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Exercise PVCs, Sudden Death, LQT
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Exercise PVCs, Sudden Death, LQT

Dear Doctors:

I am 40 yo male, I am 6'5'' 264lbs with 14% BF. I am a very active man. I row, run, & practice judo & sambo regularly. I strength train twice per week. I have a longstanding history of PVCs and mild hypertension. My VO2Max is in the low 60s, with the most recent test (2years ago when I was 23 lbs heavier of 61ml/kgmin).

Well, over the summer I had an increase in PVCs. An increase my physician & the ER attributed to dehydration and low Mg. However, I took a look at my 12 lead & my QTc is 452 ms. And the morphology of the PVCs is strange, I have notching, and positive deflections in V1 - V5.

Also, I get PVCs in the recover phase, though this is an infrequent occurrence and does most often occur when I am dehydrated (I am a heavy sweater always have been).

I've had stress tests and echos in the past. My doc and I are good friends, I trust him. My wife works for a cardiologist who said, "he's a worrywart, he's fine."

So, am I being overly concerned? Am I reading too much into the morphology of the PVCs?

Clinical note: my LV is slightly enlarged but my EF is 65%. No hypokensis, no aberrant movement
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6 Comments Post a Comment
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Avatar_m_tn
Just to be clear, I suppose what I am asking is, am I at a higher risk of sudden death? My doctor and the cardiologist says, "not really".
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1807132_tn?1318747197
I don't know if you know this but you posted in the members section not the doctors section.  You may want to post your question in the doctors heart rhythm forum for a more professional response.  That said, were you diagnosed with LQT?  I rather doubt the cardiologists would steer you wrong about your health.  No one can guarantee that you won't ever die from a cardiac event but I would trust if your doctors believe your conditions are beign then they are likely not going to cause any long term complications for you.  If you are still concerned about your ekg I would take it to another cardiologist for a second opinion.  Good luck and keep us posted on how you are doing.
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612551_tn?1247839157
I agree with what was said above, but I am not sure you will get a response from the doctors' section, but worth a try.  

You post if way too technical for me, I don't even know what a 14% BF means, i.e., what is BF?

On the fun side:  at 6'5" (I was 6'6" before age started the shrinking spreading process on me) and 264 with Judo skill, your health and an accident are about the only worries you have for being hurt physically.  "Ain't nobody gona mess with ya"...
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1124887_tn?1313758491
If you tried to get an answer from a doctor (which you can't get here, I would recommend the Heart Rhythm Expert Forum, the fee is $20 but definitely worth it..) I'm not sure if you want an answer from us lay people, but I just wanted to share some thoughts:

I quote this from your question:
" And the morphology of the PVCs is strange, I have notching, and positive deflections in V1 - V5."

Yes, I think you are overly concerned. Most of us don't even have a clue what positive deflections in V1-V5 means, and we live happily accepting palpitations as benign phenomena and we leave the rest to the cardiologists ;-)

Unfortunately, I haven't managed this myself, so I can explain that positive deflections with notching in V1-V5 possibly means that they may origin from the LV. It may, in theory also mean that they can be PACs conducted with RBBB abberancy.

I didn't know a QTc of 452 msec was terribly long. What was your heart rate on the EKG? Rapid heart rate may prolong the calculated QTc.

Try to accept what your doctor/cardiologist tells you. I think that will give you a happier life (I try to learn this after "failing" this for a long time...)
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Avatar_m_tn
Wow! I appreciate everyone's comments. I was a paramedic for a decade & I tend to way over think this stuff. That said, 'is something' I had not consider the PAC's with abberancy.
The QTc thing isn't that big of a deal. I have a large left ventricle that I know and am certain is physiological. I am an OCD exerciser. I tend towards overtraining and have to force myself to take a break, even though I know I should not overtrain. I just love to work out almost as much as I love to read.

Thanks for all these posts. I will check out the 'doc' messaging.
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Avatar_m_tn
Oh and Jerry, we have a visiting guest from Russia, a 74 yo man who is a world renown Sambo coach who tossed me on my butt like I was a bag of taters!

And you'd be surprised, my nature tends to attract jerks that want to pick on me. I'm sort of jovial and a bit of a cut up and people mistake the smile on my face as some sort of weakness.

Again, thanks to everyone. I think I'm just over thinking the PVC's. I've got zero family history, low risk profile aside from the mild hypertension, and it's normal at home and ambulatory. Moreover, my exercise BP responds normally.

I just found out my wife was preggers and she's 40 and I'm almost 40, and well...you know folks...you just start the wheels to turning. LMAO! I'm really just a giant Woody Allen, neurotic, hypochondriac, without the attraction to teenage girls.

All the Judo, SCUBA, backpacking, caving and all that other macho crap aside, I'm a little neurotic.  
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