Ventricular tachycardia

[wmac]

Hello and thank you in advance for taking my question. First off recap: I have pacs pvcs, svt, aivr and nsvt. Longest nsvt was 26 beats with 187bpm when I was on low dose of toprol xl for three days. I just recently went and saw my cardio/ep and she said that the only two options I have is to do nothing or try flecinide. Well flecinide scares me to death. I would have to be hospital for the first three days. She did a echo and everything is fine with trace mvp. My ef is 74%. She believes flecinide is my answer. I have had two attempted rf ablations at the university of Utah no luck. My cardio in Boise Id will not attempt one she says im not fixable. Well im getting 3-4 runs of nsvt a month. It is controling my life which it has for five years now but my runs are more often and its very disturbing to me. What would cleveland do would they just send me out the door and say dont worry or would they try another eps and ablabtion? I am willing to go there if you think that they would try. All my other heart test have been normal, mri, stress test, ekg, tilt table, etc... I would just like to be fixed and live a normal life. Thank you
also who would you recommend if I go to cleveland?
thanks wmac

[PikaPika88]

Copy and Paste the path (website that I given here).  It brings you straight down to the community board.
Then it'll show you to login. After login and will bring you right to the front page again.  Then you paste the path (website that I given here).  You can start to post.

It didn't have the community section at the front page anymore.  

Please try again.

[knightrider]

I went to i village,but there's no community section anymore.

[PikaPika88]

Here is the link.  It'll bring you directly to the site.  

http://heart.health.ivillage.com/community/index.cfm

[knightrider]

Well,I had my second shock in 20 hrs.I have an Appointment tomorrrow to get myself checked.This time,I was just going for a walk. PIKA,what was the old link where everyone was before they closed off our forum.

[wmac]

Gosh I havent been to that site in awhile how is everyone doing over there??

[PikaPika88]

Knightrider, the site where we come from is still open.  Sue, Tony, Ireneo and ....... many of them still there.  Ian is here too.  I think mine PCD is almost same as Ian one.  His one is newer version, smaller and lighter but the function is almost the same.  Both are St Judes.  Pacing at right ventricle can cause heart failure or LBBB, do you know that?  While my EF is still good.  This time when I see him, I'll ask him to turn it off because he didn't know how to turn it down.  
http://www.medhelp.org/forums/cardio/messages/34886.html

Wmac, why I have the PCD?  It is a very long story.  At first they told me put the pacemaker in then I don't have to take medicine.  But it wasn't true and it only lasted for 3 days.  They gave me a bag of med to take home and enjoy when discharged.  After that, each pacemaker replacement, they upgraded.
Now my left wall movement is impaired.  My left side beating can't catch up with the right side pacing!  Errrrr, hard to understand?  Hard to believe too!  I've wpw.

[knightrider]

Mountain Home Arkansas.The ICD is all one unit.

[wmac]

Why do you have a pacer and an icd?? knightrider do you mean Mountian Home Idaho??

[wmac]

Ok im a bit confused. If your heart is quivering wouldnt you be in vfib and if your in vfib you would be unconcious right. So when you got to the er were you in VT? Did they ablate your vt did it turn into sustained vt  explain to me more info to why you had an icd implanted???  Had you had heart problems before or symptoms you said they found a small blockage but it had nothing to do with it right? explain to me all you can please.
wmac
thanks for your post

[knightrider]

OK,I had a pacemaker placement in 2000.Betweeen 2001 to 2004,I had 4 ablations.The 4th one they made me pacemaker depended.2006,I needed a replacement due to the battery was low.Dec.2006,they tested it and everything was OK.Jan.2007,I had a episode where for about 20 mins.with the sweating,weak,and my chest was pounding with my shoulders feeling like they had a ton of weight on em.In mid Feb.I had another one,but it lasted close to an hour.I went in to my Cardio and he checked my pacer and the findings were,from Dec to the present time,I had 250 episodes but felt only 2.He put me on Cardizen.It was the 2nd day when the 3rd came along.This one lasted forever,but I had passed out for a few seconds.The wife took me to the ER.There they ran a EKG and B/P was 50/40 with a pulse over 200.I seen the pads coming and was shocked.This brought me down and B/P backed up.
While in the Mountain Home Hospital,they done a Angiogram to see if a blockage caused it.Results had shown no.They sent me to Little Rock Hospital to have a Electrophsiology Study done.Test results had shown I needed the ICD.

[PikaPika88]

knightrider,

Isn't it your pacemaker already had and ICD?  If I'm not wrong, why your pacemaker didn't kick in?  I think yours pacemaker is same as mine.  Would your cardio turn it down to too low?  or your Pacer had some reason FAILED! Don't scare me!  

[knightrider]

It took me awhile to find some of U.Where has everyone been hanging out.Besides U,I found VA TONY.OK,I had only a pacemaker which it's
use was for preventing my pulse from going low.With this ICD,it slows my pulse down from racing high.I have a Pacer and a Defibrillater (ICD)

[knightrider]

I just got out of the hospital about a week ago.I just went through an episode.At the time I was pacemaker depended.I was working outside when my chest was pounding and felt funny.Checked my B/P and it was 50/40.Got to the ER and the EKG had my heart Quivering and pulse over 200.They had to shock me while awake.WOW.Well that got me on the right track.They ran an Angiogram and found a small blockage 30/35 that couldn't set it off.They then shipped me to Little Rock Heart Hospital ( Arlansas ) There I had an Electrophysiology Study.They discovered I have Ventricular Tachycardia.I ended up getting  Implantable Cardioverter Defibrillator  ( ICD ) and meds of MEXILETINE 150mg 3 times aday for starters.

