questions about atrial runs,etc

[LynnSB]

I had an ablation for AVRT on 9/15 and continued to have symptoms of palpitations and runs of fast beats.2 wks ago I had an EKG that was "very different" from all my (numerous over decades)EKGS -- something about the P waves and being in atrial tachycardia.My cardiologist wanted me to go in the next week for another EP study/ablation although he said i had nothing life threatening(heart rate about 110 at that time at rest).My new EP, however,wanted more info and put me on a heart monitor.He doesn't seem concerned at all about what we've caught so far . I'm trying atenolol ( 25 mg) which seems to do nothing but make me tired). My EP said my EKG was " sure different" than before and "smelled like" the focus causing the problem "might be " to close to the sinus node to safely ablate.However, he won't know for sure unless we do an ep study and because i am tall the focus could be higher up--any comments on this? Is there any danger with just living with atrial "runs" ( up to 20 beats) in the 150 range? I get these all the *&^@) day and they wake me up sometimes. I am so tired of this but also don't want to have another ablation if this is TRULY innocuous.The EP thinks the first ablation took care of my very fast beat (210)I rarely had but didn't get the one that actually causes my daily symptoms. Also,I am STILL CONFUSED about the EKG.. why would it be SO different post-ablation. Damage from the ablation? Why would it be different if this other ectopic focus was always there?

thanks. Lynn

[CCF-M.D.-RCJ]

Lynn,

Thanks for the post.

Q1:"... because i am tall the focus could be higher up--any comments on this?"

I have never heard someone say this, so I'm not sure what to make of it.

Q2:"there any danger with just living with atrial "runs" ( up to 20 beats) in the 150 range?"

Probably not if they occur infrequently, but "all the *&^@) day and they wake me up sometimes" sounds bad enough to treat.

Q3:"why would it be SO different post-ablation"

It depends on what was different.  There are many components to the EKG.  I suspect that the overall EKG has not changed that much, but that one component (for ex: the p waves) are now very different.  Ablations certainly can change the appearance of the EKGs.

Q4:"Why would it be different if this other ectopic focus was always there?"

Probably because "this other focus" was being masked or overrun by the focus that was particularly fast.

Good luck.

[sampants]

RE: the atenolol

I am not sure if you meant that you just started taking this or not.

I felt horribly tired and weak for the first few days on atenolol.  I am only taking 12.5 mg!

I have now adjusted and feel no negative side effects.

[LynnSB]

>>Try doing a search on sinoatrial reentry tachycardia and see what you come up with. This arrhythmia is paroxysmal and ablatable , but it is very near the sinus node so it could be risky. The rate is not fast , only about 115 to 150 bpm. It can be triggered by run of PACs.<<

I already know about this but the docs ( cardiologist and EP) do NOT think it is another reentry tachycardia -- more like an ectopic atrial tachycardia.

I have only taken 1/2 of the .25 atenolol every day since Frid. then took .25 last night... feel very fatigued and sort of breathless. HATE this feelig.. and I still have just as many palps.. so frustrating!

Lynn

[LynnSB]

Thanks, Hank. I guess a couple of days on a tiny amount of a beta blocker isn't long enough to give it a fair shake.. I am going to wait and see what the EP says. If he says try it for a while longer, I will.

Yep, no one can no for sure until they do another EP study but the EP doesn't sound like he thinks a study may be necessary unless I insist. I may wait and see if I can live with the flips and blips. AFter all, the technology gets better all the time and I can always have the EP study/ablation ( if possible) in the future. I am finally feeling more at ease about this because I have an EP doc who actually TALKS to me and listens and is not just a "mechanic" zapping a spot, you know what I mean?

Thanks for your concern and info.

Best,
Lynn

[michi]

sorry to hear that lynn, hang in there.

with the atenolol has anybody expierencd that weakness and tiredness come up about 2 weeks after you startet taken the beta blocker? i am tired allready when i wake up and fall asleep around 8.30pm with my baby. when i just started on it i felt like hank, more energetic.

