Aa
RVOT VT
I'm a 43 yr old, very active, female diagnosed w/ MVP as a teen (per echo). Had unusual heart rhythms on and off for yrs. 30 day cardiac event monitor at age 35 which showed some sinus tachycardia ~ no worries. Given 1 cardizem tablet to keep in case I needed it. (threw away yrs ago). Last 3 1/2 yrs. the palpitations have become more frequent with near syncope several times in the last few months (while exercising and showering). Cardiologist (EP specialist) #1 - echo (showed mild MVP ~ can't hear on stethoscope) and 30 day cardiac event monitor (now has auto-sensing capabilities). Day 1 of monitor - VT ~ checked electrolytes - all fine. Day 3 after exercise - advised by monitoring company to immediately dial 911. (later learned that I had 24 run VT, 33 run VT, and a 77 run VT) What "everyone" is panicking about is normal to me, so I really don't get all the hooplah! Specialist #2 (Emory University, Atlanta) ruled out ARVD w/ cardiac MRI and exercise stress test and confirmed Card #1 RVOT-VT theory. Card #2 wonders if I really have MVP or if it was the RVOT-VT acting up the entire time. Tried 20 mg Nadolol but unable to tolerate side effects. Started w/ 5 mg Bystolic/day but raised to 10 mg/ day due to tiny amount of VT per cardiac event monitor.
My questions:
1. Is there any link between RVOT-VT and MVP?
2. Will the cardiac MRI give definitive answer to whether or not I truly do have MVP? (Is this better diagnostically than echo?)
3. Was I born with this and was it probably RVOT-VT responsible for symptoms through the years?
4. If I only had "near syncope" without medication (or diagnosis), do I need to be concerned that the VT can "break through" the beta blocker and all of a sudden have syncope?
5. Do I need to have a medical alert bracelet? I have an abnormal EKG and RVOT-VT (benign). Concerned that if I couldn't tell someone that in event of emergency, they'd take some drastic measure.
6. Card #1 would have preferred that Card #2 ablate to cure the RVOT-VT. Card #2 says my body is strong and tolerates this extremely well, so he prefers that I take beta blockers and only consider ablation if necessary.
7. Long term use of beta blockers - any issue?
8. Do my children need to be assessed for this? They, too, are athletes.
Thank you so much for any input. I am a wellness professional and am still trying to wrap my mind around this and there is not an abundance of information that I can find.
My questions:
1. Is there any link between RVOT-VT and MVP?
2. Will the cardiac MRI give definitive answer to whether or not I truly do have MVP? (Is this better diagnostically than echo?)
3. Was I born with this and was it probably RVOT-VT responsible for symptoms through the years?
4. If I only had "near syncope" without medication (or diagnosis), do I need to be concerned that the VT can "break through" the beta blocker and all of a sudden have syncope?
5. Do I need to have a medical alert bracelet? I have an abnormal EKG and RVOT-VT (benign). Concerned that if I couldn't tell someone that in event of emergency, they'd take some drastic measure.
6. Card #1 would have preferred that Card #2 ablate to cure the RVOT-VT. Card #2 says my body is strong and tolerates this extremely well, so he prefers that I take beta blockers and only consider ablation if necessary.
7. Long term use of beta blockers - any issue?
8. Do my children need to be assessed for this? They, too, are athletes.
Thank you so much for any input. I am a wellness professional and am still trying to wrap my mind around this and there is not an abundance of information that I can find.
Here are my answers to your questions Georgia:
My questions:
1. Is there any link between RVOT-VT and MVP? Good question. I don't know. I can tell you that I have mild MVP (and have since at least 21 years old when first diagnosed and I am 34 now) and I also have RVOT VT. I don't think there is a link because MVP is structural and RVOT VT is electrical (no structural problem, no heart disease).
2. Will the cardiac MRI give definitive answer to whether or not I truly do have MVP? (Is this better diagnostically than echo?) Yes, Cardiac MRI is top notch. My echo diagnosed me with MVP but the Cardiac MRI shows much more than an echo so of course it will show up.
3. Was I born with this and was it probably RVOT-VT responsible for symptoms through the years? Hmmm. Probably. I've always had a rapid pulse when I go to docs, when I get nervous, when I exercise. My average is 88 bpm. My RVOT VT run went up to 202 bpm. My cardiologist and ep doc told me it is not harmful. I told them I was always jealous of those with a lower pulse. They said lower isn't better. That I have a very healthy and strong heart. It's like a car. Some cars are built to go faster than others but it doesn't make them crap out sooner, ya know?!! ;) As Lady Gaga would say, baby we were born this way!
