ECHO test - could I have opinions

[hefner33]

I finally got my hands on my echo from last july of 2013. Doc said my echo was fine but I noticed some of the stats were out of the normal range and the e/a ratio was at 1.98. Again this was prior to the beginnings of my pacs and pvcs. Any how those that are ECHO savvy,  does this look typical

http://www.medhelp.org/user_photos/list/5851092?personal_page_id=3235078

Thanks

[Artaud]

Acebutolol is a Beta Blocker, they lower heart rates. Acebutolol lowers it less than similar doses of non-ISA Beta Blockers.

http://www.rxlist.com/script/main/mobileart-rx.asp?drug=sectral&monotype=rx-ad&monopage=4

vs

http://www.rxlist.com/script/main/mobileart-rx.asp?drug=atenolol&monotype=rx-ad&monopage=4

Acebutolol caused Bradycardia in up to 2% of the cases, Atenolol in 3%. The tables shown are the best way to compare side effects, in my opinion at least, as the contrast to placebo really helps to establish causal relationships.

I've seen Taurine mentioned on another forum I post on, I'll avail myself of your links to look into it more. Thanks much.

[hefner33]

http://www.ncbi.nlm.nih.gov/m/pubmed/19343117/

Heres another. More broad based on heart health but pretty extensive on what it could possibly do

[hefner33]

Haha I dont know myself. You'd have to ask my phone.

Was looking at several studies regarding acebutlol and saw one of the common effects usually in most the participants was a modest to significant lowering of hr. I know you said yours didnt but that would be of a concern for me.

Also been reading more on taurine. Read some articles that hospitals actually inject it through iv with patients with arrhythmias. Here some articles, not really the actual studies but they reference.

http://m.naturalnews.com/news/026380_taurine_research_body.html

http://www.drjanson.com/djhl-html/2010/news-2010-03.html#arryth

http://www.ncbi.nlm.nih.gov/m/pubmed/16797868/

[Artaud]

Thanks much. I've been looking at it but didn't know how it worked.

By the way, what's a Family Finger?

[hefner33]

About the alivecor though is you dont have to get a report from anybody. It stores each reading on your device and your able to print it off or if your drs tech savvy, can setup a account where he can view your readings from his own computer,  phone, etcc

[hefner33]

Hey

Yeah the app is free. The sensor you put on your phone is 199. There are some that get there insurance to pay for it but I didnt bother with the hassle. They have 3 options when you get a reading. You can pay $2 for a cardiac tech that will tell you what they see but not explanation. Then $5 for same thing but suppose to be faster turn around. However this is false cause I do the $2 and have my report in about 15-30 mins. The other is $12 and its from a actusl cardiologist that gives a detailed report and suggedtions on what you should do and how serious it is. You basically just either hold your family fingrrs on the electrode for a lead 1 reading or you can put it on your chest gor a precordial reading. Also has a knee technique for another type reading.

I dont think mine are adrenaline because I get them relaxing in bed, sleeping, hunched over or just even standing. Exercise use to be my equalizer which eliminated them so not sure what changed

[Artaud]

Ah yes, the AliveCor app. I understand the app is free, but a device is needed to interface with your phone. How much is the device, and once it's working, what are the charges for submitting the data (I trust it's analyzed by computer). What is the procedure for capturing a rhythm?

Are your PVCs aggravated by adrenaline? When the assistant was trying to capture a variety of my PVCs, I was able to facilitate the frequency of PVCs just by thinking scary things. My PVCs are a sap for adrenaline, that's why I think the Beta Blocker is the place, for me at least, to go. In addition, Beta Blockers dampen down the sympathetic input to the heart, Calcium Channel Blockers don't. I was on Verapamil one day, I walked to the top of the stairs, I thought my heart was going to pop out of my chest. That was the first E.P.'s idea, stop years of Atenolol use cold Turkey and replace with Verapamil. The new E.P. said I should have been started on Verapamil but tapered from the Atenolol.

[hefner33]

Hey..

Yeah ive been following your story since joining medhelp. You also gave me the suggestion of Acebutolol because of my slow heart rate issue. My doc didnt know what it was and persisted beta blockers wouls slow more than calcium blockers.

Ive had a stress, the same time I had the regular echo. I went to bruce protocol 5 with 13.2 mets at 13.05 minutes. But like I mentioned before this was before experiencing premature beAts.  

Im a regular exerciser my whole life actually. History of sports all the way to colllege.

At one time I discovered taking small jogs helped my evening flare ups. But soon after I jinxed myself and I have them during and after exercise. Not sure if the majority is pacs or pvcs cause havent had a stress test when this has started happening. But doc feels nothing is wrong and that I practically "broke his treadmill". But that was before the problems.

Ive started trying to catch them on my alivecor app but sometimes its hard to determine with the app when the heart rate is up cause beats are so close together.

Also, from tech reports, my pvcs look different than the typical inverted wide qrs. When ive been reported pvcs they look almost like my pacs but the s point is further below the baseline and the U slope is wide.

