MEDICATIONS related to VT /dilated left ventricle

i am concerned recently that my dilation has increased over the last 6 mos. I have had a VT problem since Dec.1994 (32 yrs old) generally brought on by vigorous exercise, I received an ICD after a short time on Ameodarone. (caused enlarged liver, spleen, high fever) June of 1995 was the first implant then another in 1999 (battery) and again in 2008. After an episode of VT in 2005 (mixing cement) the dr. ordered me to start taking lisinopril (I believe). Prior to that I took no medication. Since then my new cardiologist has me on an ace inhibitor s well as a beta blocker. I have never smoked. prior to 1994 I drank not daily but often to excess. I stopped drinking for 2 yrs after this problem.

I started having occasional drinks and then the old habits started increasing gradually although never really achieving the same excess just drinking a bit too much. Christmas 2009 - ended up in the hospital after celebrating on Christmas Day.  During the past few years I had very few episodes again mainly brought on by exertion, dehydration or the flu. I was shocked 67 times that night until finally, the ER dr. found a magnet to block the action of the ICD. Since then the Dr. has added Dofetilide to my meds 500 2x/day. The other meds are low doses 5 and 10 mg. I have hpvered around 215 lbs for th past 10 - 15 yrs. My squash playing weight was about 185. I have since started eating mainly vegetarian/vegan and am back down to 185 or so.
I am concerned about all the meds that I am taking, since my diet change I have removed Losec that i was taking for a few years. (acid reflux) I no longer drink at all. I haven't had any episodes and I don't really want to take the dofetilide anymore as I am pretty convinced that drinking was the cause of the last episode. By the way the dr. solved the VT on Christmas by by a large dose of magnesium. I tolerated the VT for quite a while prior to that been administered 30-60 min.
The recent change in my heart is concerning and we dont yet have a reason for it, as I have removed most risk factors (I still drink coffee 2 or 3 a day) The dr. will repeat the echo in 3 mos but in the meantimee I have started to look into other ways to help my heart. I can generally do a lot. My EF is or was in the mid to high 40's.
At this stage I don't even know what to ask, but I would like to know more if possible especially if my drs. are on the right path or the wrong one. My diagnosis has been ideopathic cardiomyopathy, that is all I was told. Enlarged left ventricle recently increased to 40mm I think (7mm). I think the VT has been Monomorphic? I think it is SVT (250-270 bpm). Thankyou for any comment.

[is_something_wrong]

This is a medical community, not an expert forum where you can ask doctors. Your situation and questions are advanced and I'm not sure if we should answer them.

It seems your heart function is OK (EF of 45-50%) and it's hard to say what caused the cardiomyopathy. Often, "idiopathic" cardiomyopathy is caused by a viral infection in the heart muscle, that often pass unnoticed. The fact that your ventricular tachycardia was provoked by exercise can to some degree support this, but it doesn't necessarily have to. Excess drinking is also toxic to the heart and may have the same effect.

It still seems like your VT is provoked by stressing the heart. Dehydration, exercise and infections all have the same effect. The heart need to work harder.

The 40 mm you refer to is not enough info to determine how dilated your LV is. Is this the end diastolic diameter (if it is, it's not enlarged) or the end systole diameter? Wall thickness of 7 mm is in the low normal area and may indicate dilation, as you say.

Magnesium (sulfate) is often used to convert polymorphic VT (known as Torsades de pointes) but maybe all the drinking caused your Mg levels to be low? I don't know your electrolyte balances.

Last in your post, you mention SVT. Do you mean supraventricular tachycardia (which is a completely different diagnosis) or sustained VT? A ventricular tachycardia at rate 250-270 is NOT something you would tolerate with an EF below normal. Even in a completely healthy heart, most people would faint after some time.

I'm sorry, I can't provide so much help here. This is something your cardiologist needs to help you with. But if you want, you can follow up here, with your test results, and I'm sure more community members will share their experiences. I know there are people here suffering from VT and cardiomyopathy.

[Mom2four85]

I was dx with CM and Polymorphic VT with a pacemaker/ICD they told me no alcohol whatsoever...my EF was 40% last time we checked but going to get it checked again today.  

My dr's didn't treat me with anything other than BB's and Midodrine for my ANS issues, which I've questioned for 2 years, when I asked a CC dr here they suggested an ace inhibitor and bb as well as something for my suspected heart failure issues.

That's great you can do so much, I went just the opposite - no clue for my P-VT; still searching for answers on that and my CM just confuses me but a top EP dx it; so who am I a as a patient to ask questions hehehe I ask too many questions.  I'll be going to Vanderbilt during the summer so hopefully I'll get some answers since my ANS (autonomic nervous system is involved).  I went from going at 100 miles a minute to barely being able to function in the blink of an eye; frustrating to say the least.

It may be SVT, I know I developed problems in the atria after my ablation where there had been none before.  

If it was sustained VT then I'd be really worried WHY this is happening and finding a doctor or facility like Cleveland Clinic, Mayo or Vanderbilt who are used to different types of cases.