[wmac]

Im actually from McCall!! I see Dr.Marks

Celest, I went to Dr. Freeman, Dr. Wall did the first eps and Dr. Klein did the second one.

[wmac]

I dont know if youll see this or not. But you mentioned the monthly cycle. And that is when I usually get my runs of nsvt. Is usually the week prior to the cycle if its not then its during and or after. But its always around that time of the month. Does that change the signifance of anything meaning less worrisome. thanks for your time.
wmac

[Celeste07]

Sorry to hear about your ordeal. You mentioned that you come down here to Utah to see your Cardiologist at the U. I was wondering if you have checked out other Cardio's here? I too have arrhythmia's, mainly PVC's, some runs of NSVT and recently, I've developed IST. I see Dr. Jeffrey S. Osborn with the Utah Heart Clinic. I have to tell you that he is one of the best here. Dr. Osborn specializes in Arrhythmia's and Electrophysiology. I simply adore him.
Anyway, I just wanted to give you an option if you ever wanted to get a second opinion at some time in the future...

Here's some info on him if your ever interested...
http://www.utahheartclinic.com/physician.php?Pid=15&PHPSESSID=b8419545aaae982ac3d04a00729044ed

[shooie]

Hey - I'm from Boise too!  I totally understand the frustration and how all this can overwhelm your life.  I've been through years of all the monitors, tests, medications, pvcs, pacs, psvt, etc.  I also considered a visit to CC just for peace of mind.  If you do go, I would love to know if it helps with resolution for you.  Who is your cardio here?  Best of luck!

[Forum-M.D.-MJM]

Hi WMAC,

I understand your concerns.  To some people, PVCs and NSVT has significant impacts in quality of life.  

The standard of care for PVCs and NSVT with a structrually normal heart is reassurance that this is not a life threatening rhythm and beta blockers to reduce symptoms.  Beta blockers work for some people and not others.

The next step for symptomatic PVC/NSVT in a structurally normal heart is usually a class Ic medication like flecainide.  Flecainide may help to reduce your symptoms and is worth trying.  Some physicians do not even hospitalize patients for drug loading of flecainide.

If you continue to have significant symptoms and understand the risks of the procedure AND your PVCs/NSVT have on predominant morphology (location in the heart), an ablation is a reasonable options.  Important questions are what triggers the rhythm (stress, exercise, caffeine, change in menstrual cycle).
The morphology can be tricky to catch -- it is most helpful to see it on a 12 lead EKG and that is sometimes hard to get.

As far as who to see....that is tricky question because they are all very good. Patrick Tchou and Robert Schweikert two physicians that may be helpful.

If you decide to come, bring records with you.  They sometimes don't make it from your doctors office.  Any 12 lead EKG with the PVC, echo report, previous EP studies, etc.....

I hope this helps.  Thanks for posting.

[wmac]

Well I too had a loop recorder for awhile. I just know what they feel like. My svt is fast feeling my nsvt is slow feeling even though it actually is fast. when I had the 26 beat run i felt a thug and felt like a reallllllllllllllllllllllllllllll long pause then boom. All my other nsvt runs feel like thump thump thump thump with no normal beats and I have worn a king of hearts monitor and the 24 hour monitor enough and every time I suspected it was nsvt it was for sure according to the monitors. so I really have no doubt to whats going on. I wish  was I just ignorant to all of this because I really believe it now ignorance is BLISS!
  

Carrie I would like to hear more of your story about your nsvt!

wmac

[Momto3]

EEE GADS!!  My oooops!!!  I meant VT is at least a 30 SECOND run......Sorry everyone!!

[sb786]

Hi there, hope things are good with you. I've decided to go for the ablation which is now booked in for late June! I am hopeful that the procedure will be able to offer me some relief from the anxiety. I just hope that once the svt is ablated (fingers crossed) the pvcs will not bother me as much. I'm hoping that i will be able to just accept them. Thank you for the link it was very helpful in explaing what vt is.

[maggiemag]

wmac, can you say how you know the runs you feel now are NSVT??  It could be that they are SVT, as they can feel the same.  I have both and if I feel a run it is SVT, and I don't feel the NSVT, if you can believe it!  I have a loop recorder so it is interrogated every so often.  Flecainide sounds a bit drastic with all the possible side effects.  I understand how they can produce a lot of anxiety, but... you need to do what you have to do.  Good luck.

[tickertock]

I think, though I'm not sure a 26 beat run of nsvt at 187 bpm would only last around or little over 7 seconds, not even 8 seconds. I think sustained Vt is defined as 30 seconds and over, though I imagine 5 seconds of nsvt would feel like an eternity if you're aware of it.

It is my understanding that nsvt is basically treated no differently than simple PVCs and the prognosis is basically the same with a normal heart, even normal heart VT pose very "little" risk and the "risk of SCD" is probably on par with the general population than dont have it.

They know alot more about arrhythmias these days than they did 20-30 years ago through long term studies, monitoring & EP studies. Though terrible and annoying to those who feel them they are merely a nuisance and rarely pose a threat to a otherwise normal healthy heart. This is my understanding only I'm not an MD.

To wmac if you are definitely having hard time coping, then maybe a consult with CCF would put your fears to rest. Good luck.

[CollegeGirl143]

you sound just like i did.. I wouldnt let myself be more than 5 minutes from a hospital at any given time.. dont blame yourself, its not really your choice at this point.. if you could make the choice at this point, whether to just "be ok" or keep suffering, well duh thats not a hard choice! LOL... I think you're doing the right thing by fighting back the way you can and trying to seek help.. i hope they can give you some help so you can take some of the focus and put it into other things, like healing mentally as well as physically, it takes a HUGE tole on someone mentally to constantly be fearing for their life.