bigemeny episodes

[Abeybaby]

How long do some you stay in bigemeny when having pvcs? Are they more dangerous in a healthy heart? What do you do to cope?
Getting more bigemeny episodes lasting 5 to 10 seconds not used to this.

Sorry for all the posts but this has been a week from hell.

[CollegeGirl143]

bigeminy is scarey.. after ablation i was in bigeminy for about 4 weeks constantly, no break.. i was fine :) bigeminy is no more harmful than regular pvc's, unless seen consistantly for weeks and even months on end, to the point where you may develope cardiomyopathy...

Try and think of it this way.. bigeminy is just a pvc on a schedual..at least once its started you know when they're coming and its not such a shock :) hehe

[JMWB]

It was strange I had bigeminy for several months and when it stopped, which it did all on its own, I missed it !!!! (It was a 'good' miss of course!)

[Momto3]

I was in/out of bigeminy all the time, weeks, months...Other than feeling different, they really are no medically signicant than isolated pvcs.

[mariop]

As you know by now I'm somewhat of a skeptic about these "Oh they are harmless so forget them" type explanations.  Forget what doctors say because medical science has contradicted itself many times over the years.  Just use common sense reasoning; basic physics perhaps.  Irregular beats, by definition, are not the natural way the heart is supposed to operate.  The irregularity must transfer throughout the cardio-vascular system.  Therefore some damage has to be incurred.  Think of oriental torture: one tiny drop of water dropped on your head is meaningless, but string them into a long sequence and what do you get?  So what makes PVCs any different?  My conclusion:  a long sequence of PVCs irrespective of their order produces damage to the cardio-vascular system.  And the fact that doctors overlook this is a sign of the inherent limitation of that profession.  We  who suffer pay the price.

[Abeybaby]

Mariop I don't know your history or circumstances. Perhaps you are a skeptic for some good reason, person, I am sure. My understanding of PVCs is rather simple- I don't believe that PVCs were ever meant to be normal- the human body was developed to be a perfect machine! PVCs were never a part of the equation. Twenty or so yrs ago they treated PVCs with anti arrythmics or anything that would suppress them- drs ended up killing more innocent patients all for nothing- for fear of the mighty PVC! Twenty yrs later we stopped treating PVCs because the treatment was worse than the symptoms they cause. Medical science has evolved and will continue to do so.

My own cardiologist- famous in Canada throughout N.A.and my own first cousin who is a top tier cardiac surgeon now 50 have both said one simple thing to me. "Perhaps they are not the best thing to have BUT we do know today from experience that the heart is a magnificient organ that compensates for any disiquilibrium that often occurrs and provided that the structure is in normal limits it will continue to compensate ....and continue to operate as originally designed". If am the unlucky "*******" forgive my language that drops dead then I was unlucky indeed!

My own cardiologist who has treated the famous Billy Graham in the US has PVCs too often in bigemeny as well. He takes no meds for them- he is religious in that he has often said "if God calls on him he will gladly go ..." He is 65. I am not so ready at 41- and want to get the most out my life.

So what's the point you may ask? In 20 yrs from now they'll tell us something else about PVCs and perhaps there will be a better treatment option rather than beta blockers that are often more symptomatic- caused runs for me and was next to impossible to excercise adequately etc .... Or anti arrythmics which have proven to be less than stellar alternatives or even ablation which caries significant risks if it doesn't go well ie; pacemakers more pvcs etc ... Not to mention the emotional distress it causes people including myself.

I agree that merely learning to accept them isn't a great option because it appears the only option while many and I mean many suffer endlessly with the emotional and pysical distress. I would gladly write a cheque for everything I have to rid myself of them and frankly that would buy me a lot of ablations in the US without insurance coverage ! I f-ckn hate their miserable existence BUT as my dear friend often advises there are no alternatives at the moment so don't torment yourself or rob yourself and family of a life because of them. I hope in 20 yrs there is a more safe and manageable cure. For now experience tells us that the human heart can handle the misfires long into our seventies and eighties...

As my cousin often says "I only wish my patients had your problems we would all be out of business ..."It doesn't take away from the anxiety they cause but at some point me included have to trust or simply say screw it I am not going to rob myself of everything I dreamed of. Sooner or later I will just learn to accept but never like them. My only curse was that I am symptomatic if I wasn't perhaps I would have never talked to my cousin and got checked out and started this cardiac trek to anxiety haven! So in a nutshell I agree to disagree.

