2nd Degree AVB Type 1 Wenchebach

Question

I have had what seem to me very un normal heart rythyms for the last two years. I am only 29 and I have been in the hospital at least three times for what has been diagnosed as synscope. During and after these episodes and I am unable to speak clearly for several hours and am very tired afterwards. I have edema throughout my whole body. I have tightness in my chest almost everyday and when I do any athletics I feel as though I am going to plum pass out with very little exertion. I start shaking, like there is too much adrenalin in my body and my heart cannot handle it. I have had two MRI's and the first one was unremarkable. I had the first one two years ago when my symptoms first appeard. My second MRI showed scattered foci in my frontal lobe. I have seen about 12 doctors and all of them say that I am fine and the arythmias are nothing to be concerned about. They suggest I take anti deppressants or anxiety meds. I know I am not anxious and feel as though time is ticking against me. Second degree AVB type 1 Wenchebach showed up on my most recent two week holter report. Is second degree AVB type 1 Wencheback really nothing to be concerned about, especially if I have such severe symptoms?

r_belnap · Answer

Thanks,

RaeAnne

ksig · Answer

If it gets worse, go in.  Better to be safe than sorry.  Oft times heart attacks present differently in women.  Good luck to you.  Keep your feet up and settle down with a good book.  Monday will be here shortly.
ksig

r_belnap · Answer

The chest pain is not excruciating, nothing yet that has dropped me to the floor it just hurts in the middle of my chest and radiates to the left side of my chest and up my left shoulder.  Sometimes the shoulder pain varies to one side or the other.  I have been in to the ER for my chest pain about three months ago and they cant figure anything out.

ksig · Answer

If you are suffering from excruciating chest pain, you need to go to the ER... NOW.

r_belnap · Answer

I think those resting heart rates are too high too, but the doctors don't think so.  The compression socks have helped a little bit but not alot.  I can still push on my shin and there is an indention left for a little while.  The last few days I am struggling with a lot of chest pain.  It all just ***** and I hope the new doctor can figure out what is going on.  

Thanks,

RaeAnne

ksig · Answer

Well, if your resting HR is indeed 120-150bpm, it is too high. It is a good thing that your are having the stress test in a few days.  I hope you will find some answers.  After wearing the compression stockings, has the edema in your legs subsided a bit?  Good luck to you.  I hope you find some answers so that you can start feeling better.
ksig

r_belnap · Answer

I  am  sorry  but  I  do  not  feel  as  though  I  obviously "dont  have  a  heart  disease"   something  is  being  missed  by  the  doctors. I  have  sleep  apnea  and  I  have  never  had  that.   my  resting  heart  rate  is 120 to  150  while  just  sitting  and  I  feel  sick. I am  not  on  any  drugs and  this  is  not  normal.

is_something_wrong · Answer

According to an article in "Heart forum" vol 5, 2004 by the Norwegian Cardiologist Association (which I shouldn't read at all, because I'm not a doctor) it's stated that Wenchebach during sleep is a "normal phenomenon" and not clinically significant.

The cause is high vagal activity (the vagus nerve is "connected" to the sinus node and the AV node, and high vagal activity slows both down, causing slow heart rate and slow conduction, causing short AV blocks.

If you almost passed out during a tilt table test, and the EKG was normal, it's likely to be short blood pressure drops, it's really common, and if your doctor wasn't concerned, neither should you be.

Try to relax and trust your doctors. You obviously don't have a heart disease.

r_belnap · Answer

So, what does that mean if I had the Wenchebach type 2 block while I was asleep?  Mine happened at 4 am.  I have done a tilt table test and almost passed out, "but almost only counts in horseshoes, hand grenades and atomic weapons."  Anyway the test was normal.  I dont really understand what that means if it happens during sleep.  Does it mean its not serious?   What will happen if I work to hard on the stress test.  I dont really have control of the treadmill, I dont think, while they are doing the test.  

Help, anyone.  

RaeAnne

is_something_wrong · Answer

2nd degree wenchebach is usually nothing to be afraid of in itself, and it should not cause syncope.

The sensation is just like having lots of PVCs, like skipped beats.

If you have syncope, it's likely you have another problem (a possibility is 2nd degree type 2, 2:1 block or 3rd degree, or other arrhythmias). Of course, it can be completely non-cardiac related and benign, but it must be confirmed.

This should be investigated and it's really important you get a monitoring during the syncope / near syncope events. 

Heart blocks often occur during times with high vagal activity (during rest). Adrenaline decreases AV conduction time.

Please be aware that 10-20% of all Holter tests of young healthy people have events of Wenchebach, usually during sleep (according to an article I read about this, that I really shouldn't read...) it's usually a sign of high vagal activity.

kay2486 · Answer

be careful on the stress test, do not exhaust your self, im not gonna say why unless you ask, your swolleness could be a sign of heart failure, if your ventricles dont beat how is blood being pumped around the body? is you need to look up anything go to www.patient.co.uk it will explain everything to you because doctors use it, good luck with the stress test and i hope you get well soon

r_belnap · Answer

Thank you for your post.  I have looked it up but the information is all a bit confusing to me.  There seems to be Mobitz type 1 and Mobitz type 2 and both are called Wenchebach and I am not sure when I read about them which one I have.  The last doctor that I saw who caught the block didnt go into any detail.  He just said your ventricles dont beat.  I just know I have severe symptoms that are not going away and I am tired. I am having to wear compression socks because I am so swolen...that is not normal at my age.  I will hopefully find more out on Monday, I go in for a stress test...finally.  

Thank you again.  


RaeAnne

Jerry_NJ · Answer

Sorry you haven't gotten some input from someone who knows your subject much better than I do.

But as none have, I'll make this post from the little that I know and hope the "bump" to the top of the list will attract better inputs for you.

It is my memory that 2nd degree AVB is not dangerous, I know/don't-remember anything about Type 1 Wenchhebach and while I could look it up, I'm sure you already have.

I find a little information on AVB at:
http://www.medhelp.org/search?query=AVB&camp=top_nav_search

Have you tried using the search on this forum?