Crazy heart of mine

[EMT23]

How common is it to have more than one heart arrhythmia? I'm a 44 year old female. I had an ablation for SVT (AVNRT) two years ago and was told by my EP it was a successful ablation. I continued to have persistent tachycardia with rates up to 190 and was told I had IST. Last month I had to be taken to the ER for what the EKG said was another SVT. With 3 doses of Adenosine and a Diltiazem push and drip the doctor could not get my heart to stay slowed down. The Adenosine slowed it for a matter of seconds and it shot right back up again. The ER doctor was ready to shock my heart to cardio-convert me but I was too scared to get that done by a non-cardiologist.  I was transferred to another hospital and the cardiologist told me I was also going into atrial flutter. I've had 3 documented episodes of the atrial flutter and one additional SVT  in a one months period which he thought was uncommon. I also suffer from PVC's, PAC's and 1st degree heart block.  I take Rythmol, Propranolol SR, Spironolactone and baby aspirin was just started since the atrial flutter diagnosis. Is there an easy way to tell when I go into an SVT vs a flutter or PVC? I'm constantly getting different flutters, thumps and flops in the chest and tend to be tachy most of the time. It's just a normal day for me.

Thanks for reading and helping....

[MichelleP_3811]

I have been trying to understand ectopics and I am not totally convinced the medical community completely understands them themselves.  I have read there are a couple of different variations to them being reentrant and ectopic focus.  I am not sure how to distinguish the two but what I have found in my case there does seem to be some breathing component to them.  Everyone has sinus arrhythmia where your breathing in and breathing out varies but I have found when my difference is 20 or more beats per minute is when I am more vulnerable to have the ectopics.  For example if I am breathing in at 90bpm and my rate drops to the 60s on exhalation is when I wind up getting more ectopics.  If my rate is steady with a 10 beat difference my beat stays pretty steady and the ectopics are no where to be found.  I think when we stress out our rate probably varies more extremely and so deep breathing is a very good thing to do to steady the breathing and heart rate.  Anyways, since there are a few different pathologies to ectopics the triggers to getting ectopics are likely different depending on the persons issues but I do think for some breathing is indeed a factor contributing to our problems maybe not the only factor but likely one of them.  

[hd84ironhead]

quitting smoking has been really huge for me, im glad i did after all these years.  sometimes when these things occur, i breathe into a brown paper bag about 10 or 20 times in private, that helps calm me down. sometimes i just sit down and take in deep breaths nice and slow for a minute or 2. i keep associating my problem with emotional stress because i've been dealing with it for so long that its became a normal part of my life. i dont lay in bed at night to scared to fall asleep anymore. i just try and do things in moderation now, no matter what it is, i take my time and go at my own pace. i have found that the more control i have on how i pace myself in life, the less stress i exert on myself....whether it be physical stress or emotional stress. i am learning to "get a grip".  
  it also seems as if to say that all these irregular rhythms or palpitations i controlled in my mind. like i would come home from work and want to lay down for a few because i was tired, but i would tell myself "dont lay on your left side because you'll have that fluttering in your heart" and sure enough once i would lay on my left side it would happen. then i would have to do my slow breathing deep breaths and try and talk myself into not panicking because i'm not having a heart attack and i'm not the only person out there with this problem.  
  i had just found out a few days ago that my best friend at work has the same problem. i never told anyone about this problem i have except my wife, not anyone in my family or friends. i've always tried to keep it a secret because i felt that they would cause me even more panic by telling me that i need a heart doctor because there is something seriously wrong with me. i had no idea that others had this problem  i ended up talking to my best friend about it and he said "man, i have the same problem."  i asked him how he handles it and he said that he just ignores it and it goes away.  
  bottom line is that i know i have this irregular heart palpitaion or fluttering or pause in my heartbeat and then that hard pound in my chest, whether its emotional or physical stress induced (and i've even heard that sleep apnea causes it) i'm pretty sure i'll be dealing with it for the rest of my life and with God willing, i will live for at least another 30 years to see my kids grow up. but one thing is for sure, i'm in no hurry to get to an early grave any more. and when that fateful day comes, i aint taking anything with me so i've decided to live my life every minute i can. slow and easy, pacing myself, stopping and smelling the roses.  by the way, sorry about all the rambling, it just feels good to finally learn how to be more accepting of my life instead of constantly battling my demons. i wish you all the best of luck.

