21 y/o athlete, sudden a-fib now PVCs and NSVT and anxiety

[pvcchris]

Hi,
(Sorry if this is long I just wanted to get all my info out before I ask)
Im Chris! First off im 21.  I was a competitive swimmer from age 5 till I got into college (also did motocross for a stint and all the usual sports as a kid, soccer basket ball ect. all while swimming).  Once I got into college I began to train for triathlon.  I also started hiking in preparation to do the Appalachian Trail in its entirety.  I usually would work out 2-3 hours a day (combining cardio and strength training).  My max sustained heart rate would be around 190 and my resting heart rate was around the 50’s.  In addition to my structured exercise biking was my main mode of transportation around the city (Boston).  I have never done drugs, I don’t smoke and I don’t drink.  I also limit my sugar intake and haven’t eaten fast food in 4 years.

(2010) In May I spent a week hiking the AT, in June I did 2 sprint tri’s.  On July 13 I just had finished weight training when I went out to see my friends play a show (rock concert).  After some dancing I realized something wasn’t right.  My heart was freaking out so I started freaking out and went to the ER.  The docs said I was in a-fib.  They kind of just left me there and my heart went back to sinus rhythm on its own.  From that point on I developed an acute case of anxiety and was diagnosed with PTSD.  My whole life was sports and athleticism and now my heart was the thing messing up.  I stop exercising and lost a lot of weight (went from 170lb and 4% body fat to 155lb) and I eventually quit work (lifeguard).  My doctor put me on xanax and metoprolol.  My Cardio did lots of blood tests, stress tests, echos, and holters.  Everything said I had a structurally sound heart (though they did say something about inverted t waves… but then then was never brought up again).  Around September (2010) I began to develop PVC’s and my anxiety kept me from enrolling back into college.  I broke up with my girlfriend because I was too terrified to get my heart rate up during sex.  My EP put me on a cardionet and took me off all medications.  Once that was done I met with her and she said I had a lot of PVC’s & PAC’s and one 8 beat episode of non-sustained ventricular tachycardia.  She told me not to be worried and I probably was sick in July and had a case of myocarditus.  EP said she has no idea why there happening and I should be fine.  I have a follow up appointment in one year.  But im honestly worried.  Every since then my PCVS have gotten way worse.  And have felt the same sensation as when I had the NSVT. I have several in an hour and sometimes I have hundreds in an hour.  I feel as if everything is getting worse and it’s hard for me to keep my spirits up.  Some nights I just walk to keep my mind off of it because I honestly think im going to die.  My PVC’s are much worse when im calm or recovering from light exercise I force my self to do. (just read recovery PVC’s correlate to a %30 higher risk for heart disease so that’s a plus…).  I am currently on no prescribed medications though I take daily a oneaday men’s pro edge vitamin and 100mg of CoQ10 (doc said I was right below normal range.  I take 200mg of L-Theanine for anxiety as needed (up to 3 times a day = total of 600mg).

My questions is
1: what could have caused this to happen suddenly.  I have had an extremely healthy heart for the first 21 years of my life and it sustained me through my many athletic exploits.

2: why is everything getting worse?  The PVCs are getting worse and worse and I feel like im having more episodes of NSVT.  Is there a possibility I will out grow these arrhythmias or that they could just be a phase?

3: why is no one concerned.  Its hard to believe that my heart can go into A-fib then have PVCs, PACs and NSVT for seven months and counting and still be perfectly normal and healthy.

4: What are the chances all this is going to get worse and will eventually have sudden cardiac arrest or heart disease in a couple of years.

I’m terrified my heart will just go into V-fib or something.  I try to not let it bother me but then I feel a thump and I’m back into having anxious and morbid thoughts.  I’m fine with knowing I will never be the same active or happy person I was before, but I’m honestly not satisfied with who I am now… just wish there were some answers other than your fine and don’t worry.

Thanks a bunch for taking to time to read my little story.  It really means a lot to me as not many people understand why I freak out and am so depressed.

