Aa
vtach
If I understand correctly I am allowed this last question for 6 months. I have had ekgs, 30 day event, 24 hour holter, echo all within this past year. Three years ago a stress test. I was told I have mild mvp with mild regurgitation, tricuspid mild regurgitation, mild leaflett thickening, first degree heart block, thousands of pvcs-mostly unifocal some multifocal. I was told my heart is fine. I am female age 41. last night I was leaning my head/neck on my hand and not looking for it, but fel 3-4 very quck beats followed by regular beats. The beats were fast, lsting under a second. I am not on any meds and I prefer no meds and non invasive. So, if you were me, what would you do next in light of the 3-4 beat run? Also, I was told I had 2 episodes of Supra Ventricular tachy--but it was never proven. Could it possibly have been that? I felt no flutter or pause after. Will you please tell me what you would reccomend and is there something that is tying all this junk together (block, thousands of pvcs, pos.svt, this recent vt)
just another point also; all research is done for one reason or another and funded by side A to prove their theory of XYZ [insert whatever here]. Side B then does their research to prove Side A wrong; then Side C comes into play and tries to prove both of them wrong lol it all depends on what the research is, who the subjects are and who funds the research for what the outcome of XYZ will be. Which is why now coffee is GOOD for you lol
Down the road, I'm sure the research that you found BBXX will be either supported or contradicted as all research is done, just as anything I've found will be also....
I can't agree more, we're not carbon copies of each other and dr's do need to take note that patients are individuals and look at all aspects of health issues not just some outdated research done 50 years ago; they need to look at it all.
Every so often, we're lucky enough to find a doctor who thinks outside the box and does the research for themselves...I can't tell you how relieved I am that my new cardiologist is an outside the box guy - he may find what other dr's haven't, who have tried to peg me in a round hole when I'm just a square :P
Down the road, I'm sure the research that you found BBXX will be either supported or contradicted as all research is done, just as anything I've found will be also....
I can't agree more, we're not carbon copies of each other and dr's do need to take note that patients are individuals and look at all aspects of health issues not just some outdated research done 50 years ago; they need to look at it all.
Every so often, we're lucky enough to find a doctor who thinks outside the box and does the research for themselves...I can't tell you how relieved I am that my new cardiologist is an outside the box guy - he may find what other dr's haven't, who have tried to peg me in a round hole when I'm just a square :P
MEDICAL PROFESSIONAL
Before commenting on the study that showed an association between increased PR Interval or 1st degree block with increase in the risk of atrial fibrillation and pacemaker implantation, I want to give an example where correlation studies may lead to confusion. Many years ago a major medical journal published a study demonstrating that there was an association between coffee drinking and pancreatic cancer. This single study led to almost an overnight change in medical practice, yet if one looks at the details of the study, coffee was only ASSOCIATED with cancer, therefore, only a correlation, not a causation. It was found later on that that vast majority of people who drank coffee were smokers, and therefore, coffee was a confounder. Coffee did not cause cancer, it merely went hand in hand (cigarrette and coffee mug) with cigarrette smoking, which was causing pancreatic cancer.
That being said, in general we know that 1st degree AV block in normal health adults with no coronary disease has a good prognosis. A recent study published in JAMA took a cohort of patients from the Framingham Heart Study and compared people with PR Interval >200 compared to those below 200 msec.
THey showed a statistically significant increase in the long term risk of Atrial fibrillation and permanent pacemaker implantation, and in fact, possibly all cause mortailty. While they tried to make adjustements for all known factors that could be confounding, you have to understand that this was merely an association study, and it could be that people who had 1st deg AV block in this study could have been sicker in general than those who have 1st deg AV block outside of this study, we have no way of knowing. In addition, all increased risk is not the same. If I tell you walking down the road will increase your risk of death, you should ask, by how much exactly? If I say it would double, then the next question should be, double from what? My point is that if your risk of gettin a pacemaker without 1st degree block is 0.2%, and the risk with 1st degree AV block is 0.4%, while the relative risk has doubled, the absolute risk remains very very low. To put it in perspective, the risk of pacemaker implantation went from 6 per 10,000 person years to 59 per 10,000 person years. While the relative risk looks high, the absolute risk is not.
I hope this makes sense and allays some of your fears.
That being said, in general we know that 1st degree AV block in normal health adults with no coronary disease has a good prognosis. A recent study published in JAMA took a cohort of patients from the Framingham Heart Study and compared people with PR Interval >200 compared to those below 200 msec.
