RVot VT

[jtimmerman]

i have been diagnosed with rvot vt. i noticed at first i was getting fatigued easily and short of breath. i Had a physical and nothing showed up on my ekg, at which the Dr had me wear a halter monitor? every third beat i have multiple pvc's, and these are steady all day it seems. I went to a cardiologist and i was put on verapamil, which did not work and later after 30 days i was put on 25 mg of atenelol at which my blood pressure bottomed out while i was laying in bed , almost blacked out room started spinning, and i felt like a heart beat in my feet? Crazy i know. So any suggestions on a medicine that might be better and not have as many side affects. otherwise i am fairly healthy 46 year old female. Thanks Joan

[Momto3]

Hi Joan,

I'm not a doctor, but I have learned a lot about arrythmias, and particularly PVC-induced cardiomyopathy.  Hope this helps : )

From what I understand ablations for RVOT (right ventricular outflow tachycardia) have a pretty high success rate.  I had two ablations, one was for the right side; one for the left.  About 6 months after the 2nd procedure my ejection fraction (EF) was back up to 50%.  Now, it's at 60%.  HOORAY!!   A normal EF is said to be between 55 - 70.  The EFis indicative of the portion of blood that is pumped out of a filled ventricle as a result of a heartbeat.  Contrary to what many people think, the heart does not eject all of the blood that is in the ventricle. The fraction of blood ejected is referred to the ejection fraction.  The ejection fraction is an indicator of the heart's health.

Dilated cardiomyopathy (DCM) is a condition in which the heart's ability to pump blood is decreased because the heart's main pumping chamber, the left ventricle, is enlarged and weakened; this causes a decreased ejection fraction (the amount of blood pumped out with each heart beat). In some cases, it prevents the heart from relaxing and filling with blood as it should. Over time, it can affect the other heart chambers as well.  http://www.medicinenet.com/cardiomyopathy_dilated/article.htm

In my case, and it sounds like it could be in yours as well, frequent PVC's (premature ventricular contractions) led to cardiomyopathy (detected by a decreased EF).

It seems a good idea to meet with the local EP, but I think I'd ask a lot of questions about the procedure, the success rate, risks and benefits.  After meeting with him/her, you may want to get a second opinion from a larger teaching hospital.  PVC-induced CM is somehat rare so you want to be sure the doctor has a good track record with RVOT ablations. If the local EP has done quite a few successful RVOT ablaitons, and you are comfortable with him, you may want to stick near home.  If you have any concerns, you may want to venture to a larger hospital.  You should know more once you've met with the EP.  Keep us posted.

connie

[jtimmerman]

i am meeting with a electrocardiologist, the only one in my area in Greenwood Sc. I dont' think he has done many ablations, but seems very knowledgeable about the procedure. I am wondering if I should trya bigger city, i am near Columbia Sc, Charleston MUSC. I dont really understand all of this, the wording, abbreviations etc. I guess i need to get copies of all my test, and what the doctor wrote up about me? Glad to hear the ablation worked so well for you. You had two of them?
Joan

[Momto3]

I live in NC now, but up until a couple years ago, I lived in Cleveland.  So, I had the ablations done in Cleveland where I still see my EP.  OMYGOSH!  For me, the ablation was a God-send...I rarely have PVC's now and when I do they don't even come close to the numbers I had before.  When the echocardiogram came back with a reduced ejection fraction, my doctor became much more assertive in treating the PVC's.  Up until then, they were considered benign.  But, all that changed when the CM showed up.  My first ablation was for RVOT and the second was for LVOT.  I no longer have to take beta blockers or any other medications to control the extra beats.  I still carry a small dose of Inderal (kind of like an insurance policy in my purse) just in case the PVC's stir up trouble.  But, that's usually only if I'm flying, going to the dentist; it's very rare compared to daily doses to keep things "manageable."

Good luck on the 17th!!  Where would you have the ablation done?

connie

[jtimmerman]

Thanks for your response. i did have an echocrdiogram, and it did show cardiomyopathy. I am meeting with a cardiologist on the 17th to speak about the ablation procedure. i believe hormones play a big role in this also. where did you have your ablation procedure, thanks?

[Momto3]

Hi Joan,

I had RVOT VT and found Inderal (a different beta blocker) to be effective for quite some time.  I'm not sure you would have the same success, but maybe your doctor can offer suggestions as to different BB's.  Have you had an echocardiogram?  

I also took flecainide and rhythmol (sodium channel blockers) for the PVC's, but they aren't generally a first line of treatment for PVC's.  I was only prescribed the SCB's after I developed cardiomyopathy.  I took them for about 7 months and then ended up going for ablaitons. But, that was only suggested because of the cardiomyopathy.  I think it's important that you have an echocardiogram to be sure your heart function is normal and that you have a structurally normal heart.    

Also, for whatever reason, hormonal fluctuations seems to influence PVC's.  I had my ablations when I was 46....Go figure, hormones play a role for us women : )

Connie