[blackfbird2010]

you know im glad to know im not alone with my heart...lol  i have palpatations all the time now and im 39 had my first one at 21 after my first child was born but doctors are not concerned...i guess i dont have enough but it scares the hell out of me sometimes it will flutter about 9 times in a row and when im trying to fall asleep it jumps me back awake again especially in the mornings but i know its just a symptom and not the problem but i guess it will come to that eventually...but im glad i can talk to people that has the same thing going on...good luck everyone

[EMT23]

I can understand how these arrhythmia's can cause some panic/anxiety in people. The very first time I had a full blown SVT I never really knew what was happening other than my heart was beating very fast and felt like it was trying to pound right out of my chest.  I was under great stress at that time and am pretty sure that is what set the SVT into motion. I was scared of the "unknown" and did go into the ER to have it stopped and ended up being admitted to the hospital for a full week because of some abnormal rhythms I continued to have. That was 3 years ago. I now have pretty frequent episodes and I have no fear of them at all. It's just another day for me and I know it will eventually pass. Sometimes it takes longer than others or sometimes it gets so bad that I do need to go to the ER for appropriate meds. Actually my husband usually pushes me to go in when he knows I'm having a bad attack or I wouldn't go at all. The thing I hate about hospitals is when you present with these symptoms they immediately want to admit you and I know I don't need that. I have never been a smoker but I am guilty of drinking daily caffeine. Which my cardiologist has never seemed concerned about. I rarely drink alcohol but when I do I can almost always expect my SVT or atrial flutter to show itself. You learn the triggers very fast! The PVC's, PAC's are sometimes mild and other times this hard thump has awaken me from a dead sleep. Michelle I agree you are very helpful. Thank you!!!

[MichelleP_3811]

A PVC is premature ventricular contraction or an irregular extra beat coming from the ventricles.  A PAC is the same thing only coming from the Atria (premature atrial contraction).  SVT is supraventricular tachycardia, or a fast beat that arises from a problem in the Atria.  I had an svt called avnrt (AVnodal reentry tachycardia).  There are a number of others.  ICD is an Internal Cardiac Defibrillator.  This is one step past the pacemaker in that it shocks the heart if it stops or falls into a dangerous rhythm.  I am glad I could help : )  I know how scary it can all be.  And I am glad you are doing better.  I grew up with svt so I was use to it but I was not use to the irregular beat and they can take over your day so it does indeed take some adjustment.  I smoked for 25 years and my cardiologist was more impressed that I quit smoking then having an ablation to correct my svt.  He says it is the best thing we can do for our health.  I am glad to be free of the addiction for sure.  Take care.

[hd84ironhead]

hope what i'm gonna say helps....i have had those crazy palpitations, skipped heart beats, flutters, pauses in the rhythm and then that pounding of the heartbeat since i was 18 or so....at least thats what i remember. it could've been since i was much younger and i just never knew i had it. anyhow, i am 43 now so i've had it for at least 25 years. it came and went over the years. i could go a year or two without even noticing i have them and sometimes, especially when i get panicky, i could have them 50 or 60 times a day if not more.  i drank heavily when i was younger, i smoked, plus excercised. my eating habits was terrible and my stress level was out of control. my emotional issues had taken over my life. i was a walking hypochondriac and i was angry at the world. i worked like a dog on my job, so stress was an everyday part of my life since i can remember.
   the reason im telling you this is because the more stressed i got, the more panicky i got, the worse things got for me physically. i nearly had a nervous breakdown if i actually didnt!!!  these irregular rhythms brought serious depression into my life. yes, i been to the ER, i had all the tests done on more than one occassion.  it took me many, many years to come to terms with all this emotional stress and irregular heartbeats.   my BP was out of control. as high as 210/106. all the tests i took...EKG, ECG, stress test, blood work, urine tests, 48 hour monitor, weekends in the hospital.....everything revealed nothing, all came back normal. continuously normal. nothing showed any signs of a bad heart. i've been dealing with all this hospital visits for nearly 25 years off and on.  as of right now, i take chlonidine twice a day for control of my BP in my brain, i take metoprolol twice a day, lisinopril once a day and lipitor once a day. i eat more fruit and vegetables on a daily basis, i drink at least  3  20 oz. bottles of water daily, i cut out salt, pop, caffeine, cigarettes and alcohol pretty much altogether and i still excercise but i just don't over-do it. such as a brisk walk for about 3 miles a day, some stretching, jumping jacks, sit-ups. just minor cardio stuff.  i'm training myself to not over exert myself or over analyze myself. i am feeling better, i'm sleeping better at night and i'm slowly producing at work better.  my emotional stress is still there but i'm learning that it is a part of life and that i need to let it go. i guess what it really comes down to for me is emotional stress and depression can cause a lot of problems such as irregular heartbeats.  just for the record, i dont know what PVC or SVT or ICD or PAC means.  i hope that what i said to you may help you because i have found out over the years that there is many, many people out there that are experiencing these same problems and i dont feel so all alone anymore. please let me know how your doing.  and michellepetkus, i've read some of things you've wrote on here, your insight has helped me. thanx!!!!