THey showed a statistically significant increase in the long term risk of Atrial fibrillation and permanent pacemaker implantation, and in fact, possibly all cause mortailty. While they tried to make adjustements for all known factors that could be confounding, you have to understand that this was merely an association study, and it could be that people who had 1st deg AV block in this study could have been sicker in general than those who have 1st deg AV block outside of this study, we have no way of knowing. In addition, all increased risk is not the same. If I tell you walking down the road will increase your risk of death, you should ask, by how much exactly? If I say it would double, then the next question should be, double from what? My point is that if your risk of gettin a pacemaker without 1st degree block is 0.2%, and the risk with 1st degree AV block is 0.4%, while the relative risk has doubled, the absolute risk remains very very low. To put it in perspective, the risk of pacemaker implantation went from 6 per 10,000 person years to 59 per 10,000 person years. While the relative risk looks high, the absolute risk is not.
I hope this makes sense and allays some of your fears.
Dear bbxx
I don't know who told you that 1st degree AV block wasn't benign, but if I were you, I would have faith in the MD's. The cardiologists here seems extremely qualified, and if you can't trust them, who can you really trust?
It's important to know, all the stuff we read about PVCs, VT, etc. usually apply to those with heart disease, often coronary artery disease. A heart muscle that suffer from lack of oxygen is 1) highly irritable and 2) if it's forced to beat really fast, like in the setting of sustained VT, it's suffering even more, and that's when the scary stuff with VT may occur.
I once scared myself so bad that I got immobilized, reading about PVCs, early PVCs, VT, VF, etc. After some time, I realized that while I understand the terminology, I can't place it in the correct setting, and this knowledge is useless and just scary.
The only result from reading up on this is more PVCs. Not dangerous, but not the cure you want, is it? :)
By the way, I don't think you would feel the pulse if you had a 3-4 beat of VT during a second. The heart would probably not be able to fill up with enough blood to create a pulse wave. Not sure about this, though, and it doesn't really matter. Like the cardiologist said, either way you are fine. I would trust him if I were you.
I hope you will feel better :)
I don't know who told you that 1st degree AV block wasn't benign, but if I were you, I would have faith in the MD's. The cardiologists here seems extremely qualified, and if you can't trust them, who can you really trust?
It's important to know, all the stuff we read about PVCs, VT, etc. usually apply to those with heart disease, often coronary artery disease. A heart muscle that suffer from lack of oxygen is 1) highly irritable and 2) if it's forced to beat really fast, like in the setting of sustained VT, it's suffering even more, and that's when the scary stuff with VT may occur.
I once scared myself so bad that I got immobilized, reading about PVCs, early PVCs, VT, VF, etc. After some time, I realized that while I understand the terminology, I can't place it in the correct setting, and this knowledge is useless and just scary.
The only result from reading up on this is more PVCs. Not dangerous, but not the cure you want, is it? :)
By the way, I don't think you would feel the pulse if you had a 3-4 beat of VT during a second. The heart would probably not be able to fill up with enough blood to create a pulse wave. Not sure about this, though, and it doesn't really matter. Like the cardiologist said, either way you are fine. I would trust him if I were you.
I hope you will feel better :)
MEDICAL PROFESSIONAL
certainly could have been SVT but cannot tell without the rhythm strip monitor
Either way you are fine
Either way you are fine
MEDICAL PROFESSIONAL
PVCs in the absence of structural heart disease are normal. Your echo, while showing mild mitral valve prolapse, was overall normal based on your report which is good news. The first degree AV block simply means that there is a little bit of a slow connection between the upper and lower parts of the heart, but is of no consequence currently and does not need treatment or a pacemaker. PVCs that are a few beats here and there are of no consequence. Usually, if people have PVCs more than 10,000 per day we consider them to be a lot. The only issue is that if a person has so many PVCs per day, there is a chance that the PVC burden could gradually weaken the heart, but that would manifest as a low heart function (low ejection fraction which you do not have). If PVCs are less than 10,000 per day then this would be a low risk of having any problems on the heart, and would be more of an annoyance to you than anything else.
Overall, the summarize, there has been no demonstration that any of your rhtyhm abnormalities are harmful to you and especially given your non-invasive penchant, I would relax and do nothing at this point and enjoy life.
Overall, the summarize, there has been no demonstration that any of your rhtyhm abnormalities are harmful to you and especially given your non-invasive penchant, I would relax and do nothing at this point and enjoy life.
