Meds or Procedure

[skigirl511]

I was diagnosed 5 years ago with Tachacardia (160 beats/min.) and have been taking 100 ml of Atetnol for the last 5 years.  I was interested in the Abolation procedure because my mother 10 years ago participated in the first study of the procedure and had it done.  It stopped her Tachacardia completely.  I am 49 and do not want to be on medication the rest of my life.

In August of this year I had a Event monitor attached for one month to record the heart palpitations, I was still taking the 100 mls of Atetnol.  I scheduled an appointment this week as the results were never communicated to me, the cardiologist forgot.  He stated to me that all 17 recordings in 2 weeks were normal.  My palpitations or rapid heart beat usual last 2 - 3 minutes and happen while at rest or driving or any type of anxiety.

My question to the doctor was, "Then why am I on such a high dose if nothings wrong"?  His answer was to go off the medication.  This scares me as I have at least one palpitation a day on the meds before the meds I had 3 or more.  If I forget to take the meds (at night) then I am having palpitations the next morning.  My sister has been a cardiac nurse for the last 20 years, she suggests that I ween myself off the Atetnol (1/2 pill for 2 weeks, 1/4 next)  and have the test redone without the medication.

What is your advise?

Thank you.

[Michael J. McWilliams, M.D.]

It depends on what the tachycardia is and if it is different that your palpitations.  There are many things that can cause palpitations like PVCs, PACs, sustained tachycardias and non sustained tachycardias.  There are certain things that can be ablated with high success rates and other things that have a lower success rate.

My hands are tied a little with your question because I don't know what your doctor saw on the monitor.  If they recommended coming off the medications, then it is probably a reasonable thing to do. You will need to ask them if they saw anything like PVCs or nothing at all.  If you come off the medication and the symptoms get worse, you know that should / could start them again.  It would be reasonable to repeat the monitor to determine what is causing your symptoms, especially if the symptoms are different.

I usually wean people off beta blockers unless I am starting another agent or similar class of medication.  

I hope this helps. Thanks for posting.

[Momto3]

Hi Nanette,

I'm not a doctor, but I tend to agree with your sister.  Knowing that you want to be off the meds, would your doctor agree to retesting you while you are off the medication for a period of time?  I understand better now : )

I would be interested to know how you make out if you and your doctor decide to try another holter (without the meds).  Please keep us posted.  Have a great day!

connie

[skigirl511]

I not sure of the difference between pvcs or tachycardia, all I've been told is the tachycardia.  My symptoms are fast beating or pounding of my heart for 2-3 min.  It happens while at rest but also if I am startled.  On the meds I usually have 1 to 2 episodes/day, 5 years ago I was having 4 to 5/day.  I don't think I need a pacemaker but was told if the condition is not taken care of it will eventually lead to that.  I exercise 5 days a week for an hour, I do know that you have a rapid heart beat when exercising; however you are also breathing hard etc. so I know that is normal.
My Cardio was all for the ablation then I did the event monitor (on the meds) and had 17 episodes in 14 days and he said that they were within the normal range.  My sister, a cardio nurse, suggested I go off the meds, slowly, then redo the test.  My Cardio says it's probably just adrenalin attacks but why do they occur when I'm sleeping and it wakes me up and my question to him was why take such a high dosage (100 mlg) for that.
I'm glad I found this web site as many questions I have been asking my Kaiser doctors are not being answered to my satisfaction.

Nanette

[Momto3]

I understand your desire to be med free!  I feel the same way.

I'm a little confused.  When you say you have 3-4 episodes per day, do you mean pvcs, or tachycardia?  

When I was having tens of thousands of pvcs/day, I did develop pvc-induced tachycardia, but that didn't happen until I had them for a long time.  What makes you think you might need a pacemaker.  It is my understanding that pacemakers are used more for bradycardia.  

Have you discussed ablation with your cardio?  

[skigirl511]

I would like to get off the medication but before the medication I had 3 to 4 episodes a day, I know that eventually it wears out the muscle and can lead to a pace maker.  My question was is the Abolation procedure a better way to go.  The previous medication wasn't strong enough and did not reduce the palpitations.  I do not want to take medication and am currently reducing my medication but was also told that it was not a cure therefore my assumption is I will go back to having 3-4 episodes a day, which I don't want either.

My goal is to be med free.
Thanks,
Nanette

[Momto3]

Sorry to hear you are having a tough time with the palps and the

Are you worried because you are having 1 pvc while on the medication?  Beta blockers do not necessarily eliminate ectopics.  Sometimes, they reduce the frequency of ectopics, and other times they just reduce the sensation.  I'm thinking that you are taking the medication primarily to keep you from being tachy.  Have you asked your doctor about reducing the dose?  trying a different medication?

Connie