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Diagnosed with an excercise induced NSVT

I am an active non-smoking, non-drinking 44 year old athletic man (resting heart rate = 50 and drops to 37 during sleep) who was recently admitted to the ER to be monitored after results from wearing a Holter monitor.  My cardiologist insisted that I check myself into the ER based upon the readout from the monitor.  My episodes began this year and have been coming more and more frequent triggered by adrenaline while under some physical stress. Without medication, they are occurring multiple times a day.  I performed a thallium stress test while admitted and within 5 minutes my heart rate jumped from 133 bpm to 267 bpm and they stopped the test.  I have always been able to break out of the episodes on my own but I'm afraid that one day I won't while doing something really physically demanding (which I often do).

Anyway, after spending a couple of days in the ER, I was released and given a script for 25mg of Metoperol twice daily until I can schedule a cardiac MRI and then go from there.  My cardiac MRI came back normal, and now I would like to move forward with the ablation procedure.  The side effects from the beta-blockers were making me feel very tired, I became easily winded and out of breath just going up a flight of stairs and I was experiencing chest pain similar to a heart burn feeling.  They've cut my dosage in half down to 12.5 mg twice daily to see if that would make a difference.  I want the ablation procedure right away but the doctor that is to perform it is busy and does not seem that concerned about rushing into it.

I'm writing this after day one of the lowered medication and I don't know if its a placebo effect or what but today I immediately felt more energetic and no shortness of breath or chest burning.  However, tonight I tried doing a little exercise and it did not go well.  The palpitations are back so I suppose I'll be back on the higher dosage.  I'll discuss with my doctor on that first thing in the AM.  

[ ...and finally the questions ]
Most importantly, should I be concerned about the relaxed candor of my doctor who is to perform the ablation?  He's looking at about 6 weeks out to do it.   He has told me it is not life threatening but I really feel terrible (even with the beta-blockers) and want my normal life back.   It would be different if I had the episodes say every 2 weeks or something.  I'm seriously contemplating seeking a second opinion from another specialist in the area.  

My arrhythmia appears to be uni-focal as "the team" witnessed my episode on the monitor beat with the exact same wave pattern through the entire duration of the episode.  Does this improve my odds of success and simplicity of the EPS and ablation procedure? (note: it is in my right ventricle).
1 Responses
612551 tn?1450025775
Sounds like you need to avoid physical activity while waiting for your ablation... sorry for what I think is obvious, or worse that I misunderstand your post.

I believe right ventricle ablation is the simplest and safest of all heart chambers in which ablation is performed, left atrial being the worse.  So, there is a good reason to be optimistic about your scheduled ablation.

I am on high does metoprolol (BB) up to 100 mg twice a day. While I didn't have chest pains form such a dose, you other symptoms I can relate to.  However, I have found that I adjusted to the high dose BB, even my BP has returned to a low normal range.  So, it may be that you are feeling better with the lower dose in part because your body is adjusting to the drug.

Best wishes on you upcoming ablation.  
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