps, stress tests indicate no ischemic heart disease. I'm hoping that continues to be the case for a LONG time.

You're right in that it is really impossible to tell if what you experienced was NSVT.  But, with a good cardiac workup and a structurally normal heart, you seem to have excellent heart health. Despite lots of palps, including NSVT, it wasn't a big deal until my EF dropped and there were signs of changes in the heart itself.  Up till then, I was treated with beta blockers for symptomatic relief.  

As to the cause of NSVT....that's a million dollar question.  In my case, it didn't matter if I was exercising, sleeping, watching TV, etc. The palps appeared and disappeared with no rhyme or reason.  You may find that reducing stress helps with the intensity and/or frequency of the palps.  But, for me, stress was not really a catalyst, rather just something that aggravated an already irritable heart.  Stress did not actually bring on palps....But, anxiety was/is HUGE factor.  Keeping the anxiety at bay does not stop the palps, but it helps with coping.

Have a great day!

[Momto3]

I thought you might find this link helpful.  It is a recent study surrounding the issue of NSVT.

http://eurheartj.oxfordjournals.org/cgi/content/full/25/13/1093

Try not to worry...Your dog gonna miss those summer walks : 0

Like tickertock said, I'd be willing to bet you're just fine.  The only advice I would offer is that you enjoy life and don't let the "glitches" consume you.  As many of us here will tell you, the anxiety is what will drive you crazy.

Have a great day and remember to walk the dog : )

[tickertock]

I know how you feel about all the studies and I'm not saying that the aren't valid but in most of those studies, we here as laymen interpret them in a much different way than the those who performed them or even the doctors, they have all the access to data that we don't have. Be careful what you read on the net and try to interpret yourself, while some of it is very informative when taken out of context can only lead to more fear and anxiety.

  Persons with palpitations often experience them with varying degrees of activity with each episode. For example some only experience them with activitiy or stress, others experience them at calm and at rest, with some they alternate to activity and then at rest. I have had them in every way possible , activity, rest, stress, etc. These comments only reflex my personal opinion and my personal experiences, follow the advice of your doctor or doctors , if in doubt get a 2nd or even 3rd opinion. The doctor here on the forum will give you sound advice relevant to the information provided.Take care and good luck.

[brian72]

gaspipe, cholesterol is slowly coming down through diet... its been 4 months and have seen it drop slightly, I'm trying to avoid taking a statin, don't want to add anything that might aggravate the palpitations, not to mention the liver...

momto3, my cardio keeps trying to tell me its nothing major...that, like you said with all the tests being negative I have a strong heart... but it happened a few times last year within a couple weeks while walking... i'm fairly in tune with my body (as alot of us on this board seem to be) and it felt like NSVT... what has me worried is that it was while walking... and its strange that it only happened at that time and not since... i was under alot of stress, starting a new job, new business, eating horribly (plenty of caffeine), overweight and I think at the time smoking (I quit around that time)... its funny, when it happened I shrugged it off, only now that the palps have increased has it gotten me worried... I've read through the archives and what a great success story yours is! best of luck to you!

[brian72]

the thing thats got me worried is the fact that it happened during activity, while walking, not necessarily exercise though... I've read studies which imply its a predictor of future CAD...  I also get PVC's/PAC's while at rest...here's a couple the studies I saved

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=1280018&dopt=Abstract
http://eurheartj.oxfordjournals.org/cgi/content/full/25/13/1093#BIB14

[nifer968]

When I get a run of palipations, they last for about 5 to 10 minutes at a time.  They affect every beat during that time.  I keep reading about people being worried about having 5 in a row and I wish mine would only last this long.  I have had an echo and a nuclear stress test and they came back normal.  Nothing has been captured yet.  I did not have any during my 24 hour holter.  Should I be super worried?  Does anyone get them lasting for as long as I do?

[tickertock]

I'm not a doctor but nearly every cardiologist or electrophysiologist that  I have spoken to has assured me that short runs of NSVT are treated basically no different nor does it put you at a higher risk than simple isolated PVCs once your "cardiac workup " is termed "normal". I had a 5-6 beat run of NSVT documented on an 18 hour holter monitor back in 1987, even back then I was reassured it was nothing to be concerned about. I saw some of the best EPs at that time, after 20 years and nothing bad has ever happened to me I'm reassured that this must be the case. Funny thing even tough I was awake when it occurred I never felt anything out of the ordinary and I'm really heart aware so that's strange also. I probably had many runs since then. Try not to let this consume you even if its NSVT,from my personal experience the anxiety will only eat you up alive and deprive you of most the enjoyments in life. Good luck.

[Gaspipe]

Hi I would be more concerned if I were you in getting my lipids under control than PVC's. Your current profile would likely be considered unfavorable and more of a risk factor for CAD Good luck

[Momto3]

Has your doctor told you that you have VT?  Are you sure you are having strings of palps with no normal beats in between?  Has this been captured on a monitor?  

I've had thousands of pvcs, couplets, triplets, nsvt, but no vt (whew!). I've been in bigeminy for days, weeks, months, perhaps, years.  But, to the best of my knowledge I've never had a string of more than 30 in a row.  Technically, that would be VT.  

Glad to hear your test results came back good!!  HOORAY!!