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Ventricular tachycardia -- how benign?

Hi Doctor,

I’m a 51-year-old non-drinking, non-smoking male who walks 2+ miles a day and is only mildly overweight.  I’ve been on lithium for 15 years, and I also take Wellbutrin, Celexa, Klonopin, and Risperdal (the last three in very small amounts).  I have hay fever and mild asthma.  My last physical, six months ago, was perfectly normal.  The exam included all standard blood and urine tests.

A few months ago, a routine electrocardiogram revealed that I was experiencing PVCs.  I was also having mild chest pains -- moments of brief and infrequent ‘electric shocks’ around my left breast.  I immediately consulted a cardiologist.  After examining me, he concluded that there was nothing pathological about the PVCs; as a precaution, however, he ordered a stress-echo test.

I had that test yesterday.  During the treadmill test, I experienced a brief episode of extremely rapid heartbeats in quick succession.  It started abruptly and ended abruptly (although my heart rate remained high for some time).  The technicians stopped the test very shortly thereafter; paged two nurses and two cardiologists; and continued with the “after” phase of the echocardiogram.  At no time did I experience pain under my breastbone, dizziness, sweating, fainting, high or low blood pressure, or shortness of breath.  In fact, I never even felt the rapid beats!  Eventually, the additional doctors and nurses realized that no treatment was necessary and left.

Later, after reading the results, a third cardiologist told me that my heart is healthy.  In such cases, he added, the only real danger from “benign ventricular tachycardia” is long-term; i.e., over time, too many such episodes can weaken the heart.  He made two suggestions:  first, wear a 48-hour heart monitor to determine the frequency, duration, and intensity of the episodes; and second, depending on the outcome, consider treatments ranging from surgery to medication to…well, nothing!

By the way, I told them all that I’d never had an abnormal ECG until starting Synthroid last spring, but none of them found that relevant or remarkable.

I have two questions.  First, is ventricular tachycardia ever really benign, even in a person with a healthy heart?  And second, is the standard surgery for ventricular tachycardia (up the leg vein to the heart) safe?

Thanks.
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i have an underlying sinus rhythm,wit frequent pvc,s ventricularbigeminy,rare
ventricular couplets at least 6 runs nonsubstainedvt with fastest170 beats per min  and last7 beats.also5 runsof superventriculartach  the longesy 9 beats187 beats per min.on a 24 hr holtor. stress tests
significant ischemicchanges leads 11.111.avf.v5. and v6 minimally abnormal. have minamal valve and mild cardiomegly. had cath came no cad. have hp and some scary beats and rates but goes lots of skip beats told to ignore them on toprolxl. have chest pains all the time.  q having hp for 30 yrs. can that cause vt. can non vt become substained with no cad .my doc seems unconcerned.
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230125 tn?1193365857
MEDICAL PROFESSIONAL
First, is ventricular tachycardia ever really benign, even in a person with a healthy heart?

Yes.  I promise we are not lying to you about that.

And second, is the standard surgery for ventricular tachycardia (up the leg vein to the heart) safe?

It has risks and benefits.  If VT ablation is an option, you need to talk with your doctor about the risks and benefits.  It is a safe alternative for someone that significant symptoms and potential for symptomatic benefit is greater than the risk. It can be a difficult decision.  Some VTs are easier to ablate and can be localized on a 12 lead EKG prior to the case, other are more difficult. It depends on which variety you have.

i hope this helps. thanks for posting.
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