Question about multiple sustained v-tachs

[TheButchersWife]

My husband is a 26 yr. old who was diagnosed with viral congestive heart failure and NSVT about a year ago. He is 5'11" and weighs about 155 pounds.His heart function is about 15% and his ejection fraction is between 5 and 15%. He has been in and out of the hospital multiple times with edema . He has runs of PVC's that go up to20-25 on occasion. He has had multiple episodes of non-sustained V-Tach that the doctors have told us not to worry about. He has been in the hospital for 3 days now on a lasix drip, dobutomine (sp?), and nitroglycerin to help reduce the edema, but the doctors failed to give him a potassium supplement during this time, which caused him to have 3 attacks of sustained V-Tach within hours of each other, 2 which were within minutes of each other and his heart rate is raising to 120-125 in between v-tachs. He has a bi-v pacemaker and defibrillator implanted, but has not been shocked as of yet. The doctors told him this was because of lack of potassium in his system. What I'm wondering is... Is this something that could turn into a permanent situation, as in could his non-sustained V-tach diagnosis change to sustained v-tach after having multiple episodes of it, or after he gets the potassium that he needs is it likely that it will return to non-sustained?

[TheButchersWife]

Thank you very much for your help and caring thoughts. We live in Ohio and OSU Medical Center (Ross Heart Hospital) is supposed to be one of the best in the country, with the highest about of survivors after heart attacks..  Up until now, they have been fantastic, but the problem this time is that I was not actually at the hospital to ask the questions that needed to be asked, and make the observations (such as not giving him the potassium supplement) and he has gotten so used to me being there to do that stuff for him.... I would have noticed that they weren't giving him what he needed...  This was a very big mistake on their part that should not have happened... They should be better at keeping up with stuff like this for being such a "great" hospital...  He had a heart cath today and now has a cath line sticking out of his neck and can't do anything for himself, so at least I'll be there with him now and can make sure they are actually doing their job and not trying to push him through... He's been having sustained and unsustained v-tachs for 24 hours and all they will tell me is that he's in good hands...   as if I can trust that...  
Thank you very much again for your concern for me and my family... I'll be praying for you and your family... Best of luck with your future :)

[Mom2four85]

oh wow :*( so sorry to hear that - the things they put patients through...you have to make them tell you things sometimes, make sure you keep a book with notes and things they've said or done handy and ask questions and make sure they give you the answers - it's what you and your husband deserve.

if he's having that much trouble, what about another doctor or hospital there has to be something they can do for him; they should know with the fluid loss so quickly that the electrolyte imbalance was going to be there and he suffered an a shock he didn't need to go through had they been more diligent...

did you ask if they could do a lower dose drip through the IV? so it will be continual...but if he can stomach it with pudding that may do it also; hopefully someone else will know more about it - I know we have quite a few nurses here and in the heart rhythm so maybe they'll have some ideas also.

take care of yourself also; sounds like your family has been through enough stress already

[TheButchersWife]

Thank you very much. The problem with the potassium to begin with was that they just didn't give him any potassium supplement, even though he was on a high dose lasix drip. He lost 14 pounds of fluid in 18 hours, and for some reason forgot he needed potassium. They gave him the liquid potassium and he tried, but could not stomach it. He has problems taking pills, and the pills are VERY large and grainy... When they gave him the pill form, he puked. Then they tried IV potassium... That burnt so bad he was crying and rocking back and forth, and he does not cry....  ever...  So FINALLY around 2 a.m. they crushed one up and put it in pudding and he got it down, but still had a sustained v-tach afterward because it wasn't getting in his system quick enough. Then around 4 a.m. they did the same thing, and the v-tachs have stopped. I just always feel like the doctors are keeping information from us because they think we are too young to handle it... I just turned 25 (was only 23 when he was diagnosed) but of course this situation has caused both of us to grow up very quickly...  

Thank you so much for your reply. I wish you all of the luck in the world with your situation and health.

[Mom2four85]

There are many of us with pvc's and magnesium or potassium are the culprit, once it's treated and on an even level, the arrhythmia's it has caused will go away.  

Your husband's case is a bit more complicated with CHF, hopefully they will get the potassium under control but there may be a reason they don't want to do it with other meds he's on - I would definitely ask his doctor about this to get some answers.

I have a pacemaker/ICD due to malignant pvc's (polymorphic VT) and have NSVT runs about every other day, sometimes 2 or 3 times a day.  My Teligen 100 senses the arrhythmia's and paces my heart rate down to where it's supposed to be.  Mine is set at 220 bpm and if my hr stays at 220 or I get VT more than 30 sec then I get shocked...normally by the time that 30 seconds is up my hr is down and my pvc's have abated.

Please talk to his doctor about this and if the hospital doctors don't give you answers, get his regular cardiologist/EP to give you straight answers.