4. If I only had "near syncope" without medication (or diagnosis), do I need to be concerned that the VT can "break through" the beta blocker and all of a sudden have syncope? Beta blockers are very sensitive to RVOT VT, meaning that they really really help it. Beta blockers are like a chemical pace maker of the heart. You won't have as many palpitations. I was on a half of a betablocker (12.5mg) for 2 days. I was breathing so good on it. I thought is this what normal feels like? I don't feel my heart beat fast if I'm nervous. But then after 2 days, I actually missed feeling my heart race. Can you believe it?!!? I feel alive when I can feel it, it's all I know. What I'm used to. So now I have Xanax and a betablocker on hand, but I don't use them. Just having them makes me feel better.
5. Do I need to have a medical alert bracelet? I have an abnormal EKG and RVOT-VT (benign). Concerned that if I couldn't tell someone that in event of emergency, they'd take some drastic measure. No, you don't need a medical bracelet. You're totally fine. It's benign and harmless.
6. Card #1 would have preferred that Card #2 ablate to cure the RVOT-VT. Card #2 says my body is strong and tolerates this extremely well, so he prefers that I take beta blockers and only consider ablation if necessary. Answer: the ablasion is just to treat the symptom (your palpitations). it is not clinically necessary. You don't NEED the ablasion unless your palpitations are causing symptoms like passing out. If the beta blockers don't do the trick, then go for the ablasion. Or if you don't want to be on medicine your whole life, then go for the ablasion. Otherwise, it's not necessary.
7. Long term use of beta blockers - any issue? I'm the type of girl that doesn't even like to take tylenol unless I'm really hurting so.. all drugs have side effects. You will have to do a cost/benefit analysis and see if it's right for you. long term beta blockers have saved lives i'm sure. but are they necessary for a benign RVOT VT? I'm not sure. talk to your docs until you feel comfortable with an answer.
8. Do my children need to be assessed for this? They, too, are athletes. Yes. Not because you have RVOT VT. But because it is a small price to pay for a life-saving knowledge. I think everyone is worth getting a heart checkup. If more kids got checked out, there wouldn't be so many young athletes dropping dead.. I say, absolutely get them checked out. Not because you have something terrible, cuz RVOT VT is not dangerous.. but because there are scary heart probs that exist that if treated, can save lives!!! :) Again, peace of mind = everything. hope i helped! and take care!!
My questions:
1. Is there any link between RVOT-VT and MVP? Good question. I don't know. I can tell you that I have mild MVP (and have since at least 21 years old when first diagnosed and I am 34 now) and I also have RVOT VT. I don't think there is a link because MVP is structural and RVOT VT is electrical (no structural problem, no heart disease).
2. Will the cardiac MRI give definitive answer to whether or not I truly do have MVP? (Is this better diagnostically than echo?) Yes, Cardiac MRI is top notch. My echo diagnosed me with MVP but the Cardiac MRI shows much more than an echo so of course it will show up.
3. Was I born with this and was it probably RVOT-VT responsible for symptoms through the years? Hmmm. Probably. I've always had a rapid pulse when I go to docs, when I get nervous, when I exercise. My average is 88 bpm. My RVOT VT run went up to 202 bpm. My cardiologist and ep doc told me it is not harmful. I told them I was always jealous of those with a lower pulse. They said lower isn't better. That I have a very healthy and strong heart. It's like a car. Some cars are built to go faster than others but it doesn't make them crap out sooner, ya know?!! ;) As Lady Gaga would say, baby we were born this way!
4. If I only had "near syncope" without medication (or diagnosis), do I need to be concerned that the VT can "break through" the beta blocker and all of a sudden have syncope? Beta blockers are very sensitive to RVOT VT, meaning that they really really help it. Beta blockers are like a chemical pace maker of the heart. You won't have as many palpitations. I was on a half of a betablocker (12.5mg) for 2 days. I was breathing so good on it. I thought is this what normal feels like? I don't feel my heart beat fast if I'm nervous. But then after 2 days, I actually missed feeling my heart race. Can you believe it?!!? I feel alive when I can feel it, it's all I know. What I'm used to. So now I have Xanax and a betablocker on hand, but I don't use them. Just having them makes me feel better.