[sampants]

If I don't take the atenolol at the exact same time every night the next day I can feel a little off.  One night I missed my dose and took it at 5 in the morning.  I felt flu-ish for about 12 hours.  But who knows, maybe I had the flu.  I also have to take it right around 5 pm.  Earlier and I am groggy too early.  Later and I feel sleepy in the morning.

Of course, I am super-prone to the power of suggestion.  I often question whether any of those feelings are in my head.  The whole heart-worry goes right along with this.  As long as I am busy and am not thinking about what could be wrong with my heart, I feel great.  As soon as I read about a symptom, I start questioning whether I have that symptom.

I am wearing a Holter monitor as I type this.  Woo hoo!

[LynnSB]

>>>I am wearing a Holter monitor as I type this. Woo hoo!<,

thanks for making me laugh!  I loved your "woo hoo..."

Lynn ( wearing HER event monitor and wondering how many of us reading these posts are wearing them.. hahahahahahahaha... oh, well, we are a SPECIAL, palpitating, breed  o' folks apparently!)

[Linda123]

Lynn, I'm REALLY sorry to read of you going through all this, what a terrible disappointment for you.  To give you food for thought though, I do have a friend who had 2 accessory pathways and one of them was very close to the sinus node.  Her first ablation got rid of the pathway not close to the sinus node and on the second attempt they got rid of the one that WAS close to it, she is now totally cured and this all happened about 5 or 6 years ago - and in the UK, probably behind the US in technology.  On the negative side though, from what I understand accessory pathways are generally easier to ablate.
I wonder how old you are Lynn, and if you are having any menopausal symptoms?  I don't like to promote HRT because of the controversy surrounding it - to be honest I'm worried about taking it myself - but I have to say that my life, before commencing HRT, was one long nightmare of all sorts of different heart disturbances and my chest felt weird/electric the whole time.  Now that I am on a rather whopping dose of HRT my chest once again feels normal and my palpitations are liveable with.  My heart specialist tells me that falling levels of estrogen can effect the cells in the heart that are sensitive to estrogen causing palpitations.
After much soul searching and worrying about the palpitation side effect I have recently started taking a low dose of paroxetine which has helped calm me down and stop worrying so much about the palpitations with the result that I now feel more positive.
Just a few thoughts for you.
Hoping very much that things improve for you soon.
Best Wishes, Linda

[sampants]

Wow, Linda.  I didn't know there was such a link between hormones and palpitations.

I started having them after stopping breastfeeding with my 3rd child.  I had been either pregnant or nursing for about 4 1/2 years.  When I stopped my body completely went haywire with hormones.  Sometimes I feel like I am going through early menopause.

I need to bring this up with my cardiologist.

And Lynn, I am glad I gave you a chuckle.

[sheryl1945]

Hi Hank...I read your post on nightmares; atenolol does that to me, too!  I began taking atenolol about 12 years ago for rapid heartbeat and it works beautifully...but I swear I've gotten more PVC's since I started taking it; is this possible?  My PVC's are benign; I've had them checked out.  Hope you have happier dreams!  

[jobob52 ford]

Hi Lynn, Sorry to hear about your situation but I'm happy for you that you finally found a Doc who would listen to you. As you may recall, we had our ablations at about the same time(it was my third). I was getting pretty good about tuning out the "flips and blips" but started having bouts of a-fib around end of Nov.
I thought it might've been caffiene but I guess I was wrong. I started on 25mg atenolol 3 weeks ago. I'm bummed about that but still thankful that the the fast ones(250) are gone.
I wish I could offer you better words of encouragement but hope you somehow find comfort that you're not alone.
Wishing you the best, Bob

[sydman3]

Just want you all to know that I have been visiting this site for years. I have all the same symptoms as all of you. I've had extended AF (been in the ER 3 times in the last 12 years), but have also had  short episodes that have reverted by themselves. I also have heaps of pacs, pvcs and every other flip flop sensation. I am currently on 12.5 mg of atenolol and am also trying other suppliments such as magnesium to see if I can reduce the number of palps. What I'd like to share with you is that I have been able to significantly reduce the number of pacs, pvcs etc.. by eliminating any food with preservatives. This includes (believe it or not) your normal 'off the shelf' loaves of bread, which, if you read the ingredients on the label do have preservatives. This also includes your breakfast cereals as well. It will takes about 7 - 10 days for your body to be completely rid of preservatives, so don't expect an immediate outcome. Make sure also that the food labels must say 'No Preservatives'. Some labels say No ADDED preservatives - this is not the same as no preservatives. Hope this helps reduce your palps.

