multiple atrial arrhythmia cause

[bama jane]

for four years I have had multiple atrial arrhythmias, sinus tac to 150 or 160, (once 197) accelerated junctional rhythm, junctional rhythm, short runs daily of atrial tach, wandering pace maker,sinus arrhythmia,daily pacs (trigeminy and bigeminy of these) and some pvc's.  This all came on suddenly after a trip to Yosemite. Was very active aerobics instructor and showed horses, ran 7 miles behind a dog sled in Canada just months before this started. Never had a misbeat in my life that I know of before this. Tests have been 2 super fast ct scans (0 score)nuclear heart scan, clear except for sinus tach to 160 during test,blood tests for normal things and lyme disease, all okay. Numerous treadmills, echos (no valve problems) and an ep study at San Fran. Diagnosis being hypersensitive sinus node. My diagnosis is multiple atrial rhythms of unknown cause. Father had svt starting at same age mine did 48. Recently his turned into afib, but contributing factor of serious copd. Have been told by 2 ep's that my heart is all over the place but not to worry isn't lethal.  My question is any ideas on what could have caused this to come on so suddenly? I feel if we knew why this is happening it may lead to a fix. The extra beats really affect my sleep and quality of life (although I have gotten better at living with it.) I take atenenol and attivan to help with sleep since I do better with some sleep. Have tried almost all other meds and didn't work or had intolerable side effects.  Have seen some good docs, no one knows why and they don't think an ablation could fix everything.
thanks

[Scientist]

On pubmed (and in other sources) I've seen lots of articles relating various viruses (not only coxsackie but, e.g., Epstein Barr, which seems to be a causal factor in my CFS) to arrhythmias, often through myocarditis, but also involving different infections.  I haven't found any research that investigates the proposition that arrhythmias such as afib are generally caused by a chronic viral infection.

Personally I suspect that my atrial flutter is caused at least in part by infection.  One phenomenon I find interesting is that when I take an antiviral (I've used many, including Chinese herbs, other herbs, foods and spices, but mostly ionized silver) the arrhythmia is affected (with silver, improvement followed by worsening as I increase the intake).  This may be caused by immune mediators (histamine) or it could be (that and) something else.

[dodgybeats]

Hey Scientist
Thats a very interesting point, I do know that PVCs can be used as a rough indicator of lymphocytic interstitial myocarditis in immune-compromised patients, such as those with AIDS.  Some of the viruses involved include entero- and adenoviruses.  Has pubmed revealed anything?  I've put this sort of question to my cardiologist before and he is only aware of coxsackie B-induced myocarditis leading to dilated cardiomyopathy.

[Scientist]

Some arrhythmias. I understand, are caused by chronic infection (usually I see references to various viruses).  Does anyone know the prevailing speculation of informed medical practioners and researchers, regarding infection as a likely cause (albeit not a proven one)?  If it were a reasonable probability, it would be possible to treat the underlying disease experimentally, as certain antivirals seem to carry little risk.

[dquenzer]

I wouldn't rule out an ablation.  The EP that I went to at Mayo stated that even if an ablation doesn't fix everything, it can fix enough that meds will work better.

[CCF-M.D.-RCJ]

bama jane,

Thanks for the post.

Many cancer patients ask themself the same question: why me? or why now?

The bottom line is that we don't know why most people develop arrhythmias when they do.  A minority of persons will have an obvious precipitator, such as a thyroid disorder, overintake of caffeine, sleep deprivation, alcohol intake, etc.  But the majority of persons have none of these things.

The history of a high exercise level and new diagnosis of hypersensitive sinus node may point to a new lack of activity as a potential problem.  Asking one of the EP's about the possibility of IST (Innapropriate Sinus Tachycardia) might be helpful.

Also, seeing an expert in autonomic dysfunction might be helpful.  There are several good centers in the US, including one here.

Best of luck.