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Arrhythmia Help[ Please

Dear Dr,

I am a 45 year Old Woman,
5*6
139
Who has always been in great shape?
Last summer I was working out at the gym, (at the end of may work out) I began to get very severe and fast heart palpations, It came on with a (one thud) and then it just raced up to 199. I became very breathless unable to breathe or slow my heat rate down.

At the time I thought I was having a Panic Attack , But this continued to happen each time I worked out , I will be walking slow on the treadmill ( 3.3) for about 30 Min and if I bump it up a bit It happens again.

I have become extremely anxious now because of this.

I finally went to a cardio Man (a great guy) he did really not believe me at first and did a stress test, on the stress test it happened. I have all the x-rays done and an echo.

He said my heart was fine, but I was having arrhythmias due to a short circuit in the natural pacemaker of the heart,
And put me on a aspirin a day and toprol-xl 12.mg at night, due to the fact that I was born with hypothyroidism my blood pressure is very low and he did not want to lower it to much,

My questions are:

1) If I have such low blood pressure in the first place , why and I having arrhythmias
2) I asked him if this was Panic Attacks and he said no,
3) If it is Panic can you tell the difference on the reading of the EKG on the stress test, does it show something else if its panic?
4) It seems to be happening more , but not as strong just ore frequent ,
5) I am not a pill person and leery of taking beta Blockers and medication if I really do not have to , I just want to understand better what this is > Why Is happens and How to at least control it ,
6) I really love to work out and would like to resume exercise but I am unsure if it will keep happening that the gym
26 Responses
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Avatar universal
I just want to thank everyone for there comments and support ,
I was told I have SVT, But because I have such low blood pressure , 90/58~ I have been taking only .12 of trophyl .. It is helping but I still have side effects , very slow breathing , and silght depression, weight gain , and low exercise tolorance , Mostly it is helping I think , My SVT is only getting to 140 when it happens , and a shorter time , but I really do not like these side effects , I am going to a second opinion , as my Dr told be that the mapping is a very severe procedure to do <I have read otherwise here > I really would like to permently treat this and not be on the beta blockers. I was a gym nut until this , Now I am a blob and getting depressed from the medication , I know 12mg is so low its not funny , but If i talke more by blood preassure drops so low I really cant breathe or move , any Idea's ... HELP

cindyred
ps I am a terrible speller sorry :(
Helpful - 0
Avatar universal
Hi, just wanted to comment on Inderal.  I've been trying several different kinds of beta blockers and Inderal does have more extreme side effects. If you have asthma, I would warn against taking it as it can ( and did for me) cause problems such as an asthma attack. it also has some more bizzare rare side effects like hallucintions.
  Beta blockers can help, though.
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Avatar universal
The location of the foci which cause PACs is pretty much determined first by an experienced EP capable of figuring an approximate location from the ECGs alone, and second, by an actual electrophysiology exam (electrodes/catheters, etc).  During an ablation procedure, this is definitley done.

The thing about premature beats is that the process is complicated and affected by many factors.  One huge factor is the state of the nervous system surrounding the heart.  In cases where foci cause skips, the electrical noise they produce needs to travel from the foci to the pacemaker.  This trip is made easier when the autonomic nervous system is tuned up...it's why people get a skip when they get nervous or anxious.  The increase in PVCs you may experience may be caused by something this subtle.  It's why meditation is sometimes prescribed.

-Arthur
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Avatar universal
Thank you for sharing all or your well informed Heart information here.
What test showed the location of your pvc's and such ?
I have had the holter monitor, echocardiogram, tilt table test, ekgs, stress treadmill, king of hearts, cardio-beeper and a yearly check up with my electrophysiologist to check 2 heart murmurs and symptoms. The print outs show details on my heart's condition But not to the detail of where or what is causing such a increase in pvc's from the previous year. Heart Healthy lifestyle as always.
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Avatar universal
Testing - "all the usual tests" which included EKGs, stress and
normal, CAT scans to exclude tumors/embolisms/aneurysms, monitors to catch the arrythmia and document it.  The most useful test were EKGs during stress which showed PACs on the verge of degenerating into PAF, as well as a "documented" PAF while at home (using a portable monitor).  The mainstay of any EP is documentation...until you have that, you have nothing in hand to convince anyone that there's something up.