[mariop]

We all are unlucky bastards.  I went through an ablation two weeks ago and doctor could not reproduce PVCs even though day before I had tons of them.  If it wasn't for bad luck I'd have no luck at all.  And it takes 10 weeks to schedule one; thats how far back he is booked.

The misery of PVCs imposes itself on my mind and arrests it so that everything I do has to go through that misery.  It trivializes my suffering for someone to say that you can just wish them away only if you don't think about them.  This thinking presumes that it is a voluntary act to forget them and being a stubborn fool one just refuses to do so.  I am suspicious of these explanations because one could apply them to other things.  Imagine you have a bad toothache and I tell you not to think about it because it isn't going to kill you.  Hopefully you will have enough sense to slap me in the face.  Ditto for PVCs.

[Abeybaby]

I understand now where your coming from... I agree with you on the analagy its like saying suffer with the toothache because it won't kill you its acceptable!

I am curious why ablate them? Are you getting thousands daily? Or runs of them? In Canada no EP would ever consider a request like that unless one was so symptomatic and his/ her ejection fraction was getting compromised? What's your story I am intrigued by your choice to ablate?

[eagerheart]

I am also curious. I even wonder if it actually wasn't good luck that you had no PVCs the day your ablation was scheduled. I am sure you have weighed the risks and now  feel ready for it. I understand how intolerable it sometimes feel.

[mariop]

All the meds I tried failed. Amiodarone, mexiletine, rythmol, flecainide, propafenone, verapamil, etc.  My insurance covers 100% if doctor shows that meds have failed.  An ablation is as close to a permanent fix as you will ever get.

For ventricular ablation success is 70%, no success is 20%, and something worse is 10%.  I do not tolerate PVCs well; they have caused me immense misery, so the promise of a fix is too hard to pass up.  Moreover there are numerous posters who have gone through this.  Atrial ablations are even safer that ventricular.  Mario LeMieux (hockey) had an ablation because he didn't want to mess with meds for his whole life.  A ball park cost is $40000.00

[eagerheart]

I understand fully well. I am at this juncture myself. I was put on atenolol 25 mg in November, which I did not tolerate because it lowered my blood pressure, which was already low, then I took verapamil late December for the last two months, which for a while seemed to be better, but again my blood pressure got to be too low, and my episodes seem to increase rather than lessen. Three weeks ago tomorrow my doctor advised me to admit me to the hospital to get a "pill", I believe he meant get tested for an anti-arrhythmic drug; he agreed that the verapamil was not working and suggested that I talk to an arrythmia specialist to consider an ablation and carefully weigh the pros and cons. In my case, he told me, upon reviewing the event monitor readings, that I had atrial fibrillation, flutter, and tachycardia. I reflected upon that phone call, sent him an e-mail letting him know that, with his permission, I would be stopping the verapamil. I didn't hear from him, so I went ahead and stopped the medication, decreasing it carefully over a full week. For two days and a half I enjoyed no palpitations whatsoever, they did come back of course but do not seem as severe as when I was on the med somehow and the heart rate is not as fast either. I note everything I eat, drink, take my blood pressure daily, and try to keep a positive outlook. Work has proved very beneficial because it requires concentration. But I still don't know where all of this is going. I could very well consider an ablation in the future. In my case, the chances of success are not very good because I have a mix of atrial fibrillation and flutter, and it could also happen that my heart may be completely normal right before such a procedure. I have enjoyed all your comments. You are doing the best you can. What else can we ask for?

[mariop]

Just one point:  The only doctor qualified to evaluate you for an ablation is an EP (Electrophysiologist).  Before you make a decision, you should see one and then go on from there.

[maggiemag]

I may have missed it in your post, but did you say what kind of arrhythmia you were having that your doctor chose to attempt a PVC ablation?  Were you developing a cardiomyopathy?  How many thousands a day were you having?  I am very surprised that a reputable EP would try Amio and all those other drugs for benign PVC's, since they have very serious possible side effects.   You know, just the fact that he was unable to reproduce the PVC's could be taken as proof that they were in fact benign, in a setting with a structurally normal heart.  I would be very wary of an EP who does ablations for benign PVC's.  Just my opinion! :-)

[mariop]

They maybe be harmless but he/she who suffers them is not immune to misery.  They originate from left ventricle.  There is also a VTach that originates there.  My insurance, Highmark, will cover ablation for PVCs if at least two meds have failed to control them.

If you check Clev Clinic posts on other side of forum you will find that PVC ablations are becoming very routine.