Will It Continue to get worse?

[JazzyJJ]

Hi 31yr M. ASD repair @ 15yrs. Lots (7500 - 13000 on 24 hr monitor) Of history of pacs & pvcs on 100mg Toprol Daily used to drink 3-6 beers a day. Quit cold turkey in Oct '05. Did a Stress Echo late Oct ,05, Cardio says everything o.k. In mid Nov. 05 I had my first ever A Futter & Fib Episode. Since then I have more Pacs & Pvcs then ever. Short runs of svt on Holter March '06 Pacs in a row sometimes up to 6 I have lots & lots of anxiety. I am about 100lbs overweight and super afraid to exercise bcause it brings on the beats. Choloteral in 300 as well. Family history not on my side either. Mom died of a MI @ 44. I dont smoke and she was a heavy smoker. Dad still alive and moms parents made it till 75 yrs.My ?'s are-1. How accurate is a stress echo in determiing CAD? 2. How accurate is the new 64 scan? 3. Do you feel I could have reason to be worried about my mortality with history and all? Cardio tells me not to worry about any of the weird beats no matter how frequent unless I become very symtomatic. 4. Is this consistent with your thoughts? When I get these beats I take my meds, lay down, sleep and start the cycle again. Very Sedetary out of fear. I am afraid I might have CAD causing the beats and flutter but no one has found it!!! In '98 had angiogram which was all clear. 5. Could the scar tissue from asd repair be causing the beats to become worse with time? 6.Will it continue to get worse the older I get. &. Anything you could recommend would be very appreciated. I live life one beat at a time and am very tired of all the worry and living life in a box. Thank you so muc

[CCF-M.D.-MJM]

Hi JJ,

From the sounds of your question, anxiety is a significant portion of the problem.  We see this everyday, so don't feel alone.  The tough part is recognizing the nature of your problem, making appropriate choices and moving on.

1. How accurate is a stress echo in determiing CAD?

It depends on the clinical suspicion of CAD prior to doing the test.  It is doubtful that you have significant CAD yet, but you should make appropriate actions now to reduce your risks

2. How accurate is the new 64 scan?

I will answer the unasked question first.  you don't need a CT scan.  It is very common for people to have A. flutter after ASD repair.  You may even respond to an atrial flutter ablation or more complex ablation if your symptoms are significant enough.  CT scans are increasingly inaccurate in the setting of very frequent PVCs/PACs and atrial fibrillation.  You are very low risk for CAD at your age and absence of very convincing symptoms,  you should accept the clean cath and negative stress echo and move on.

3. Do you feel I could have reason to be worried about my mortality with history and all? Cardio tells me not to worry about any of the weird beats no matter how frequent unless I become very symtomatic.

You need to take action on the things you can control.  You cannot control your PVC/PACs.  Do what ever you can to accept that these do not increase your mortality and move on.  You can change your cholesterol and weight issues.  You should do so aggressively now before you do develop CAD.  Now is the time.

4. Is this consistent with your thoughts? When I get these beats I take my meds, lay down, sleep and start the cycle again. Very Sedetary out of fear. I am afraid I might have CAD causing the beats and flutter but no one has found it!!! In '98 had angiogram which was all clear.

The sensation of PVCs scare you.  that is understandable.  However, you need to do your best to move on and accept that you will not die from PVCs.  Do not let them control your life.  CAD is not causing your AF.  You  have 2 negative tests (echo and cath).  If you need to see an EP to move on, do it, but be willing to accept their conclusions if you decide to do it.

5. Could the scar tissue from asd repair be causing the beats to become worse with time?

Only time will tell if the arrhythmias will get worse. The scar is stable now and shoudn't change.

6.Will it continue to get worse the older I get?

There is no way to know this, only time.  Consider seeing an EP to see if there is anything that can fix or do to help reassure you.

Good luck and thanks for posting.

[JazzyJJ]

Sorry to add forgot to tell You in '04 seen a electophysiologist and nothing was done. when in a flutter and fib came, no meds worked to convert had to be converted with lowest dose of cardioconvertion.

[Fran71]

Hi, I have PVCs and some PACs. I don't have any other heart problem so I don't know if my situation is like yours, however my cardiologist told me it isn't at all certain that the arrhythmia will get worse with time. Like the Dr on the forum he said there's no way to know, but when I told him that many people and many resources on the web say they generally worsen with age, he said he doesn't have this impression, and that in his experience it is actually the other way around - i.e. sometimes they even improve! So let's hope for the best. I cling to this hope but try not to let the PVCs control my life...though at times they do :-).

Take care and good luck

Fran

[lance1881]

JJ,
I am a 38 year old male and had experienced PAC/PVCs for months on end until one day last year I split my dosage of Toprol to a morning and afternoon dosage.  I take 100mg in the evening and 50mg in the morning.  It took about two weeks but then the PAC/PVCs stopped or were so weak I could not feel them.  You obviously need to check with your cardiologist before you make any changes to your medication but it definately worked for me.  I was diagnosed with a thoracic aortic aneurysm in January of 2005 and had an afib attack in March of last year which required medication to correct back to normal sinus rythum.  I was extremely stressed because of the diagnosis, which is what I believe enhanced my PAC/PVCs.  Right now I am in a holding pattern of watching the aneurysm for any growth but so far, thank God, it has stayed the same size.  PAC/PVC free since Mid-December 2005.

[JazzyJJ]

Man that is awesome. I will ask cardio, thanks for the post & support from u and fran!!!

[Fran71]

Hey no problem! I love to give some support because I need support so much too...! We know that these rhythm disorders will probably always be there to some extent, but they can be controlled, they can get better. We just need to find the right intervention, and maybe the right intervention will change as we change. I'm seeing my cardio soon after my new holter report comes in. I have many questions for him but I guess the most important one, the only very important question, will be: what will we do if they get worse? I'm convinced now that PVCs and sinus tachy are not life-threatening. Now I need to know that there will always be something different to try if I start feeling worse, like increasing the BB dosage, changing BBs, switching to antiarrhythmics, ablation (though my cardio would not like to do it), etc.
Let's always think for the better, both because being pessimistic won't help our PVCs, and because there's realistic hope that we may feel better if we ever start feeling worse :-). There are lots of medications out there that we may try.

Ps. This is addressed to myself as much as it is to you...I often fall into the "what if" trap!

Good luck and keep us posted

Fran

[Jennah]

Sorry to hear about your concern.  I wanted to post regarding if it will get worse.  I know there seems to be a lot of info regarding it getting worse with age.  My mom had PVC's all through her 20's and they got really bad in her 30's.  She now has zero.  They just dissapeared and never came back.  She is now 56.  Im hoping to follow suit.  I asked my cardio this, and he said there is no way to tell, but it can go either way- meaning it could get worse or it could get better. I have started taking Zantac daily (i have some spasm thing in my lower esophagus) and i have found it has reduced the number of PVC's dramatically.  I also take 400 mg of magnesium, which if it doesn't help, it is at least very healthy for your heart.  Ask your cardiologist though before adding anything new.  I also find that walking helps the most.  When I stop walking daily on my treadmill I feel them more. I have read a lot of places that cardio seems to really help these things.  Good luck and trust your doctor.  If he/she isn't concerned, and the doctors on this forum aren't (who are the best of the best) believe it.  Don't believe everything you read on the internet.  It's filled with half facts and misinformation. Listen to the heart docs.  They are the only ones with the backgrounds to give you the "true" facts.