Symptoms showed up after a soccer match when I was 52.  Sounds odd, however, I was and am in excellent aerobic condition.  The heart's "structurally normal", however, somehow or other PACs started showing up out of the blue, being caused by foci (hot spots) in the pulmonary vein connections to the back of the heart (a common location).  EPs don not know why these things show up.  Currently this is an area for scientific investigation...and some EPs believe the foci show up with a combination of stress and age, wherein the cardia tissue may develop some minor separation at the cellular level (which presumably permits the erratic signalling from foci to travel longer distances and reach the pacemaker systems).  The origin of the foci is largely genetic, ie, we are all predisposed to their existence (they are simply made up of electrical cardiac tissue located in regions where they are not needed).  

Magnesium - it's an important cofactor for the proper functioning of muscle tissue.  There are lots of tales regarding its efficacy in normalizing the heart.  Generally it's harmless to take in moderation...check with your doc first and try it.  Folks with arrhythmias generally try everything.

Inderal - never took it.  Beta-blockers do reduce the reactivity of cardiac tissue to adrenaline...and for PAF, this is a normal suggestion, since it can get kicked up by adrenaline.  In addition, since the blood pressure is reduced, one may also not notice the skips quite as easily.

In my case, I've been troubled by the leftover PACs.  For about a year and a half now, I've made it a point to avoid thinking about them and especially, avoiding checking my pulse.  So I went from feeling each and every skip to being oblivious to their presence...I simply don't know if they are occuring.  So, basically, I've cured myself...since if I can't tell they are there, they are gone.  I continue to play soccer and feel great.
In the end, since these buggers are harmless, it's a mind-game.

-Arthur


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Avatar universal
This web site is so helpful in Heart Health .
Have you ever read Mitral valve prolapse syndrome/Dysautonomia ?
Very informative. Visit http://clubs.yahoo.com/clubs/mitralvalveprolapse2 for additional help. What did you think of my additional posts here.
Have you visited www.mvpsupport.com ?
What does your cardiologist say is your hearts condition after all the tests ? thanks
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Avatar universal
Thank you so much for your message.

How come you had to have a preliminary session a week before your ablation, rather than having the ablation done right after the EP study/mapping?  What would the advantage be to having two sessions?  (Sorry if that's a dumb question.  I'm fairly new to this heart talk. lol)  

I'm really hoping that I won't need a neck/collar bone catheter.  I find that idea quite unsettling!  

I was told to expect to be sent home the same day as the procedure.  Rarely do they keep people overnight here.  

That is wonderful that you were cured of your arrhythmia. And yikes, you were running a week later?  And it has now been 3 years since your ablation and it hasn't returned?  That's terrific to hear!

Thank you again, Arthur.  I appreciated your reply.
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Avatar universal
What cardiac testing was the most helpful in your evaluation to where and what was causing the arrthymia's ?
At what age did you start having symptoms and with your healthy lifestyle did they say it was genetic ?
Any input on taking magnesium and increasing potassium in your diet for heart health ? My cardiologist said Magnesium has helped some of his patients. I have tried extra nutrients for over 3 months .
Did you try Inderal ?
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Avatar universal
The reason for a preliminary session was to establish a procedure by which the EP could guarantee generating the arrhythmia.  This was important in my case, as PAF is by its nature is an arrythmia that shows up sporadically, and in order to perform the ablation the EP needed to have a way to initiate the arrhythmia.  This session simply involved being monitored (EKG etc) while being administered several different drugs, in particular, the adrenaline-like drug, since PAF is often kicked up by adrenaline surges.  It's possible that for other arrhythmias, and even PAF, the EPs have electronic "tricks" wherein they could initiate your arrhythmia using the catheter/electrodes...so everything could be done in the one session.

As far as post ablation is concerned, it's pretty clear that it takes about a week for any "injury" due to the rf ablation to fully heal, so when I went out to run, it was slowly and carefully...I really wasn't back into engaging in real athletics for a few months (again, just to be careful).

