benign arrhythmias

[jan]

Dear Dr.,
When I wore a holter a couple of years ago it showed long periods of tachycardia and I was diagnosed with IST, but I rarely had palps with that. I wasn't even aware of the tachycardia. Now I get palpitations everyday here and there and never thought much of them, everybody gets them was my thinking. I always figured they were PAC's or PVC's, they felt just like everybody describes. I wore an event monitor to try to catch an episode of syncope, that never happened, figuring that might be the case I recorded several times when I had palps or dizziness. It didn't show premature beats. My primary said I sent runs of tachy, tachycardia (I guess sustained),bigeminy, and trigeminy. I don't know what else was found because that was in the beginning of the month wear'g the monitor. I was also admitted to the hospital after my 2nd syncopal spell. (They had tossed aside my diagnosis of NCS that they had given 2 yrs. ago, also, because ONE spell looked like a seizure). While being monitored there I had tachycardia and a night of afib, I don't know if anything else. I was on Toprol XL 50 mg.

Anyway, all of that just to ask if these are benign, too. I have mild MVP w/mild MR and TR, but since dr.'s seem to think this is normal I don't think that should matter, but have read...

Also, about the NCS...I was told in the beginning I wasn't textbook by both my neuro and EP. According to Dr. Blair Grubb (not my dr.) some people do experience episodes sitting down and it isn't uncommon for it to appear like a seizure. Are you aware of this? It doesn't seem my dr's are. I am now being sent to an epileptologist at a univ. hospital and I am not thrilled! I will be seeing an EP there, also. I have seen the EP once, (He needed more info.), but it seemed he jumped on the seizure ban wagon already.
Thank you for your time and any thoughts you might have.

[Twelve]

I too have been suffering from PVC's for sometime now.  The irregular heartbeat that I have was only diagnosed last October following a fainting spell at work.  Since then I have also been diagnosed as "a classic case" of Vasovagal Syncope which they recommended installing a pacemaker for.  As I am only 34 years old and in fairly good health otherwise, I was not in favour of jumping to a pacemaker.  As my blood pressure is normally low for me, I have been told to increase my salt and water intake and most of the time, this works however during the time of my period, my dizziness seems to get worse.  I am now waiting to see an electrophysiologist for a second opinion.  The PVC's occur constantly in my case.  My heart goes thump, thump, space thump and then repeats itself.  Sometimes it beats so strongly that if I am sitting watching TV or lying in bed my body actually moves. I have been told not to worry about it but that's easy to say and  not as easy to do when you feel like you heart is beating as if you were running a marathon when all your doing is trying to sleep.  Hang in there and seek the medical advice that you need until you find a doctor that is easy to talk to and can help you deal with the emotional reactions to the PVC's.

[tpeterson]

I have no idea why he told me to cut out carbonation - I suspect it has more to do with trying to raise my heart rate than it does with blood volume. My therapy has three goals: raise blood pressure, raise heart rate, and decrease the size of the left side of my heart.

[CCF-M.D.-CRC]

Dear jan,

To answer your second question first, yes you can have some unusual types of syncope when sitting down and it can look like a seizure.  The best way to exclude this is to try to cause a syncope episode during a tilt-table test.  However, that being said it is also a good idea to exclude seizures as these are a common cause for "syncope".

In regard to your first question, bigeminy and trigeminy are in general benign.  The finding of tachycardia is non-specific and could be due to a variety of different things.

[tpeterson]

I also have sporadic episodes of syncope (may 3-4 a year) and while they just feel like passing out to me, my wife was freaking out becuse to her they looked like seizures. My eyes roll back in my head, my body goes rigid, and I make snorting noises like I can't get any air. My cardiologist suggested a tilt table test that immediately duplicated an episode with what appreared to be a seizure. It turned out to be a miscommunication problem between my heart and brain. So my therapy was to drastically reduce my exercize (down to an "average" level), eliminate caffine, carbonation, sweets, and increase my salt and water intake.

It seems to have worked, I haven't had a spell in 9 months.

[SHER]

I'm just curious. Why did you cut out carbonation? Did your doc suggest that? I can understand cutting out the caffeine and increasing water and salt ( to give you more blood volume ) but what's the deal on the carbonated beverages?

thanks.