Hello, First of all I had a run of three pvcs in a row one night with heart rate of 140 now my cariologist says i have v-tach! Why? I have pvcs, pacs, mvp with some leakage. Are there other things to consider with v-tach as far as making the diganoses?
She says im at no greater due to the fact ive never had a heart attack, heart disease or heart damage. She is also a ep doc. I have read conflicking info. on this, 6-10 in a row or for 30 seconds. So which is it?? Also why is it with pvcs sometimes you feel a hard thump and sometimes not? Should one be scared with the thump cause its scarey! Then also the pause is awfull, and that one scares me to death, should one be scared with that? Also if it is only three pvcs in a row that make v-tach than most everyone with pvcs have v-tach? Also does the most of the population have pvcs and some just dont feel it? This last summer I had a racing heart had no monitor on it felt as though i was going to drop dead, it felt as though all my blood pressure dropped felt weak and short of breath it came on suddenly and stopped suddenly im scared that it was v-tach. Im not on meds choose not to be, they wanted me to go on metropropol small dose im afraid of the side effects. I just dont know how to get past this fear i think of it everyday.I just need to know the true defintion of v-tach thanks so much and the answers of the pvcs thanks so much
Non-sustained ventricular tachycardia(NSVT) is when >3 ventricular beats occur in a row. Sustained ventricular tachycardia lasts for >30 seconds or results in hemodynamic compromise(serious drop in blood pressure).
You had an episode of non-sustained ventricular tachycardia.
In the setting of a structurally normal heart NSVT or PVCs do not portend a poor prognosis. Beta blockers are an excellent medication for controlling NSVT and PVCs. Hope this helps.
Im not a doctor, in fact Im only 18, but I know a bit about this subject. As far as I know everything Im posting is correct, but a doctor's advice is much more reliable than mine.
A run of 3 or more PVCs in a row (triplette PVCs if they occur in groups of 3s) would be considered a "run of v-tach". "Regular" (v-tach is not regular and certainly not good) v-tach is continuous v-tach that doesnt stop (ie all an ekg shows is v-tach). The thumps that can accompany PVCs are scary, but you just have to learn to cope (if your doctor has given you special instructions regarding what to do when you feel PVCs then of course that is what you should do). There are people I have heard of who have PVCs and PACs without realizing it (they are lucky not to notice them IMO, as long as they are benign). I have had "thumps" before, but I dont know for certain if they were PVCs (as far as I know I havent had a PVC durring an EKG or while on an event monitor). Sometimes PVCs occur alone or in twos (couplettes) as well, so not everyone with PVCs would be considered to have v-tach. Pauses can be scary as well, and should definately be addressed with your doctor (as well as the rest of your concerns). A sudden racing heartbeat with other symptoms could be caused by v-tach, but it could also be caused by other arrhythmias such as PAT or PSVT. The best thing to do is discuss any previous episodes you have had with your doctor (ep would be excellent) and ask them how concerened you should be. As far as medication - I have never heard of metropropol, but if you mean metoprolol (very common in the treatment of arrhythmias), then I would definately recommend trying at least a low dose. I have episodes of sinus tachy and sinus arrhythmia and am currently on Toprol XL (the controlled release version of metoprolol) 50mg daily. The Toprol has certainly reduced my tachys and even brought my resting heartrate down (now my heartrate averages in the mid 70s when resting and the 60s-50s when lying/sleeping). The only side effects I have noticed are the slow(er) heartrate, and lower BP (I had hypertension anyway, so the Toprol brought both my heartrate and bp back to safe levels).
Yes, dont worry the doctor will answer soon. I have actually been waiting two weeks just to post my quetion but its always full when I try. Oh well, my question is really long and includes EKG strips so I guess its worth the wait.
I too have tried and tried to post a question for a long time and just so happen to get lucky. I usually end up doing the one where you pay and get three medical opinions. This time I got lucky but still waiting for a reply.
Just saying hi -- nice to see you two "heavy hitters" commenting here on the boards. You both provide very interesting and useful perspectives.
As for the issue of vtach (non sustained in a structurally normal heart), everything I have ever read/researched suggests that it is essentially the same as having "a bunch" of pvcs. It is, of course, "complex ectopy" but doesn't carry an adverse prognosis (thank God, since I have thrown at least a six-pvc run of vt documented via event monitor). For those of you reading this who "only" experience isolated pvcs, in the dozens or hundreds rather than the thousands that some of us get -- please be encouraged: if even those high numbers and nsvt can be "benign" you can be assured that your fewer pvcs with less complex forms are "ultra-benign."
What do either of you make of the recent studies linking pvc activity post stress-test with increased risk? Or thousands of pvcs and cardiomyopathy? My cardio seems not to be aware of these. Am I correct in assuming that my high EF means that my thousands of pvcs (at times) are not yet creating an impact on heart function/muscle?