And it's true, in my case, the one focus that the EP found was correlated to the initiation of the PAF, was toasted and three years hence, it has not come back, not even under extreme stress while engaged in very physical sports.  So, I guess I'm cured.
You should talk to your EP to make sure you understand the risks of an ablation procedure.  When I had it done for PAF, the cure rate was about 60-70%, and the risk of a stroke (due to a loose blood clot) or pulmonary vein edema was about 2-3%...although my EP's record had that at 0%.  These percentages vary with the type of arrhythmia, the procedure, and the EP.

Good luck!  It sure beats taking drugs.

-Arthur
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Avatar universal
please excuse my lack of education here, i really dont know anything about the medical field....i am a 21 yr old female.  im not over weight and no serious med probs as far a cholestoral and blood press and all that stuff goes.  a little over a year ago i had an episode....lets call it a "panic attack"...the doctors told me there was nothing wrong with me and offered some antidepressants and basically sedatives.  i declined both offers, because i dont like taking medicine.  soon after at a routine check up a doctor suggested i have an echocardio done because he heard a "clicking" in my heart (as found with mitral valve prolapse)  the echo showed nothing at all.  lately i have been having "disturbances" in my heart beat, but nothing to make a big deal about until yesterday.  my heart will speed up real fast and then stop for a second then go and stop and speed up and stop, all with no consistency or rythm at all.  some times it feels like the blood is kinda gurgling up a little the discomfort is from my chest all the way up to my throat sometimes, and is increased in humidity (hot shower) and when i lay on my side.  theres some other symptoms involved  but from what ive said does anyone have any advice or suggestions.  this discomfort started yesterday late morning and it is still happening now at 6 pm the next night.  thanks for your time,  sny comments would be helpful.
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Avatar universal
So thankful for this well informed web site post.
I am 34 and have suffered on and off for years with pvc's, pac's,svt on holter results.
I was a premature baby and have always had 2 seperate heart murmurs and mvp. My primary concern with heart disease in our family that we live heart healthy and have strictly for 8 years. With the increase in pac's,pvc's and suggestion to try a beta in the hospital first due to asthma, allergies and sensitivity to drugs. However I have been trying progesterone cream to help with hormone level and my menstrual cycle has been too often.
Can't just one part of our body act up at a time ? I have low b/p 89/58 and 42 for a heart rate often. Any Feedback welcomed
Helpful - 0
Avatar universal
Ablation - I had one done for paroxysmal atrial fibrillation, basically a subclass of tachycardia, due to pulmonary vein foci.
I imagine the overall procedure may be similar for many such rf ablations - in my case, a preliminary session was required to develop a protocol to assure induction of PAF (this was done with iv-delivered isoproterenol and adenine to see which drugs/levels will induce what arrhythmia).  A week later the ablation was conducted.  The overall time of the procedure will vary with the individual/circumstances...in my case it took about 6-7 hours.
I received catheters in two groin veins and an artery? along my collar bone.  I was under mild sedation for an hour or two while the EP "mapped" the location(s) of foci.  No pain was felt, although some discomfort did occur just thinking about those groin catheters.  I was unconscious during most of the procedure while actual ablation was going on.  Afterwards, I stayed overnight at the hospital for observation, care being taken not to move about much in order to assure proper blood clotting at the catheter insertion sites.  Again, no pain, just mild discomfort.  Left for home in the morning, and stayed at home a couple of days just to be sure the groin lesions healed properly.

I was cured of PAF.  I do have some PACs (but this was expected since a number of foci were discovered, and only the offending one was ablated).  As I am an active athlete (52 years old at the time), I had to wait a week before running (just to be extra safe regarding the groin clots).  I felt a bit weak due to the drugs prescribed at the time (beta-blocker/tambocor)...in a few months I stopped taking them.  I have resumed all sports activities and deal with a modest PAC background, and have not had any PAF since (it's been three years now).  I am very glad to have had the ablation.

-Arthur
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Avatar universal
I have been having similar symptoms and nothing showing up on tests.  I finally drove to my GP's office while having one (it was close)  they have not officially diagnosed, but after GP, cardiologist, and electrophysiologist: they put me on a low dose beta blocker.  I've only been taking it 4 days, but am not having the problems, heart rate feels very steady, it seems to be eliminating most of the uncomfortable symtoms.  Feeling much better, I'm hopeful in a week or so I will be able to get back to normal activities which I have gradually had to stop due to the symptoms.
Good Luck
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Avatar universal
Ladies,
Are you using knowingly or unknowingly the artificial sweetener, aspartame (Equal,NutraSweet)

In 1995, the FDa was forced to reveal, under the Freedom of Information Act, 92 symptoms caused by aspartame.

