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Avatar universal

atrial tach and atrial runs

Thanks as always for this wonderful service. I'm back on an event monitor because I began having runs of skipped and fast beats around the clock WHILE ON BETA BLOCKERS. I took them for a month and was so fatigue I thought I was going to croak. The dosage was reduced ( i was still having some palps). don't know if that had anything to do with it but I have never in my life had such awful palps, so my doc ordered another event monitor(had one in June showing many PACs, few pvcs,non-sustained PSVT for a few seconds and lots of sinus tach just standing up or doing anything).Had a normal thallium stress a year ago. questions:
1. all i know is my internist took a peek and said i was having some atrial runs ( cardiologist is on vacation)what are atrial runs? I hear runs of fast beats when I send my events via the phone.. those are the ones i correlate with feeling really bad.. they are 3 to 30 rapid beats in a row like you turned on a switch. they start and stop suddenly.
2. I feel my heart skipping a bit when I exercise and afterwards for a minute or two.. I've heard different things -- dangerous or not? of course, on a stress test not one skip.
3. my cardiologist doesn't think an ep is warranted based on last monitor of non-sustained PSVT, etc. what DOES usually warrant an EP study. I WANT TO GET THIS PROBLEM FIXED! tired of it after 20 years.
4.theoretically, could being on metoprolol for one month and stopping altogether have caused me to be extra sensitive to adrenaline and have horrible palps for a while? they started calming down after about a week to 10 days.
10 Responses
239757 tn?1213813182
MEDICAL PROFESSIONAL
ALynn,

trial runs could be a number of things depending on what the rhythm is. Atrial fibrillation/flutter with rapid repsonse, reentrant pathways, even sinus tach. It would depend on what the rhythm is on the monitor. The rhythm will determine what the treatment options are.  

The symptoms of palpitations you have are not dangerous. Not to say they are not an annoyance however.

An ep study would be useful if you have a fixable problem causinf your symtoms. This would be something like an extra pathway that connects the top of the heart to the bottom. This could be localized with and EP study, then potentially ablated using radio frequency energy.  

Some people experience rebound symptoms after stopping beta blockers suddenly.  

Hope this helps.
Avatar universal
Lynn - my (faulty) heart goes out to you and my advice is to get an EP done.  I messed about for 30 years until eventually I asked for an EP, had it, and and now I know what is wrong with me.  You need to tell your doctor what you want - not the other way round - it took me a while to understand that.
Beta blockers made my palpitations worse too.
By the way - you know what they say - "if you don't like what your doctor says - change your doctor"!
Best Wishes, Linda
Avatar universal
thanks, Linda. And, if you don't mind my asking, what WAS wrong with you that the EP study revealed? Did you have an ablation?

Thanks so much for your time.

L
Avatar universal
Lynn if you look back at my posts it details my heart problems!  If you leave your email address I'll drop you a line.
Best Wishes
239757 tn?1213813182
MEDICAL PROFESSIONAL
Lynn,

You should work with your doctor to come to a satisfactory conclusion.  There are certain things an EP study will not help with.

An EP study is an invasive procedure that defines the electrical anatomy of the heart. Once areas are defined to be abnormal, subsequent procedures are done (like radio frequency ablation) to fix the 'faulty wiring'.  An EP study in itself is not curative.  Before having an EP study, there needs to be some evidence that the wiring is abnormal. This would be determined by your event monitor.  If it shows an abnormal wiring connection, or other rhythm problems that are ammenable to ablation then an EP study is warrented.

I'm a very big patient advocate but demanding a procedure is not the solution (Linda, I'm sorry to hear about your ordeal). You should approach your relationship with your doctor as a team, if the answers you are recieving from your doctor are not reassuring or satisfactory, seek a second opinion.


Thanks.
I hope this helps.
Avatar universal
>>>atrial runs could be a number of things depending on what the rhythm is. Atrial fibrillation/flutter with rapid repsonse, reentrant pathways, even sinus tach. <<

My cardiologist said ( about my last month long event monitor results) , and I quote, " there is no suggestion of a fib at all and we don't see any signs of a reentry tachycardia. In fact, I ran by one of the PSVT rhythm strips to Dr.___, (an EP) for another opinion and the more we look at it the more it looks like sinus tachycardia. You do have a lot of sinus tachycardia and a lot of PACs and rare PVCs."

BUT how on earth can an even monitor show things like reentry tachy? maybe the best question, in hopes you can answer this, is CAN it show if a rhythm is reentry or not?

and one more -- if you can please answer -- isn't it true that sinus tach does NOT come on and stop abruptly? there's a "warm up" phase? so runs of 3 to 30 fast beats that start and stop suddenly couldn't be sinus tach? or could they?

Thanks  so much.


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