[andrew0099]

Hey Chris.  I sympathize greatly with you, as I first developed very similar problems three years ago at the age of 26- at a time when athletics were my entire life.  In that time, I have had three episodes of sustained AFib, one of which stopped by itself, and two of which were cardioverted in the ER.  I very frequently experience PVC's or PAT's, which really are a pain in the butt.

With all that said, it seems I have largely come to terms with my condition over the past while, and am not freaked out by my heart issues nearly as much as before. Like you, I have had every test in the book multiple times, and scores of doctors have assured me that I am in no danger- While I often can't prevent my daily episodes of PVC's etc, I have learned to mostly ignore them.

I take 100mg of metoprolol a day for rate control, but I am lucky in that I experience no side effects.  I have the "pill in the pocket" propafenone just in case, but thankfully I have never had to take them- my most recent episodes subsided by itself.

Also, I have decided not to get an ablation just yet- while I am sure I will get one eventually, my quality of life really isn't effected enough to go through the procedure and deal with the potential side effects.

Not sure if you you are into hockey, but read up on the Toronto Maple Leafs goaltender Jonas Gustavsson- like us, he is a young male athlete that has struggled with arrhythmia in recent years.  I believe he is going on his third ablation.  Call me crazy, but I always get some comfort knowing there are other people out there in my age group that are going through the same thing (not that I would wish it on anyone).

[mike8496]

i feel the same way i use to jog at least a mile a day then lift for like an hour like 5 times a week. For the past couple of months i have just been having bad heart flutters and im scared to death to excersies. I also have real bad anxiety and I just started to see a therapist. I also have been to the cardio twice and he said everything is fine its just anxiety

[is_something_wrong]

Hi!

Happy to help. See you on the top answerer board when you're feeling better :) You know a lot about this stuff too, so you will be of excellent support to other sufferers of anxiety and palpitations.

If there is something we can do for you, please tell us :)

[pvcchris]

hahahaha I didn't know the forum sensors curses, funny.

[pvcchris]

Thanks everybody for sharing.  I know you probably hear this all the time but it honestly helps.  And no worries tazgymuk not offended at all.  I know have to chill and relax and im honestly trying.  I just get bummed because my favorite activity put me deep in the woods without a hospital or Doctor close by.  I know things could be way worse and I kind of feel like a ***** (excuse my words) letting something as little in comparison as this get me down.

I agree itdood the PTSD is my worst enemy and i have been receiving EMDR treatments but im not sure if its working.

is_something_wrong thanks you from the bottom of my quivering heart for all the information that's way more than my doctors have had the time to tell me, i know your not a doctor and should consult a doctor and what not but your words give things to either follow up on or take refuge in.  Its a great thing you all do, giving support to chumps like me.  once i conquer this little hurtle i hope i can help other like you all.

Thanks a **** ton
Chris.

[tazgymuk]

Brother i'm 40 but feel your age as i train 6 times a week. I run 3 miles in 18 minutes flat then hit the bag for 7 3 mins rounds with a minutes rest. I then do 1 hour of weights and then stretch. I do this 3 times a week, the other days i do 90 minutes of weights. I eat very healthy, stay away from smoking, drink and drugs. Have a good clean life, My wife is chronically ill as is my mother. Have a nine year old daughter. The only thing that let's me get on with life is exercise. I know exactly how you feel.
I've had A fib since 23rd december first episode, then again today and 5 days before, each episode is getting more frequent. Dr's recommend Ablation, or mediceine.
I feel my life is over, so brother i know exactly how you feel.
Just chill relax and take each day as it comes, what's the worst that can happen, you'll die, then game over. That's how i look at it, why upset yourself and become worried making yourself anxious and getting yourself in a state. Just relax and enjoy the time you have. I'm just making you face the truth. I hope i haven't offended you brother!

[itdood]

I had a similar scenario though mine was all PVC related.  I strongly suspect mild viral myocarditis.  This is usually, but not always, caused by something in the Coxsackie Viral strain.  I had tons of tests, even a cardiac MRI, everything was "normal".  Not normal to me though!!

If your echo and other tests are checking out OK then there are no worries.  It took me about 8 months before things leveled off and started to get better.  I'm starting to hit two years and i get really good days and some days with mild PVCs.

