Atrial Tach. and Norpace

[Sue143]

I had a heart echo which was normal and wore a holter while I was on atenolol and then 2 wks after stopping it cold turkey because my BP had dropped too low 90/56, and at night I felt like I was going to pass out, and my HR was 42 at night. My BP is now 98/60 which is ok for me. I weigh 103.

Holter showed PAT and lots of PVC's. Atrial tach is usually 120-150bpm. HR at night was still at 43. I still have lots more palps than I ever had before my a-fib episode in July. But there have been some days since I quit taking them that I have hardly any at all.

Dr. said the PAT is what triggered a-fib and is going to talk to the EP Dr. to see what meds I should take and possible ablation, but he said he's leaning towards me taking Norpace. He said it may be hard to find the focal point for the ablation. I read about Norpace and it said you shouldn't take it unless you have a life threatening arrythmia since the mortality rate is higher in people who take it than the people that live with their PVC's.

Is Norpace the right med to take for this? Can one a-fib episode cause such an increase in palps over what I had before or could it be from going off the atenolol and it's taking my body time to adjust, since my HR is still 43 at night. I admit I do focus on them sometimes now when I never used to, but if I had an eyelash stuck in my eye constantly bugging me, I'd focus on it too. Also, is an ablation for PAT that difficult? An ablation scares me alot but so does the medicine. I don't know which one is worse.

Thank you for any help! Sue

[Sue143]

Sorry I was confusing. I'm only 38yr old, I don't believe I have heart disease. I have occasional bouts of atrial tach., maybe 2-3 a month. Normal sinus rhythm and they usually only last a few seconds. I've always had PVC's which never really bothered me. I've had all this for almost 7yrs. I've only had one episode of a-fib with HR 180. They stopped the a-fib with a Cardizem drip and I haven't been in a-fib since then. I now get more PVC's than I used to after taking beta blockers. They sometimes even make my breath catch with them and I never had those before. Right now I'm drug free and normal sinus rhythm, just extra palps. and the bouts of a-tach.
The Dr never mentioned a calcium channel blocker, which I'd rather try first.

Thanks for the help! Sue

[pat57]

WELL, I take norpace, it was a godsend for me. I was not aware of any problems with it. To tell you the truth, I don't care, I functioned poorly without it. I do have a differant diagnosis, neurocardiogenic syncope.

good luck

[Cleveland Clinic]

Sue,

I'm a little confused by exactly what your diagnosis is. If you have atrial fibrillation and are getting occasional bouts of it causing palpitations, if you have an atrial tachycardia, or if you have isolated PVCs.

If you have atrial tachycardia a EP study may be helpful in isolating the pathway. If found an ablation may work and save you from having to take an antiarrhythmic medication.

If you are having recurrent atrial fibrillation, some antiarrhytmic medications may keep you in sinus rhythm and spare you the palpitations from the fibrillation.  There are some EP procedures available to try to keep you in sinus rhythm if you are refractory to drug therapy. Also if this is the case you should investigate coumadin therapy.

If you are having frequent PVCs norpace might be considered as an agent if you fail beta blockers or calcium channel blockers. Norpace is an antiarrhythmic agent that carried some risk of causing arrhythmias. In patients that had a history of heart attacks, these agents caused an increase of mortality. Thus they carry pretty serious side effects. If you choose this type of medication you should make sure you do not have heart disease. There are slot of ways other people on this forum have dealt with the side effects of beta blockers and the symptoms of PVCs that you might seacrh to look into.

good luck.