PVC's and sleep apnea

[tinasig]

I currently have sleep apnea and have been on the cpap machine.  Here is the real kicker when i wear the cpap i wake up and sneeze continuously plus nose is running and congested. Either i get a good night sleep and I am sick the whole next day or I am tired the next day and do not feel sick.  All the dr's i have gone to don't seem to be doing anything.  I recently went to strictly a sleep dr and they are changing my machine out to an auto machine which i will pick up today.  In the meantime I have had these PVC's going crazy on me.  They put me on a Beta Blocker for me it made it worse.  I have seen two cardiologist and have been through a series of test.  Now they want to do an ablasion in about a month. The Surgeon is just super busy will have this done sooner if there is a cancellation.  I would like to get some input on this.  By the way the PVC's all started a year ago they were discoverd when I had to have rotator cuff surgery.  Any help will be greatly appreciated.

[Mom2four85]

Tom I've been a members since July 2009 but I changed my name this year =) I did take a "break" of about 2 weeks in April but other than that I've been here posting.

unfortunately for me I let my temper get the best of me sometimes and I stick my foot in my mouth on more than one occassion :P meds have definitely helped with the moods and supposed to help with arrhythmia's but I haven't noticed any change.

I wish I had been one of the lucky ones with a successful ablation, I'd be out living my life instead of still searching for answers and ending up with only more questions.

I think the reason there are less ablations for pvc's say vs svt is most dr's deem pvc's harmless unless very numerous >15-20% and there aren't a bunch of us who have that many on a regular basis; maybe I'm wrong and it's a completely different reason.

[tom_h]

Here on the forum.  What I was saying is that I haven't encountered "many" people who've had the procedure specifically for PVC's.   I've been a member for a year, and I think you've returned to the forum after an absence.  OTOH, there are many more of us that had it for SVT.  Yet, there are scores of members complaining of PVC's as opposed to SVT.

tinasig:
When informed of my OSA, the hospital instructed me to bring my CPAP with me.  It was next to my bed when I awoke from anesthesia, but they didn't need it.  BTW, I was intubated while under general anesthesia specifically for my OSA condition.  They don't ordinarilly do that for an EP study there, even if they put you out. I'm glad I told them ahead of time as I had no problems.

[Mom2four85]

tom_h what do you mean? I can't think of anyone offhnd that had the procedure specifically for PVC's. here in the HR forum or in person? (sorry my brain's on vacation maybe I'm reading what you're saying wrong)

I had a RF Ablation for very frequent pvc's & vt runs (50,000 daily) after abltion pvc's went away for awhile and pac's psvt started then pvc's came back with the pac's and psvt.

I found out 3 days before abltion that I had OSA; had no clue because I had no symptoms but after ablation I've had horrible problems; even going into Vtach during sleep... which has been perplexing to the dr's.  Possible OSA/ANS or CNS connection?

Tinasig make sure you tell them you have OSA; my dr told me they would no longer give me Propofol and to make sure with any procedure they don't give it but I can't remember why.

[tinasig]

I also have a humidifier on my machine.  I am hoping this will at least help the problem along.  I know when these PVC's kick in it totally wipes me out and i am so exhausted.  I also think they said it was coming from he left ventrical if that is the right term.  All of my studies are showing the same pattern with the PVC 's and they are in the same spot.   Like the doc said if i am having them like this the day of the surgery it makes everything go a lot smoother.  If for some reason they are not acting up they will have to force them on me.   My brother in law just an ablaion for AFib but he is not in the best health.  I will have to say yeserday was the first day in a long time i didn't feel any PVC's but this morning they are starting up but they are mild and i hope they stay that way.

