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Trigeminal and Bigeminal PVCs
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Trigeminal and Bigeminal PVCs

Hi,
History:  MI late September right coronary (angioplasty) 90% blockage discovered in left coronary artery which was treated in late October by bare metal stent.  Meds followed were Plavix 75, Simvastatin, Aspirin 81mg, Metoprolol 100mg)  PVCs began late November with below symptoms that were mild at first and increasing over time.

I was just released from the hospital this past Saturday (Monday-Saturday).  I went to the ER on Monday with recurrent bigeminal and trigeminal PVCs and some PACs with symptoms including: (heart attack like) nausea, shortness of breath, chest pain, dizziness, headache, confusion, cold extremities, high and low BP, fatigue.  BP at time of admission to the hospital averaged 140/70, HR 60-70, ECG showed MI and an elevated ST.  

I had been complaining to my cardiologist about these symptoms since the end of November (One month following left artery stent placement).  Hospital ran lipid panel showing LDL 68, Triglycerides 400, HDL 28, nuclear treadmill stress test that achieved hr of 150, BP held at 140/75 and revealed an ejection fraction of 67, small thrombosis below right artery, bigeminal and trigeminal PVCs and occasional PACs during recovery phase - none occurred during the test itself.  Cardiac cath performed the next day revealed a re-narrowing of right artery.  Above the narrowed section, a tear was discovered (presumed site of plaque rupture).  The artery was stented.  The transient occlusion of the artery caused by the procedure resulted in cardiac arrest, and I was defibrillated.  Metoprolol was DCed, replaced by Sotalol 160mg.  Niaspan 500mg was added along with Tricor and fish oil.  Trigeminal PVCs dissipated to 5-10 per day now with only slight shortness of breath; an improvement felt immediately after the cath procedure.  BP average is now 105/60 HR 50-60.  ECG shows only brachycardia with normal sinus.  I am having some side effects from the Sotalol as well.

Question:  Could the right artery re-narrowing have caused the PVCs and/or worstened thrombosis inflicted by the MI in September?
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