Atrial Flutter & Ventricular Ectopy

[Lauren999]

While recently in hospital, Telemetary monitoring revealed frequent episodes of Ventricular Bigeminy, Tachycardia on activity and Atrial Flutter. I have become very symptomatic with this, with lightheadedness, shortness of breath and irregular fluttering/pounding in the chest with the Bigeminy/Flutter. Any sort of activity brings on these symptoms. ECG's also showed frequent runs of PVC's/Bigeminy. Echo is fine. I had EP study yesterday which failed to induce Atrial Flutter and pacing of the heart just made the ventricular Ectopy dissapear, thefore the Cardiologist could not ablate anything. I am now taking Verapamil 160mg daily with good effect so far. The cardiologist has mentioned putting in a implantable loop recorder to get more information about my arrthymias, as the Dr has said there are at least two abnormal rhythms going on.

My question is: Can Verapamil cure this? and are there any long term problems associated with taking Verapamil indefinitely? I am only 22

What information can the cardiologist gain from more heart monitoring when he already has a whole heap of telemetary monitoring evidence. Could he possibly attempt another ablation?
Will the verapamil help with the exercise intolerance and shortness of breath on activity?

Thanks very much

[Lauren999]

Nah initially before the EP study he suggested just Beta blockers, but i said no coz i found they  did practically nothing, but now im guessing it may be worth putting them together. i have some propranolol so i might add that to the conconction, would just have to keep an eye on the blood pressure. Haha anyone who claims to be bored shouldnt be on this forum

[Brooke_38]

I have been on CCB's&BB's simultaniously. Did your Dr suggest this as an option? I  sent you a a private message as I didn't want to bore others with the same sad story *lol* Humor...very important part to dealing with all of these gifts that keep on giving

[Lauren999]

Hi Brooke,

I had my EP study done in New Zealand, i have no idea where most people on here are from. I guess maybe if he sees even more EKG's etc then he may get more info as to where my rhythm disturbances start from. However i have heard that Bigeminy PVC's often originate from many foci, so therefore are hard to ablate, although they could possible ablate some of the sites and reduce the severity of the palpitations. As for the flutter i dont know. Maybe he suggested the ILR because of the ability to put it in and forget about it, rather than having continuous holter monitors whilst trying to work etc. ( i am a theatre nurse). But still i think the ILR will come after he does holter and event monitoring.

Do you know if its possible to combine verapamil with Beta blockers? Im just wondering if its worth trying this as its a couple of months till my clinic appointment with cardilogist.

Is your situation similar to mine?

[Brooke_38]

It is true that for some, even with countless strips, ekg's etc., that during EP study the arrhythmia has decided to play a game of hide and seek. It is definitely a very frustrating experience to go through the study and leave with no resolution (been there and done that!). On the other hand, I am a little surprised that he didn't just do an empirical ablation in the typical flutter circuit. It is safe to perform due to its accessibility and because it is located far from the AV node, even though they have no evidence that this site is the cause of atrial flutter. For many, once this single line of lesions is placed in that area they never have a problem again.

I will be the first in line to agree that we are way to young to be worried about these issues. Life is already way too short and then to waste time worrying about all this, makes it even shorter!

Where did you have your EP study done? Also, I wonder why the Dr recommended an ILR which is usually used in patients that suffer from syncopal episodes over an external even monitor that seems to be standard protocol. I guess I can't argue about what his theory is behind that one...just curious:)

Well, here's a wish for you, that the Verapamil works and you have better days ahead! I always say, "Best to keep looking forward to where you're going and not waste time looking back to where you've been". I Can't remember where I heard it but I loved it and live by it!

[Lauren999]

Thanks for that, good to hear from someone other than the dr that actually understands this.

Are there many other people who have documented, as in countless rhythm strips and ECG's showing SVT....in my case Atrial Flutter and Bigeminy PVC's, who then go ahead for ablation, and the Dr cant induce the arrythmia properly??? this is so frustrating. Is this common?

The EP consultant was pacing the **** out of my heart, causing all sorts of hideous feeling rhythms, but he said he was fairly sure his catheters were causing them. It was identical to my symptoms though which was frustrating him. I think he was increasing the voltage he was using coz towards the end i was sort of twitching each time he was pacing. He then asked a nurse to make sure the defibrillator was ready to go, as he "was burst pacing in a dangerous place". He then said it was getting to the point of dangerous and he could not see well enough where he should ablate. so we stopped it there.

The other strange thing that happened was that when he was threading the first catheter into my heart, i felt absoloutely nothing, but my vision suddenly went black and i felt a crushing pain in my chest and my heart rate shot thru the roof. this seemed to interest him. im not sure of the significance

As im sure we all aggree, its frustrating to be young and have these symptoms.... whilst most people go through life basically never aware of their heart beating.
Im hoping the verapamil works.......

[Brooke_38]

Verapamil can reduce the symptoms that you are experiencing. As far as long term effects, I have not heard of any. This medication can upset the stomach so you may want to take it with food if you experience this. Also, grapefruit or grapefruit juice should be avoided.

The more documentation that your cardiologist can obtain by additional monitoring will be helpful in determining where the focul point is to your arrhythmias. If he is able to figure this out, than yes I would imagine that you would be a candidate for another attempt at ablation. From my experience, Dr's do not like to go fishing around if they don't have rhythm strips to back them up.

If the shortness of breath is related to your tachycardia and the verapamil works by supressing this tach than you should feel better during activity.

Good luck and let us know how you make out :)