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

[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]

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

[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.

[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.