5. Do I need to have a medical alert bracelet? I have an abnormal EKG and RVOT-VT (benign). Concerned that if I couldn't tell someone that in event of emergency, they'd take some drastic measure. No, you don't need a medical bracelet. You're totally fine. It's benign and harmless.
6. Card #1 would have preferred that Card #2 ablate to cure the RVOT-VT. Card #2 says my body is strong and tolerates this extremely well, so he prefers that I take beta blockers and only consider ablation if necessary. Answer: the ablasion is just to treat the symptom (your palpitations). it is not clinically necessary. You don't NEED the ablasion unless your palpitations are causing symptoms like passing out. If the beta blockers don't do the trick, then go for the ablasion. Or if you don't want to be on medicine your whole life, then go for the ablasion. Otherwise, it's not necessary.
7. Long term use of beta blockers - any issue? I'm the type of girl that doesn't even like to take tylenol unless I'm really hurting so.. all drugs have side effects. You will have to do a cost/benefit analysis and see if it's right for you. long term beta blockers have saved lives i'm sure. but are they necessary for a benign RVOT VT? I'm not sure. talk to your docs until you feel comfortable with an answer.
8. Do my children need to be assessed for this? They, too, are athletes. Yes. Not because you have RVOT VT. But because it is a small price to pay for a life-saving knowledge. I think everyone is worth getting a heart checkup. If more kids got checked out, there wouldn't be so many young athletes dropping dead.. I say, absolutely get them checked out. Not because you have something terrible, cuz RVOT VT is not dangerous.. but because there are scary heart probs that exist that if treated, can save lives!!! :) Again, peace of mind = everything. hope i helped! and take care!!
Yay! My cardiac MRI results showed that I have RVOT! :) I was so worried about VT and of course looking stuff up online scared me.. but it just so happens that I fall into the 10% of VT that is "benign" and harmless. Thank you God. My holter monitor caught a run of VT. I did a stress test a few weeks later and passed it with flying colors and had no VT during this test. So they said there was a 95% chance that it was RVOT. But the cardiac MRI was scheduled to rule out ARVD, which is a different entity than RVOT but can sometimes co-exist with it. But I got the great news today that I don't have ARVD.. I'm super excited but my heart is still heavy for all of those lovely people on the forum I've chatted with who do have ARVD.. so my take away message from this whole experience (since I believe things happen for a reason) is to be GRATEFUL. This has only made me a stronger person and makes me want to help people because I understand, especially now, how it feels to have your life turned upside-down with a health scare. So if any of you are reading this and you do have ARVD, keep the faith. Sure it's scary but the technology these days (ICDs, etc.) are keeping people alive so much longer now.. and I believe there is a way to make such a diagnosis work for you and not against you. If you feel like you are on the edge, or if you wonder whether you are at risk for sudden death, the feeling that you get, that fear, can actually be used as a tool to make you live your life with more passion than ever before. I am so thankful for my health scare because I feel like it has changed my life and I wouldn't trade it for anything. God bless all of you... educate yourself but don't freak yourself out with obsessing over worst case scenarios on the internet; get the best cardiologist and also speak with an electrophysiologist; get a second opinion; get the tests for peace of mind. The worst thing is not knowing. I drove myself crazy the last few weeks because I didn't have a definitive answer. 95% RVOT was not "good enough for me." I thought, well if I can fall into a 10% category for RVOT (of all the vt's) than why can't I fall into a 5% not RVOT. that was my reasoning. and it sucked and i literally couldn't take not knowing 100% what was wrong. But when you know 100% what is wrong, then you can treat it. So now I'm gonna go celebrate being alive and I am going to pray for all of those suffering in this world over health issues... keep the faith.. I know you will be okay!! I believe it! xoxoxo
VT especially @ low rates is sometimes hard to ablate; not sure what your hr's were when caught. There have been some who have had EP studies to try, some have success while others of us don't. I think alot has to do with the rates involved and any other problems.
Here's some info a dr referred me to that I copied in my journal about vt's: http://www.medhelp.org/user_journals/show/266305/Tachycardia--VT--Vtach?personal_page_id=861727
I can relate to this - "It's very hard to put into words that what I thought was normal and great was actually abnormal" I was used to arrhythmia's from age 9 to 42 so it was a complete shock when they told me I had something seriously wrong. I sought a few other opinions and didn't want to think anything bad could happen.
Pay attention to changing symptoms and anything that may crop up for potential problems. Sometimes they won't find anything unless they do an EP Study.