Ill try to get one uploaded on my profile. But im disappointed im having them during exercise because before they were my relief

[Artaud]

I'm in the same predicament with too many PVCs. I've had them, on and off for 40 years, they seem to be stuck on anymore. My last Holter showed 6000 PVCs, sheesh. One E.P. zealously offered to ablate them, claiming they were in the RVOT, an older E.P. had his assistant continue to take 12 lead EKG recordings until a PVC was represented in each lead, disappeared with the recordings, came back and firmly asserted that the other E.P. was wrong, that the focus for the PVCs is the Purkinje Fibers, although he said it is still ablatable.

He suggested Lidocaine, Amiodarone, Sotolol (with 48 hours hospitalization), or a few others. I asked about changing to another Beta Blocker, he dismissed that possibility until I suggested Acebutolol (suggested to me by PVCTOM on this forum), he jumped at that, I was surprised. He started telling me about it's ISA properties, but after Tom's suggestions I looked it up. ISA is Intrinsic Sympathomimetic Activity, perversely enough it slows your heart and speeds it up. It blocks the Catecholomines as other Beta Blockers do, but the effect on the heart rate is less that a similar dose of another Beta Blocker. I read that 200 mg Acebutolol is equivalent to 50 mg Atenolol, but by 75 mg Atenolol, my resting rate was 55. I'm on 600 mg Acebutolol and my resting rate is 60. The E.P. wants me to move to 800 mg (the range of dose for ventricular PVCs with Acebutolol is 400 mg to 1200 mg and it didn't sound like 1200 mg was the absolute Max).

Pindolol is another Beta Blocker with ISA. Acebutolol is Selective, Pindolol is non-Selective. The non-Selective Beta Blockers like Pindolol and Propranolol (Propranolol is not an ISA drug) are known to exhibit "Membrane Stabilizing" effects that are conjectured to be part of their effectiveness for reducing PVCs, so if Acebutolol doesn't work I'm going to ask for Pindolol. Right now I'm getting fewer PVCs than the original outbreak, but my heart likes bigeminy and other patterns. But they no longer feel like someone is in my chest and trying to punch their way out. In addition, trying to check my pulse one night, I was astounded I was in a geminal pattern but could not feel it, of course I panicked and they grew stronger.

I have read some articles that state that Stress Echo tests are as effective as Nuclear Stress tests in the majority of people and offers some advantages, such as being able to see the valves and blood flow, not exposing the patient to radiation, and, drum roll please, are much less expensive. At the very least, you should have had a Stress Echo. An interesting point was my last bout of PVCs went away 3 days after my Stress Echo, I believe the stretching of the heart muscle somehow altered the PVC focus. My E.P. says he believes my PVCs would go away with exercise, but I'm afraid to since I don't want to make them mad ;-)

NO ONE SHOULD EXERCISE THAT IS EXPERIENCING PVCs FOR THE FIRST TIME WITHOUT BEING CLEARED BY A DOCTOR. (My wife worked for Doctors over the years and she has a few unpleasant stories).

A good doctor keeps an open mind and is open to suggestions.  Providing you with an event monitor, another Holter, or a Stress Echo is not asking too much. With medical records the way they are, it may be best to tell the new Doctor that you're looking for a second opinion and why. You don't need to elaborate on the findings by your first doctor.

Just curious, how many PVCs a day are you experiencing? Any other type rhythm disturbances or symptoms suggestive of such?

[hefner33]

Hey

The norpace was tried on me because I went in with the same complaining of so many pacs/pvcs. I was originally put on cardiazem but was dropping my hr to levels he wasnt comfortable with. Anyway the ecg was a 3 day follow up I had to go in for cause norpace is known to cause long q-t. But I have quit it since because I felt I was having more episodes10-20 a min when trying. Let alone the possible side effects are scary.

The echo I just wanted to know aboutthe values out of norm by a little bit. This echo was taken before I had pacs/pvcs but was having boughts of pre syncope and dizzyness. The lvpw is above the norm range given and not looking at the scan (on phone) there was another value out of the range. Just wondered if this had any significance to the apperance of my chronic and consistent pacspvcs. The ea I read was normal around a 1 from what I read but maybe im interpreting it wrong. I will read your links.

I bring this up because I asked for new echo and maybe stress but doc dor snt think its worthy since I had these back in sept. But things have changed drastically so im trying to piece things together.

Actually got a appt at the mayo in florida and wondering if I should go with my olf info or show up like I never had the test.

Thoughts?

Thanks again

Hefner

[Artaud]

Absolutely fascinating. First of all, I'm not familiar with reading Echos or EKGs, but I'm always willing to learn. Your EKG says you are on Norpace, what is that taken for? (Specifically, I'm familiar with the medication)

The thing I found fascinating was the IVC collapse. I never knew. The IVC is the Inferior Vena Cava, or a huge vein returning blood to your heart. (You have a superior one as well) Inferior meaning below and superior above.

That said, I was curious about the IVC collapse on inspiration or sniffing. It appears that it is natural for it to collapse when we breathe in. Who'd thunk. If you're the curious type, here is more on the phenomena.

http://resus.me/ivc-collapse-depends-on-breathing-pattern/

The E to A ratio decreases as you age. A few more sources.

http://www.ncbi.nlm.nih.gov/books/NBK2215/

http://www.echopedia.org/wiki/Normal_Values_of_TTE

Things looked pretty good, was there a specific question you had in terms of the results indicating a correlation to the PACs and PVCs?