[mbimom]

Hi, I had a succesful ablation in 2001 and was fine until this Dec when I had a comlete hysterectomy.  I started having a new arrythmia with the night sweats and having dizzy spells. Also for the first time in my life I started having high blood pressure 160/110. My doc put me on 50mg of atenol and I did the halter monitor (turned it in on Mon.) I am extremely tired on the atenol but it does really calm my heart down.  I take it before bedtime so it helps me sleep, as the night sweats were keeping me up. I can't help but think that this was all caused by the lack of hormones because of the timing. I am curious to get the results of my halter monitor.

[sheryl1945]

Please forgive my ignorance folks, but what's an ablation?

[LynnSB]

Thanks, Hank.. read this post after seeing my new EP doc yesterday. Here's the scoop-- he went over all the transmissions from my event monitor with me. Just as I thought, yes, I'm having very brief SVT runs or atrial runs -- whatever you want to call them. I'm talking about only 3 to 12 beats.. but MOSTLY I'm having PACs and PVCs , sometimes both close together. He is absolutely not concerned.Yes, they got the AV spot responsible for the very fast beats but the one that's acting up now, apparently, doesn't go past a few beats when it gets going. he said if it drives me nuts, i can call him and we'll do an ep study and see if it is "fixable" but he advised doing nothing -- taking the atenolol ( trying to up it to .25 a day) and blowing off the palps. I'M TRYING! it helped also that the doc ordered an echo ( hadn't had one for 12 years) and that made me feel better. I had an ejection fraction of 60 and everything was completely normal -- i do have a tiny , and i mean tiny, amount of mitral regurgitation but nothing to worry about.. the tiniest of murmurs that wouldn't even show up if they didn't have the super duper new doppler technology probably. any comments would be appreciated! I am feeling very reassured and much better although-- wouldn't you know -- i woke up with MEGA runs of these stupid flip flops!!!!!!!!!

[sydman3]

An ablation is when the Cardiologist or Electrphysiologist inserts a catheter into your heart, identifies the location of the 'sites' that are triggering your palpitations, and basically blasts these sites so they don't cause any more palpitations. That's the theory. The success rate varies among patients.

[sheryl1945]

Thanks so much for explaining ablation to me :)  Best of luck to you.

[LynnSB]

Here's a good explanation of ablation:
http://www.naspe-patients.org/patients/treatments/cardiac_ablation.html

[sydman3]

Thanks Lynn. The webb site certainly explains it in 'laymans' terms.

[cheeseburg]

hello everyone, I can't believe that after nearly 20 years of atrial filrillation, puc's, pac's, atrial flutter, ect.. i finally come accross a web site with people experiencing the same symptoms.  i find this site very helpful with my problems.  i have had a-fib since i was 24 years old, i believe it was induced by alcohol, anyway, i am 43 soon to turn 44 yrs. old, i have had all the heart tests, stress test, catheterzation,holter monitors ect... and the specialists tell me i have no signs of heart disease wha-s0-ever, anyway, i feel palpitations or what you would call i guess pvc's almost daily, although i go quite often without feeling them, i am very intrigued with the fact that foods high in carbs could be the culprit, i mostly experience these bouts after meals, also at night when i am resting and am snacking, some of these times, i get feelings of anxiety, i have been hospitalized approx. 5-6 times over the years for a-fib to get the normal rythm back.  i have not drank any alcohol in over three months and feel a lot better, it seems i can tolerate the arythmias better, however i do at times get paranoid. i take 0.25mg of lanoxin per day for this , i was also prescribed cardizam recently, but it brings my blood pressure too low, and brings on the arythmias, so i have ceased taking them, has anyone heard of a herb called hawthorn berrie, i heard it was good for pvc's.  sorry so long!