I remember being at a point where I would not elevate my heart rate out of fear. Not any more though and it's hard for me to even remember what it was like, but I know I was there.

Now for the PTSD that you have, you'll have to work on that.  cognitive behavior therapy is really good here.  I've been there and done that, it worked for me.  It wasn't easy though, you have to challenge yourself.

usually docs will know in the first 2-4 weeks how bad viral myocarditis will get.  It's a very broad spectrum as to outcome.  Most cases resolve quickly, some take longer.  Others may end up with muscle damage but again you'd know that in the first few weeks and that's not the case.  Keep an eye on things and try to focus on resolving the PTSD.

[is_something_wrong]

Hi Chris.

During my time here, I don't think I've ever read a post (and I've read some thousands of them and answered about 1000) that is better written and more "straight to the point" than this one. If you haven't already, you should bring a copy to your PCP or cardiologist. It really describes how you feel and what you're struggling with.

You are probably aware that there are no medical doctors present at this forum. But many of us have experienced problems similar to yours. Many of us probably have something to offer regarding the link between the mind and the heart. They are closely connected.

First: Atrial fibrillation (AF or A-fib) is actually not that uncommon in athletes. You can find a lot of posts here describing the relation. There is no link what so ever between AF and ventricular fibrillation (VF). I'm not sure if you are having more runs of AF than the first one? Please remember that anyone can get AF if their adrenaline levels are high enough. High adrenaline can trigger AF, PACs, PVCs and atrial tachycardia. My dad had runs of AF after bypass surgery. They lasted for a couple of hours, now and then, until a week after sugery. They have never returned.  

After your traumatic event, you had a lot of PACs and PVCs. We all would. We all do, but if the mind and body is constantly alerted, you will get more of them. With stress, anyone can have thousands of them during a day. After the stress levels reduce, they slowly go away.

You mentioned myocarditis. It's not easy for your doctor to confirm or rule this out, so it's often diagnosed as an assumption. If you have a major flare up of PVCs after a cold or another infection, it's likely that your heart somehow got affected. What's more interesting, is that every infection in the body somehow affects the heart (and other organs). If you get headache during a cold or a flu, it's a sign of a minor affection of the brain membrane, but few doctors would diagnose this as meningitis. Anyway, this is one of the reasons why we shouldn't do heavy exercise if we're feeling unwell. There are no limits for what's myocarditis and what's not. Heavy infections in the heart would of course manifest as heart failure. But small infections can affect spots in the heart, which afterwards can get irritable and fire PVCs or PACs if they are provoked by adrenaline.

NSVT: I assume your heart is carefully scanned with echo and that no disease is found. Further, I assume that most of your tachycardia events aren't monitored, so you really don't know what it is. It's not necessarily NSVT, you know. Atrial tachycardias can also present like this, and you shouldn't assume that every run is VT. Atrias are more irritable than ventricles, so atrial tachycardias are a lot more common.

That said, don't read up on VT and relation to VF. This almost only concerns unhealthy hearts, heart failure and coronary artery disease. A structurally normal heart can tolerate runs of VT with no problem at all. I would trust the cardiologist.

PVCs and PACs are supposed to occur during rest or after exercise. That's normal. What happens is that your ANS slows down the sinus node while your body is still full of adrenaline. That's a major trigger for premature beats.

I'm sorry your girlfriend broke up with you because you were to afraid to have sex. I've been there, but luckily she didn't break up with me, but it was close.

What I did was asking my doctor for a small dose of propranolol (nonselective beta blocker) and it really worked. Along with that, I started exercise again and regained trust to my heart. I'm feeling way better. I was so afraid that I couldn't walk 200 meters, and even standing up was scary. I completely understand you. I know how depressing this can be.

I hope this was somewhat helpful at least. I can't give you specific advice because that would be irresponsible when I'm also a PAC/PVC sufferer and not a healthcare professional.

If you want, you can follow up or send me a message, and I will answer as soon as I can.

I hope you will get lots of answers to your post. Again, all best wishes, I really hope you will be OK. :)