Halter Monitor Results Getting Worse

[lld301]

Hi, I am 44 years old and was diagnosed with PVCs in April 2013. I was put on Metoprolol 25 mg once a day originally. I went in for a 2nd halter monitor, 24-hour to see if the medication was helping and it was. It had cut my PVCs from around 2,831 ventricular bigeminal cycles to 904. I think the ventricular bigeminal cycles is the PVC reading, but I'm not sure. During the time between the very 1st holter monitor (pre-medication) and the 2nd holter monitor (post-medication 25 mg/once a day), I totally stopped drinking caffeinated beverages and alcohol.

Then my doctor started me taking the medication twice/day, once in the morning, and once at night. I have been on 2/day pills now for about six months and I just got done with my third holter monitor and it is worse than before I even started on the medications. I am now showing 1841 PVCs, but my ventricular ectopics and isolated beats are higher, plus I'm showing 25 couplets and a few triplets.

In between the 2nd and 3rd holter monitor reading I drank A LOT of decaffeinated coffees, teas, and colas, as well as, I ate a lot of cakes, cookies, and chocolate. With this 3rd holter reading scare, I have given up everything now and I only drink water and no more sweets and chocolate.

My heart doctor didn't change my medication when I came to see him and I did another stress test which both have been normal. My echo was normal, also. He is suggesting that I go see an Electrophysiology doctor for a possible catheter. All of my EKGs done in the office room have always been normal.

I just don't know what to do. On one hand I'm concerned that my holter monitor results were worse than ever before and I have been experiencing more shortness of breath lately. I'm not sure if the shortness of breath is from my heart, my anxiety with dealing with this world totally natural (no caffeine, chocolate, or alcohol), or from the medication I'm on.

I am about to start a new job and I am relocating across the country. I do not want my new employer to think that they hired someone with medical problems. I just don't want anyone to sense that I have heart problems. I think other people can easily pick up on these things, especially when it involves your heart.

I'm here on this forum asking for your advice on ongoing medical treatment, and even if I should let my new colleagues/boss know about my condition. Is it possible that my bad rhythm will one day return to normal, or once you have a bad heart rhythm, you always will? I'm really scared to do the whole heart catheter thing, but I might be willing to do so in maybe 25 years when I retire, if needed. I am sometimes scared that I might just kill over with a sudden cardiac arrest, also, but I hope that is not the case.

Thank you all for your input, I really do appreciate it.

Sincerely,
lld301

[lld301]

Thank you Michelle, but do you,  or anyone else have any advice about dealing with shortness of breath? After a year since my diagnosis without having this symptom, now I have shortness of breath pretty much all day and night, except when I'm sleeping.  I'm concerned that people are going to notice it. Is there anything whatsoever I can do to stop the shortness of breath or control  it better? Any techniques?  Thank you so much!!

[MichelleP_3811]

Sorry to hear about your troubles.  You are not alone and actually what you are experiencing is considered by most cardiologist to be pretty benign.  I am not exactly clear on specifically how many ectopics you are having but it is only when one reaches the 20,000 a day or if they get runs that sustain and cause a person to pass out do they get concerned.  My EP would not even consider trying an ablation unless I was near the 20,000 mark.  They have to be able to trigger the issue so they can map where to ablate and that can be very hard to do if you are not having them quite often.  Hear them out if you like but really trust your gut if it is the right choice for you.

As for your tiredness it could be a combination of both.  Meds will likely make you more tired if it is lowering your heart rate as well giving up sugar and caffeine will bring down you energy.  Though it may help you sleep better at night.  It did for me.  So if the tiredness is interfering with your ability to stay up during the day then I would discuss this with your doctor otherwise hopefully you will adjust or just try and get more sleep at night and see if that helps.

The one thing I want to impart on you is that most pvcs are harmless and will not cause sudden cardiac death unless there is some underlying heart disease especially damage and scarring from a previous heart attack.  If your heart was evaluated to be structurally fine you really only need to try and find and eliminate your triggers.  Stress and acid reflux are the biggest triggers.  In the whole scheme of things ectopics are really just extra little beats your heart is throwing off.  In an healthy heart the heart can handle it just fine even if it throws off the beat cycle a bit.  So try to do your best to not stress about it all.  If you feel it important to tell your employer do so but I see no reason you need to reveal it unless you have a job that requires full health disclosure for safety reasons but follow what feels right to you.  In general these ectopics are fairly common.  From what I read upwards of 40% of the population has them so that is a fairly large percent.   And most of us will never have to worry about them.  Best of luck getting a handle on yours and keep us posted on how you are doing.  Take care.