[DeltaDawn23]

I have sleep apnea and Afib (under control right now on Norpace Cr and Atenolol), occasional pac's, pvc's and short runs of tachycardia.  I have been using a cpap machine with humidifier since 2003.  Last year I had 2 Afib episodes and my cardiologist send me to the heart clinic's sleep clinic for another study.  They found  bi-pap worked better, sent me home and after a month I took my machine back and they extracted the data on a card and determined it was working properly.  I never had such a thorough study and follow up done before.  After my last hospitalization for Afib, I learned that 50% of the cases are due to sleep apnea.  My pressure setting is 14.  I use a Nasal Aire II device (kind of like how oxygen is deilvered, only larger), no mask pressing on my face.  I use Ayr Saline Mist before bedtime, as well as Ayr nasal gel and Breath Right strips to keep my nasal passages open.  I also have a humidifier on my machine. I hope some of this helps.  Good luck.

[itdood]

From what I know the highest success rate for benign PVC ablation are those that occur in the right ventricular outflow tract or RVOT.  I'm not familiar with PVCs sources in the lower channel ('m not sure what that means).  Is that in the left or right ventricle?  do you know that actual structure name for the source?

I ask because knowing where they originate from can help with making a decision on whether to ablate them.

[tom_h]

I'm sorry you continue to experience the PVC's.  A year on CPAP would seem to certainly be enough time to correct them if your OSA was the problem.  While a lot of us here have had The EP procedure with ablation (including me), it was for SVT.  I can't think of anyone offhnd that had the procedure specifically for PVC's.  I use a humidifier almost year round, but found that high moisture levels made me stuff in the morning, so I make sure that it's not too high.  CPAP really restarted my life, and I'm thankful that my GP who is also pulmonary specialist, questioned me in depth about my sleep habits when he saw the high red blood cell count on a blood test, and got me on track for a sleep study.  I hope you can find a resolution to your PVC's.

[tinasig]

I have been on the cpap almost a year.  My pressure setting is 9.  My CPAP does have a humidifier on it.  I am having about 8000 PVC's per day.  I have been through extended testing.  The metropolol has not done me any good except to bring my heart rate down to 40.  These are originating from the lower channel of the heart.  I currently went to a sleep dr where the other was a pulmonary specialist.  I just picked up new cpap yesterday and it is an auto so it will adjust my levels automatically.  I will have this for 4 weeks.  But when I woke up today the sneezing started again it is like i am allergic to it.  My heart muscles are good i have no blockage anywhere.  I will try this new machine to see if it does anything.  The electtophysiology explained everything to me and it sounds like the surgery will correct it.  The PVC's are isolated and or every other beat

[itdood]

As my wife would say to me, "you're just falling apart"  :-)  I mean that in a funny way, when I've had that many things going on at once my wife would kid around with me like that.

Anyways, it might be best in your head to divide and conquer.  Perhaps the increase in PVCs is related to the CPAP issues or maybe not.  It's so hard to tell.

So let's focus on the PVCs.

What part of your heart are the PVCs originating from?  How many per day?  Have you had an echo to assess the structure of your heart?   Have you had tests to check for ischemia?  Are the PVCs Isolated or are you getting them in runs, bigeminy (every other beat), trigeminy (every 3rd systole is a PVC)...

You may not know the answers to these questions, try to find out the info.  

[tom_h]

Couple of questions for you:

How long have you ben on CPAP?
Do you know your pressure setting on your machine?
Does your machine have a humidifier?
Do you know what your AHI (apnea-hypopnea index) was prior to CPAP?

Before I got on CPAP, and for a while afterwards, I had many PVC's daily.  I had very severe OSA, and I believe that my heart was reacting to dangerously low O2 levels, and pure exhaustion.  My blood was over-enriched with red cells, very similar to people who live at high altitude, a condition call Secondary Polycythemia.  CPAP corrected just about all of these symptoms, but sice I was predisposed to PVC's I still got them occasionally, but not at the rate I had prior.  My beta blocker metoprolol seemed to have no effect of PVC rates.  I can tell you that ablation for PVC's yoelds mixed results.  In the meantime, read up on the procedure and learn a little about the it.