Thank you so much. That helps HUGELY! I appreciate that you took the time to reply and help alleviate my fears. Just the fact that you did that, when you could have been content to just move on, shows you are a caring doctor/person. Thank you so much.
you asked why I researched this? The truth is, a lot of doctors are too busy to really look into your health issues as if it were their own. I was mis-diagnosed once--told I was healthy and nothing was wrong, yet I did not accept what I knew was bogus information inspite of it being told me by my primary care doc, as well as an ER doc, as well as another doc. that I had nothing wrong other than anxiety. I could have died had it not been for my persistence. You see--they use standard charts to diagnose--I am not a carbon of someone else--I am me. My brother was always told he was fit as could be--all growing up--told him is low heart rate was due to his fitness level--in spite of him telling them he never exercises--He almost died at 20 when he collapsed and was taken for emergency surgery to get a pacemaker. I can give you another situation -also, the time a relative had open heart surgery and was having some issue after and her surgeon and doc. were stumped. It took me several hours a day and two weeks, but I found it. I cant remember the name of it now, but anyway my point is they dont have the time to research like I do and they dont usually look at things in more than one way, and when it comes to your health you have to research things in case they miss something. Obvously they have an understanding of things in a way I dont, which is why I can ask them if 1st degree heart block can cause afib, could it be causing my pvcs, or svt also? I dont know how the whole heart works, but they can take my question and tell me if its related to the same parts of the heart or not if its possible or not. I am in no way minimizing their knowlege nor the concern that many of them to have for their patients. I just want to be sure something is not being overlooked. :)
The study I am talking about is the Framingham study (I will send you the link). It is the "newest research" that says 1st degree heart block is not benign and is 2xs more likely to cause afib, and 3xs more likely to need a pacemaker. I will send you the link. I just have enough rythn issues already to deal with.
Sorry to reply to this post again (but it will not affect if a doctor will or will not answer you).
Are you referring to the studies by dr. Bernhard Lown?
Well, several things may contribute to A-fib. PACs can contribute to A-fib but most people with PACs don't get A-fib. And, if you should get A-fib, the 1st degree AV block will actually help you slowing down the ventricular response. That's a good thing.
I don't know if there is a correlation between this, but I would assume that people with A-fib often have other conduction disturbances. I think A-fib rarely appears if the heart is completely healthy. Often long-standing hypertension, causing some sort of structural change, is to blame.
I'm sorry, but I have to ask you the same question I often ask myself. Why on earth did you discover this research? This is meant for specialists in internal medicine and cardiologists, not for us. We (you and me) are not able to interpret this research (as you say) and that's a pretty good argument that we shouldn't try.
As you probably know, A-fib is not a lethal condition, and you shouldn't be afraid of it. If you once in the future develop A-fib, see a cardiologist to get it converted, and if it reoccurs, get it ablated. If your heart is structurally normal it will probably succeed. Until then, forget the A-fib. We can't spend our lives worrying about lots of conditions that will probably never happen.
Are you referring to the studies by dr. Bernhard Lown?
Well, several things may contribute to A-fib. PACs can contribute to A-fib but most people with PACs don't get A-fib. And, if you should get A-fib, the 1st degree AV block will actually help you slowing down the ventricular response. That's a good thing.
I don't know if there is a correlation between this, but I would assume that people with A-fib often have other conduction disturbances. I think A-fib rarely appears if the heart is completely healthy. Often long-standing hypertension, causing some sort of structural change, is to blame.
I'm sorry, but I have to ask you the same question I often ask myself. Why on earth did you discover this research? This is meant for specialists in internal medicine and cardiologists, not for us. We (you and me) are not able to interpret this research (as you say) and that's a pretty good argument that we shouldn't try.
As you probably know, A-fib is not a lethal condition, and you shouldn't be afraid of it. If you once in the future develop A-fib, see a cardiologist to get it converted, and if it reoccurs, get it ablated. If your heart is structurally normal it will probably succeed. Until then, forget the A-fib. We can't spend our lives worrying about lots of conditions that will probably never happen.
Well I Find this very scary and upsetting. This study was done on healthy hearts. I have always been told my 1st degree heart block would not progress, now it not only may but causes afib? Supposidly this test was in all healthy patients. I see on all experts the cardio there told someone in 2006 "it will never cause anyone any trouble". Well, tell me something--dont doctors monitor their patients and notice that gee, my 1st degree a/v block patients almost always worsen or get afib? I mean what- do they just wait for someone to tell them "now we will say it is not safe" come on? Surely they can notice things on their own. For YEARS I was told it would most likely never worsen and that it wouldnt cause any other issues. You would think at least of my doctors would have noticed a trend and re-thought what they were telling me? I am sorry, but I didnt really understand the long complicated study. Can someone tell me what is the % out of how many people that end up with afib and needing a pacemaker? I hope the doctor replies soon since none of the ones I see, seem to have a clue.
Oh stink, I hope you see this. Someone just pointed me to a study on 1st degree heart block not being benign as they use to think. Does this make my situation worse?
Thank you so very much for taking the time to answer my questions.
Thank you for your reply. Is it possible it was svt?
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