[MichelleP_3811]

The pacs feel like little blips if I notice them at all and the pvcs feel like a fizzle unless I have a bunch of either in a row or close together then it actually feels a little like a flutter with some thumps thrown in or a long fizzle with thumps.  That said, sinus tachycardia can also feel a little like a flutter for me as well.  I wonder does atrial flutter actually feel like a flutter or does it feel like a fast manic beat like avnrt?  

I can see why the doctor would want you to not rush into the pacemaker especially and ICD although that may have been suggested to help you get out of flutter when it happens.  But it is a huge permanent step to allow little devices to take charge of your heart but I get the whole worry about cardiomyopathy or congestive heart failure, if you are having daily episodes of svt it has got to be a bit tiring for the heart to deal with.  I asked my doctor if my svt caused my pacs and pvcs and he seems to think no but I no I have had svt my whole life but I am just now feeling the pacs and pvcs the last 5 or so years so I am not convinced.  He did say that most people don't "feel" their ectopics so I guess I could have had them when I was younger and just didn't know it.  I do know the pvcs were my svt triggers.  My ablation report states that any ventricular stimulation caused me to go into incessant tachycardia so maybe the pacs and pvcs progress as we get older and is why the svt becomes more frequent.  I really don't know, the ectopics are something I have only been conscious of the past six months so I am just beginning to understand them.  But because the pvcs and pacs are a big trigger for svt is why I suggested about some zen therapy.  I know I have to watch stressing about anything now or my pvcs go crazy.  Luckily they slow down once the adrenaline from the stress is gone but it is kind of odd to know if I stress I will get these pvcs.  Like my body forcing me to face my stress and anxiety issues.  I still get them everyday regardless if I am stressed but stress definitely makes them worse.   And I never really saw myself as an anxious person but I guess I am a little.  I have always been one of those go, go go types rushing around to get things done so I am probably more of an adrenaline stresser than fear stresser.  Well still trying to understand and move more slowly through life.  It is hard to change old habits though.  : )

Well hang in there, I am always hear if you need to talk.  You have found a good place where people understand what you are going through.  

[EMT23]

Thanks so much for your reply. :-)

My EP has suggested a pacemaker and I had an ER doctor suggest an ICD implant. My regular cardiologist is telling me to "hold off" on the pacemaker for now and continue medication therapy. Seems like they just keep adding more meds and of course every med has its own side effect to deal with so I'm not liking that either. I'm just hoping with all the different arrhythmias I'm not causing some cardiomyopathy or other heart issues by holding off on getting another ablation with the insertion of a pacemaker.

What do your PVC's, PAC's feel like when you have them. I'm trying to differentiate those from the A flutter.

[MichelleP_3811]

It is not unheard of but I don't know how common it is for people to have more than one svt but it sounds like that is what is happening in your case unfortunately. I wish I had some advice to give you.  I do think it is common for people with heart rhythm issues to have more than one issue, I had avnrt and I'm still dealing with pacs and pvcs but you do seem to have the gamut of problems that is not really typical.   What have they suggested to help you out?  Has a pacemaker been recommended?   I guess the best advice I can offer is to try and do whatever you can to find stress relief.  Pacs and pvcs are fueled by stress and adrenaline and pvcs and pacs can trigger the svt.  If you can find some zen then maybe you can help stave off some of the episodes.  I don't know that it will help but it is what came to mind.  Well take care.  I hope you can finds some relief soon and feel better.  Keep us posted on how you are doing.