Non-stop ectopics

[jazzmowsky]

I wondered if other sufferers can help me cope with absolutely non-stop ectopics.

I have posted before when desperate, and I still am desperate in spite of having seen the cardiologist and being admitted to hospital for 24 hrs in suspected afib.  I was told on discharge that they were not sure what had happened to me and that effectively I had to learn to live with being in bigeminy/trigeminy moreorless permanently. I am SO worried that this constant arrythmia will damage, alter the dynamic of my heart; also the sotalol 80mgx2 daily seems to have little effect and if I try to add a 40mg dose I feel ill and if I try to halve the dose to bring BP up I have erratic fast/slow irregular pulse. My BP today has been 80/50 all day and it makes me feel ill and non-functional. I have had adverse reactions to both propanalol and metoprolol recently ( breathing problems ) and because my symptoms continue unabated I am seriously worried. I have been referred on for an EP assessment sometime in the future and in the meantime my cardiologist has written to my GP calling me anxious ( which is actually a gross understatement ). I don't know what to do, am passed coping level and cannot live the rest of my life like this. Apparently I am not suitable for ablation as my ectopics are mult-focal. Can anyone help me please ?

Thank you. Julie.

[mariop]

I agree with Momto3's post.  Doctors today are better at ablations and multifocal problems can be done with success.  My EP at Cleveland Clinic told me that in multifocal cases they try to take out the dominant spots.  This can reduce the PVCs significantly.  Even in cases of ARVD which are polymorphic they can alleviate the problem by burning out the most pernicious spots.

Your best bet is to get a doctor who has experience handling these issues.

[Momto3]

Hi Julie,

I'm sorry the ectopics are driving you crazy.  Been there, done that!  The fact that you have been checked out by a cardio is GREAT!  The good news, as you probably know, is that ectopics are generally considered benign and for some reason seem to come and go.  I had 2 ablations (I am also multi-focal, but 2 predominant foci), but prior to that I was in bigeminy a lot.  Had tens of thousands of PVCs a day, so I can relate to living with the flip flops.  

I have had PVCs (very rarely now) for over 30 years, and it took many years of persistent PVCs, but I did eventually develop "PVC-induced cardiomyopathy."  It is very rare, but it can happen, and it is something to be aware of.  Please do NOT worry; the chances of it happening are very slight. The main reason I wanted to respond was to let you know that I was multifocal and had 2 successful ablations.  I went from having over 20,000 PVCs a day to a handful.  The important thing is to get checked by a doctor and to have an echo, at least for a baseline.  If that points toward a healthy heart, it is best to try and deal with them in ways that you and your doctor feel are best.  Be sure to eat a healthy diet and get enough rest.  Diet and a lack of sleep are common triggers for some arrythmias.  

Since you have frequent ectopics and some difficulty with the preferred medications, has your doctor considered an EP study to see if any of the dominant foci are ablatable?  I hear ya on the low BP; I used to feel like a turtle...moving ever so slowly.  Whether you are considered "anxious" or not, you are symptomatic.  I tend to have anxiety, but my doctor did not feel the anxiety was causing the PVCs.  However, it does in some cases.  It is quite possible the anxiety is contributing to the ectopics, vice-versa, or that the anxiety exascerbates what's already going on.  You may also want to get a 2nd opinion.  You may hear the exact same thing; but it may be delivered in a different manner or you may feel more comfortable just knowing another specialist concurs.  Hope that helps some.  Feel better.

Connie