Fred, there is no doubt in my mind that pvcs are not mentally "benign," but I think the jury is still out on whether they are benign physiologically. In my particular case, both cardio and EP are calling them benign, despite complex ectopy (couplets, triplets, the run of vtach and high overall numbers -- up to probably 10,000 per day on a really bad day). This is likely due to the absence of any underlying abnormalities, high EF, and that I am a 37y/o female w/ low cholesterol, physically fit, with zero family history of heart disease (all grandparents lived past 85 and my fantastically fit 70+ y/o parents medal in 5Ks (they do have ectopy as well, but lots less than I do, and it doesn't seem to bug them so darn much).
I have been offered the following: do nothing, no meds at all; take more beta blockade (25mg atenolol does absolutely nothing); tambocor (no thanks); ablation w/ a projected 80% success rate. I have days where I only get a few dozen or a hundred or so... then there are days close to 10,000. Apparently when the overall average of your pvcs goes to 10% of your beats, they then recommend ablation. I am close to that but not quite. I'd say that 75% the time I have a "normal" level of pvcs, very acceptable, and then 25% it is pretty tough. Frankly, I am just waiting for the ventricle ablation techniques to be perfected (2-5 years I'd guess) and then will avail myself of this potentially life-changing opportunity.
I have researched this within an inch of its life (as I believe you have) and am so far feeling comfortable living with it (for now). I do believe it is possible that this many pvcs can be benign in some people (and of course hope I am one). What I suspect is going on with these studies is that pvcs can be either an indicator of something else (bad) or a complicating factor when something else (bad) arises. But what to think about so many pvcs when there is no evidence of an "else?" Baffling. I like the thought that some of us just have patches of inappropriately placed/charged cardiac cells that are more or less proximate to the appropriate triggering sites and that the closer they are, the more they will fire off with any catecholamine changes, etc. So someone like me with a ton of pvcs obviously has cells very close to the trigger sites, but your average person has fewer cells farther away from trigger sites. People like me have a heart "hot button" of sorts. Perhaps we could be used like barometers, or divining rods for subtle catecholamine shifts? Ha ha.
I always follow your posts with interest and hope you will share information or theories you may have, now and in the future. It is very helpful.
Since I also have exercise induced PVC's, I am very interested in the link between these and increased risk of coronary artery disease. The way the doctor has stated this and the one study I have read, the PVC's "increase the risk". Does that mean that PVC's somehow promote the development of artery disease, or are they a symtom of some existing blockage and associated ischemia?
In my own case, I had fairly severe exercise induced PVC's that would start at a pulserate of 100 or so and progress to trigeminy or bigeminy by a pulse of 140. I was then found to have a 95% blockage of the LAD which was bypassed surgically. The PVC's if anything got worse post surgery. Magnesium supplementation seems to be helping significanty but I guess I won't know for sure until I quit taking it for a while.
I am currently under the care of an excellent EP who is trying to identify whether my pvc's (20,000+ on a 24 hour Holter monitor) caused a drop in my EF. For over 20 years, EF has always been OK, but last year's echos showed a decline. Echo report showed drop in EF and signs of myopathic changes. Hmmmmm.... Since January, I have tried two different antiarrythmics to see if the EF would stabilize or improve. At 3 months, the EF had gone up nearly 10% and I will be checked again in another few months. From what I understand and from the TONS of stuff I have read, I do not represent the "average" pvc sufferer, but I do think it is important to note that MAYBE thousands of pvcs CAN cause these types of changes....I have the utmost faith in my doctor and will abide by her suggestions....
As for the pvc activity post stress-test, Dr. Lauer's report from the CCF is very thorough. You can access it on the CCF website.
It is my understanding that when your pvc's represent 20% of your heart's beats, treatment may be advisable (medicine, etc). As for ablation, it would be wonderful to be pvc-free, but we'll have to cross that bridge when it is time. For now, I'll stick witht the medicine and hope for continued improvement.
Good luck to you!
I'm 42 and have just been diagnosed with V-tach (I've had PACs and PVCs just about all my life). I have a few questions that my doctor never seems to answer and thought some of you may have some input.
1) I have a spontaneous cough after my v-tach episodes. Why is this?
2) I'm taking 25 mg of Atenolol twice a day and am still getting the episodes. Is there any tricks to stopping them once they start? I've heard "bearing down" sometimes helps. Any other ideas? I've tried getting up and walking, sitting, laying down. Nothing seems to help.
3) I've been told that my heart is healthy. So, WHY AM I GETTING THIS? It's certainly changed my life. I'm afraid to exercise. (although, it can occur when I'm doing nothing at all!)
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