NSVT

[andie5]

I am 27 years old and have had palpitations for several years. I recently pushed my GP to refer me to a cardiologist after several in office EKG's that showed nothing and a 24 hour Holter that he said showed "a few skipped beats." My cardio gave me a 30 day event monitor to wear and I got a call after transmitting one day that I had a 6 beat run of VT and needed to be on a beta blocker immediately. The beta blocker (Toprol) didn't work well with my body (I was taking it 1X a day) and one day, my BP was up and my HR was up, so I went to the ER. I was admitted and had a heart cath the next day which came out good--no blockages. I had an Echo, which was good and was told I have a structurally normal heart. While in the hospital, the EP doctor mentioned that I did indeed have a "wide complex tachycardia" on the event monitor, but he never said it was VT then. I then had an EP study done which showed "dual AV nodal phsiology but no tachycardia induced and bundle branch aberrancy but no VT induced." I was told by my EP that I was fine and that the abnormal rhythms were from the upper chamber of my heart and not VT and that I didn't need to continue on the beta blocker if I didn't wish, so I didn't because it really made me feel bad--I had GERD really bad and was really tired. It kind of confuses me though how they could say it was NSVT from the event monitor and then say that maybe it wasn't really???

[andie5]

I felt better after the EP study, but it was a very scary time with all the test and I still have fears when I feel the "thumps & bumps" (as my EP says) in my chest. During all this, I also learned that I have a I/VI systolic murmur. I had a murmur as a baby, but as I got older, I was told that it was gone--had closed up. I go for periods where I don't feel anything and then I will have some skips and flutters and I just get freaked out!!! I sometimes wonder if I should seek a second opinion? I think I had good care and my doctors all seemed good--my family all seem to think that it was find & tell me not to worry, but it is very hard sometimes. I appreciate your help and answers.

[andie5]

My report does show ventricular stimulation "using 8 beat ventricular drive train, cycle length 600 msec, the VRP was 230 msec at both the apex and outflow tract", so does that mean that "it was performed correctly with full MUST or MIchigan protocols at 2 different sites int he RV apex and RVOT" as you said? Thanks for your help.

[Cleveland Clinic]

I wish I could tell you exactly what you EP study showed, but I wasn't there and didn't perform it. You should direct this question to the EP physician who did perform the study. But from what you told me they found no inducible VT, and whatever wide beats were present were secondary to aberrancy, that is they were supraventricular in origin ( that is originated above the ventricles) and should have been narrow, but because their rate exceeded the ability of the conduction system to conduct the impulses they conducted aberrantly or wide and looked from a surface EKG like VT.
If there was no VT induced in the EP study, and it was performed correctly with full MUST or MIchigan protocols at 2 different sites int he RV apex and RVOT, then there is not need for you toworry about the likelihood of its being VT.
Having dual AVN physiology is fairly common, but unless you have a clinically demonstrable narrow complex tacycardia which is inducible in the lab then it is not worth the risk of ablating either pathway.

[andie5]

I also recently have felt as though my heart skips and then will beat really fast for about 10-12 beats before returning to normal...I haven't felt that before, so it really scared me. Can you inform me more of what exactly the EP study results showed? I don't understand the terminology. Thanks for your help.