Also, if you have dizziness or pre-syncope/syncope issues you may want to ask about a Tilt Table test to rule out any autonomic nervous system dysfunction. here's some info on syncope & heart related issues: http:/ /www. cccgroup. info/ neurosyn . asp (take out the spaces)
Here's some info a dr referred me to that I copied in my journal about vt's: http://www.medhelp.org/user_journals/show/266305/Tachycardia--VT--Vtach?personal_page_id=861727
I can relate to this - "It's very hard to put into words that what I thought was normal and great was actually abnormal" I was used to arrhythmia's from age 9 to 42 so it was a complete shock when they told me I had something seriously wrong. I sought a few other opinions and didn't want to think anything bad could happen.
Pay attention to changing symptoms and anything that may crop up for potential problems. Sometimes they won't find anything unless they do an EP Study.
Also, if you have dizziness or pre-syncope/syncope issues you may want to ask about a Tilt Table test to rule out any autonomic nervous system dysfunction. here's some info on syncope & heart related issues: http:/ /www. cccgroup. info/ neurosyn . asp (take out the spaces)
Thank you all for the posts. I thought this was going to a doctor, so sorry it's so lengthy. bbxx: Thankfully, RVOT-VT is a benign, electrical disorder. ICD/antiarrythmic drugs would have been course of treatment for ARVD. (ps - While waiting for the cardiac MRI to rule this out, I DID NOT GET ONLINE AND LOOK IT UP!! Why give myself something to worry about unnecessarily? I truly believe protecting my mind/attitude was paramount in this journey.) I am grateful that I've had palpitations all of my life, so I never felt afraid (until after everyone around me started freaking out!) I do giggle now that I've been speaking to large groups of people for years while my heart was kicking into VT. I learned to live with it by asking someone to speak with me, asking questions to the audience, etc. I just figured this was the "butterflies" people talked about. Bystolic is the drug I've been prescribed. Love it so far ~ no VT (per cardiac event monitor), great energy and mental clarity, etc. It's too much fun to feel what normal must feel like. It's very hard to put into words that what I thought was normal and great was actually abnormal and I could feel even better. I wake up each day and think, "This is the day that the Lord has made. I will rejoice and be glad in it!" Thanks for your responses and enjoy your new day!
1. RVOT is not local to the mitral valve, I don't think they are related structurally.
2. Cardiac MRI is a better image than echo for sure. They can make movies of heart cycles. Here's mine http://www.youtube.com/watch?v=9Ab4vqdB4Vo This shows slices moving up from the bottom of my heart towards the top. By the 5th, 6th, and 7th slice you can see the mitral valve working.
3. Sorry I can't answer this very well.
4. I think it would be too hard to predict, maybe you can try the medication and see how it works out? Sometimes getting the right medication and dose is trial and error.
5. I haven't heard of that myself, I wonder what your doctor thinks?
6. ugh, this is a tough call. It might be wise to get the a consult with an EP?
7. Some BBs have been around for a long time, sounds like they're fairly safe even long term.
8. I think it's a good idea to get EKGs done on anyone. If anything they will have a baseline EKG in case something down the road happens. They can compare their baseline to the latest to check for changes.
2. Cardiac MRI is a better image than echo for sure. They can make movies of heart cycles. Here's mine http://www.youtube.com/watch?v=9Ab4vqdB4Vo This shows slices moving up from the bottom of my heart towards the top. By the 5th, 6th, and 7th slice you can see the mitral valve working.
3. Sorry I can't answer this very well.
4. I think it would be too hard to predict, maybe you can try the medication and see how it works out? Sometimes getting the right medication and dose is trial and error.
5. I haven't heard of that myself, I wonder what your doctor thinks?
6. ugh, this is a tough call. It might be wise to get the a consult with an EP?
7. Some BBs have been around for a long time, sounds like they're fairly safe even long term.
8. I think it's a good idea to get EKGs done on anyone. If anything they will have a baseline EKG in case something down the road happens. They can compare their baseline to the latest to check for changes.
I have to tell you, lots of us on here panick over just the sensation of lots of pvcs never mind runs. Your attitude is FANTASTIC! Seriously! I wish I could think that way dealing with mine. lol
I think it's because it's RVOT. There are cases where they can deem that type of arrhythmia "benign." But, there's a lot of controversy on the subject too.
I am actually surprised they didnt put an ICD in you. My understanding was VT is extremely dangerous and they they ablate asap and if needed--ICD. Perhaps I understand this wrong? I am anxious to read the others response.
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