Vtach and PVCs worries. Help!

[ee215909]

A little back ground, I had 2 documented cases of AFib over the past 5 years were I was cardioverted both times. In that time period I have had 2 echocardiograms, multiple EKGS, blood tests, and even an EP study done. They found I have a structurally normal heart with no 100% certain rational for the AFib.
During EP study they tested both left/right atrial and the right ventricle. They were only able to introduce AFib during the study and reported everything else appeared to be normal functioning.

Since that study I keep having what feels like my heart stops of skips a beat for a slip sec. It takes my breath away and then is returned soon after. It’s like a sinking feeling in my chest and throat… I hate it so much. It causes me great anxiety, but as soon as I reach to feel my pulse, it has stopped and I am left with just a normal pulse. Like I said, it happens very quickly and maybe comes every couple of months.  

However, recently this past week and half, I have had a lot more. It all started with that weird sinking sensation on 6/16 that lasted a few secs. By the time I check it was gone and left me with fear and a quickened pulse. The next day while running, I had this anxiety feeling and it felt like I was having skipped beats. I wasn't running super hard, but forsure putting effort into it. I stopped and felt my heart rate and it was very fast, faster than I could count. 170+ I would guess. I could breathe fine and had no other symptoms. I continued to run and had the same feeling again. This time I came to a complete stop this time and took my pulse. Once again it seemed very high and I was noticing that when I went to breathe in (kinda deep) my heart would skip a beat. After the skipped beat, my pulse would come back and beat even faster. I was also feeling kinda panicked at this point. I felt like I couldn't get a good breath and then when I did, I had a skipped beat. Finally, I just gave up and began to just walk and cool down. My pulse came down slowly, but as I continued to walk it felt better and better. By the time I got home, all was normal.

Since then, I have had multiple times where I had that skipped beat feeling.

Questions:
Does this sound like single episodes of PVCs or Vtach?
If it is Vtach, should I be worried that it will become sustained and turn into VFib or Sudden Death?
Could they have missed something on my EP study or Echco?

Just very nervous and worried. My EP ordered a 30 day monitor at my request.

[hefner33]

Ask your cardiologists about LINQS. http://www.medtronicdiagnostics.com/us/cardiac-monitors/reveal-linq/index.htm

I had this implanted back in March. Took literally 5 minutes to do and your drs can track everything that happens for up to 3 years. It even has automatic detections of Afib and most other serious arrythmias. And its automatically transmitted to your Dr. so no need for calling in or pressing any buttons. Even though you are given a device to press if you feel symptoms. The reports will show auto detected or manual.

[researcher09]

Cardioversions are not meant to be a long term solution for AFib and my guess is that it was a recurrence of your AF.  If you enjoy running and exercising triggers it, then cardioversions and drugs are not going to help with your quality of life over the longer term.  Since you are probably still paroxysmal, the holter monitoring may not capture any events unless you go running or other exercises.  You want it to happen while wearing it but then it may not so ask your EP about using either an event monitor or getting the Alivecor app.  You want to get this fix while it is paroxysmal because success rate (ablation) goes downhill rapidly if it progresses towards persistent.

[MichelleP_3811]

Yes, the internet can be informative but we must keep it all in perspective and stay objective about things.  Look at the symptoms for what they are and try to not jump to conclusions until all tests are in.  Best of luck and keep us posted.

[ee215909]

Thank you both for your words of wisdom. I think this situation is made worse by this fear that I have some kind of channelopathie that has been missed. I did the stupid thing of getting on the internet and found some stuff about CPVT and Long Qt. Both of which cause Vtach and PVCs among other things during exercise. However, the vast majority of these condition's I believe are hereditary... Both side of the family are clean there. I guess its a waiting game.

[MichelleP_3811]

It's doubtful it would be vtach.  Possibly afib or another svt if it felt overly fast compared to how you normally feel after a workout however it could be panic related as well like the previous poster stated.  I think getting the monitor is a good idea.  My EP told me to go ahead and do what I can to get the concerning symptoms going so if running triggers a concern in you then do your normal runs and hopefully catch what is going on.  But the pause feeling is very well an isolated beat.  I do know that they can trigger the heart to speed up in response.  They are not a concern in an otherwise healthy heart.  I suspect you are having run of the mill isolated pvcs that are simply causing a bit of panic in you that is compounding the situation but its good you are getting checked out.   Best of luck with the monitor and keep us posted on the results.

[trus75]

I'm not an expert, but I have lots of PVCs and I also have a friend who recorded 8,000+ PVCs in a 24h Holter, and he has the exact same symptoms as you (the sensation that it takes the breath away for a short period).

The 170+ HR is not very surprising, once you were running and anxious. I have panic attacks and my HR can go from the normal 70bpm to near 200bpm in less than 30 seconds and it's not Vtach.  I'm not saying this is your case, I'm just talking about my experience. I hope someone else can help you better ;)