NO. 15 IS CHANGE IN HEART RATE
Surf over to www.dorway.com for a library of information.

Personally, I have read hundreds of case histories from victims with rapid heart rate.  I myself once took some aspartame unknowingly and thought I was having a heart attack.  
Symptoms should ease or cease in 60 days.  Can be a tough detox as aspartame is 10% wood alcohol/methanol.  Purified water is an antidote.

Watch out for the new Listerine strips, Doublemint  gum now has it along with the 50 or so other sugar-free gum.
Check OTC and prescription drugs.  This is no longer just a diet Coke problem.
Best,
***@****
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Avatar universal
Hi. Because the best info. out there is often from people who have 'been there....done that', I am hoping to get input from anyone who has had an ablation. I'm also hoping to get suggestions as to questions I could ask the electrophysiologist when I see him next week.

How long did your ablation procedure take?
Was it successful? or do you wish you hadn't had it done?
Did you require stitches in your groin afterwards?
Did you feel fine right away?
If not, what 'after affects' did you experience? (Were you tired, weak, suffer more palpitations afterwards than you had prior to the procedure, or ?)
How long was it before you felt like your normal self?
Do you wish you hadn't had it done?

I have AVNRT and am scheduled for an ablation in 8 weeks (sooner if there is a cancellation). However, I have an appt. with the EP next week and it will be my only opportunity to ask whatever questions I may have. Anyone have any suggestions?

Thanks!
Marie
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Avatar universal
Cindy - Just wanted to say I hope your appointment goes well.  And make sure he/she answers all of your questions!!!  Seriously.  I always feel so much better when I am not left in the dark.  Good luck.

Cyn - That's terrific that your ablation went well.  May I ask what type of SVT you had ablated?  I have AVNRT and will be having an ablation done soon.  I have an appt. with the EP next week, so have to decide what it is I need to know, and, therefore, what questions I should ask, since it will be the one and only time I will see him before the procedure is done (in June).  

Can I ask how long your ablation took?  I have heard that it can take many hours.....  Did they insert the catheter through your groin? and was that area really sore afterwards?  I have also heard that some people feel very tired for weeks afterward.  (I'm hoping they were totally exaggerating.)  How long was it before you felt normal again?

I'm quite nervous about the whole thing, but I know that I will feel more at ease if I know exactly what to expect.  

Thanks. :)
Marie
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Avatar universal
Cindy - Just wanted to say I hope your appointment goes well.  And make sure he/she answers all of your questions!!!  Seriously.  I always feel so much better when I am not left in the dark.  Good luck.

Cyn - That's terrific that your ablation went well.  May I ask what type of SVT you had ablated?  I have AVNRT and will be having an ablation done soon.  I have an appt. with the EP next week, so have to decide what it is I need to know, and, therefore, what questions I should ask, since it will be the one and only time I will see him before the procedure is done (in June).  

Can I ask how long your ablation took?  I have heard that it can take many hours.....  Did they insert the catheter through your groin? and was that area really sore afterwards?  I have also heard that some people feel very tired for weeks afterward.  (I'm hoping they were totally exaggerating.)  How long was it before you felt normal again?

I'm quite nervous about the whole thing, but I know that I will feel more at ease if I know exactly what to expect.  

Thanks. :)
Marie
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Avatar universal
cindy,  i had svt and had an ablation done at Yale New Haven. I have never had another episode and was so greatful for that procedure.  Good luck to you.  Im  33 and the MD said i was way to young to live with those episodes.  I put me into panic as well.  Dont let it go on to long  it will rob you of your life.
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Avatar universal
I just noticed that you said you were prescribed Xanax. I just want to warn you that is does work but is extremly addicting. Even at that dose. I have fighting this drug for months trying to get off of it. So if you can do without please do. Best of Luck! Danielle
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Avatar universal
Dear Cindyred,

Sorry to hear about your heart problem. What you are describing sounds like an episode of SVT. The following are answers to your questions:

1. Having low blood pressure or normal blood pressure for that matter does not exclude one from having rhythm disturbances. Rhythm disturbances can occur in anyone.

