Symptoms post cardiomyopathy recovery

[PIM]

In 1991 I was diagnosed with dilated cardiomyopathy and was forced to leave the Armed Forces because of it. With the cardiomyopathy came other symptoms ie. chest soreness, ectopic beats (I believe you call them PVC's), atrial fibrillation and an inability to push my body physically for long without becoming tired and hitting that 'brick wall' much earlier than when I was fit and without this condition. My wife and I did a role reversal and over the years my heart size has reduced to within acceptable limits. However, the symptoms I experienced have not gone away. I suffer mostly from PVC's which become more frequentthe more tired I become. In the past, when these have built up to such an intensity they have led into periods of atrial fibrillation which I now have under control with the use of Sotalol. I find it particularily hard getting any real help from consultants over here and would be grateful if I could ask you some questions.

Many people on this site talk about 'ablation' as a technique for curing PVC's. I am not sure this technique is used in the UK much; what are the risks/success rates?

Are these symptoms I experience normal post cardiomyopathy and does this indicate that permanent damage has been done to the heart muscle?

Is it normal to feel 'out of energy' very quickly with this condition?

During exercise (ie walking) I am not aware of PVC's but later on they will start when I feel that possibly the heart has relaxed, is this normal? and would,nt it be wonderful if you could keep the heart in a 'tightened' state to prevent PVC's.

[Navigator]

Hi Pim,

My ablation was for inappropriate sinus tachycardia and supraventricular tachycardia.  (SVT) I often found that the ectopics would start the SVT off!!

Glad to hear that your indigestion remedy seems to help. I've read a lot of other postings on the net that seems to suggest a relationship between ectopics and acid reflux.  Maybe this is so in your case too.

Best wishes

[PIM]

Dear Ann

Thanks for that info. I attend St Georges once a year at the atrial fibrillation clinic, however, I was hoping to get more feedback from my questions on this site. Unfortunately, the Dr did not specifically address them.

Have read some interseting things regarding medicines for indegestion and am having some success with gaviscon. Early days yet so we will see.

I assume you had a successful ablation for ectopics?

Regards PIM

[Navigator]

Dear Pim,

I am delighted to inform you that ablations are done in the UK and very successfully too! As the doctor pointed out St George's hospital in Tooting, London carries them out and in my personal case, my ablation was carried out at the Royal Brompton Hospital by a very capable electrophysiologist, Dr Jonathan Clague.
I believe that ablations are also carried out at the Freeman in Newcastle. All these establishments are very good at what they do.

All the best

Ann

[CCF-M.D.-CRC]

Dear PIM,
The first step would be to determine if the ectopic beats are coming from the atrium (premature atrial beats or PACs) or from the ventricles (premature ventricular beats or PVCs).  This would be done with a Holter monitor test where you wear a heart rhythm recorder around for 24 hours.  There are ablation procedures for both of these rhythms but they are each slightly different.  An ablation is done through a needle stick in one of the veins in the leg and catheters are threaded through the body up to the heart.  The area that is causing the problem is found and then a 'burn' using radiofrequency energy is applied to this area.  Depending on the type of arrhythmia this can be quite successful.  I am not as familiar with the UK medical system but am sure that ablations are being done there.  St. George's hospital in London has an international reputation as a heart center and I would start there if possible.  Dr. Malik is very well known but I don't know if he does ablations himself.

The symptoms you are experiencing are 'normal' for people with cardiomyopathy and energy levels may be quite low.  It is possible that you have more PVCs when your heart rate is slower because when it is faster they don't have a chance to fire.  The best way to treat however is with medications such as a beta-blocker or with ablation if that option is available