2. Panic attacks usually do not result in a heart rate of approximately 200. Panic attacks can result in palpitations and increased heart rate, but usually not to this degree.

3. I think a beta blocker is an excellent medication to be taking for this problem. There is no reason not to  continue your regular exercise regimen.

I would recommend an appointment with an electrophysiologist (EP), which is a cardiologist specializing in rhythm disturbances. The rhythm disturbance that you have described needs to be clarified further. It is possible you may be a candidate for catheter based treatment leading to the discontinuation of your medication.

Thanks for your question,


CCF-MD-KE
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Avatar universal
Dear Linda,

Thank you so very much ,
This is all so very new and crazy to me ., i am still trying to find out what kind it is , from him I have a appointment in 5 days and I will really pick his brain , He is very nice , just a little evasive with info .... I was just told today that my colosterol is up to 299 / total and the other 179 /
I have never had a problem with any of this and no one in my family has , I truly think that both are tied in with eachother , But they will not listen to me , and tell me seperate ! But it all happened at the same time .
Before my colosterol was 186... and I was working out like crazy and them 3 months later both of these happened ! , I keep telling them that it has to be related . Somethng underlying ....
The Endo now wants me to take both lipitor and zocor at the same time ? I have never herd of this and said no . I wil re search it ... gosh . I have not been on any meds like this in my life ..... this this is crazy ... I am really awaiting to hear ffrom the Dr in the forum ... Thanks for you email .... anything that anyone can advise will be so wonderful ... information is power to understand and to be a bit more articulate when I go to the Dr , excuse my spelling as always :)

Cindyred
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Avatar universal
Hi there
I'm no doctor but from what I know and have read it sounds very much to me like you are having episodes of super ventricular tachacardia (or SVT).  A friend of mine had this and was cured completely with an ablation - she had the ablation about 5 years ago now and has absolutely no recurrence.  The doctors found when they got my friend all wired up for the ablation and set off the arrythmia that she actually had 2 extra pathways.  She had noticed that some episodes didn't feel quite as powerful as others - which maybe is the case with you if you.  The cardio managed to zap both areas.
If you do have SVT I think ablation is very effective and has good success rates.
By the way - this is NOT panic that you are suffering with.  It's the abnormality that makes you panic, not the other way round.
I feel annoyed that the doctor didn't believe you at first!  As if we want this!
Good luck.
Best Wishes, Linda 123
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Avatar universal
Dear Maria 77,

Thank you for the letter , I am not really sure ,I tried to Pick my Cardio Dr's Brain as Much as I could , but he was on a very tight apointment day.

I know that he has said that dur to fact that my BP was naturally very low , 100/80 and sometimes 90/68 he was very leary of using the beta blockers so made me cut the 25mg dose in half , It seems to help a bit but makes me very tired and I am use to being very hyper and running arround , He did day that the next inavasive treatment is to shock the circut to beating properly ,

I am desperate for info on this , to really know EXACLTY ! what this is ? what causes it ? How to keep it under control , How to exercise with it , etc ,

Mostly when I exercise it happens , but after about 30 min of cardio, pow .. on heavy heart beat and then up to 180.. and then hyperventalation , and that is what really makes be nuts , the heart beat thing I can deal with but the hyperventalation is what really does me in ... and has made me very intimated to work out or exercise in any way ....

Exercise is a great way to make your mind and body feel great and I really miss it !

The Dr. Put me on Xanx .25 three times a day along with toprol xl ... ?? I question the med's as I do not like to take medication if not nessessary , I want to make sure exactly what is it before I start to be a pill popper . I do not want to make the symptoms but want to repair then problem ,.

Any info is greatly appriciated ,please excuse my spelling ( no spell check here lol )

Cindyred

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Avatar universal
I have been having a rapid heart rate and shortness of breath for about 3 months. I am 31 yrs old and 24 weeks pregnant. my resting heart rate is 110-120 and if I do any activity it is not under 130 and it is never under 100 at any time. I don't know if I should be worried about this or not. My OB doctor told me to hold my breath or to act like I am tring to have a bowel movement which is easier said than done.  Does anyone have any ideas on what this could be or any advive on what I should do or am I overreacting?
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