Ventricular Tachycardia

Posted by spittman4962 @spittman4962, Apr 16 5:05pm

I had an episode of Ventricular Tachycardia about two weeks ago…I passed completely out…paramedics said I was at 250 BPM they shocked me on the ambulance. This is only episode I have ever had…Doctors immediately wanted to implant an ICD should I have waited to get other details first such as cause of my episode…I let them do the implant now I’m living in fear everyday…thinking about having the defibrillator function turned off….I need help…

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Wow, that dr sounds very unfeeling. If he thought you didn’t have a choice, he should at least explain why. He might be a medical expert but it’s your life and your body.
You said you’ve had a pacemaker since 2018? Is that for the AFIB?
Can you go to a different medical center and see a different dr? From my personal experience, a heart can be good and strong but still have electrical issues.
This may take awhile to sort out.
Meanwhile, I agree that anti anxiety medication might be helpful. I take Xanax myself as needed and it’s been a game changer.

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@kudzu

Wow, that dr sounds very unfeeling. If he thought you didn’t have a choice, he should at least explain why. He might be a medical expert but it’s your life and your body.
You said you’ve had a pacemaker since 2018? Is that for the AFIB?
Can you go to a different medical center and see a different dr? From my personal experience, a heart can be good and strong but still have electrical issues.
This may take awhile to sort out.
Meanwhile, I agree that anti anxiety medication might be helpful. I take Xanax myself as needed and it’s been a game changer.

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Yes the pacemaker I’ve had was for the Afib…since I came home from the hospital I have just felt since this event was the first and only one I’ve had ever had…some options should have been presented to try and see if they work and if they didn’t then talk about the implant…when I said I guess I don’t have a choice their response was well you always have a choice but…….then anything else I might choose was bad and dangerous….I just wish I had been sent home with time to process all that had happened before making the decision…instead the awful event happened on Sunday..took to ER by ambulance and shocked in ambulance while still conscious…then on Monday they were in telling I needed to have the device and could work me in to their schedule on Tuesday….it was quick with no thinking or processing time….thank you for your input…

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@kudzu

Hi; I feel for you; I was having episodes of vt, mostly nonsustained, but not all following mitral valve replacement surgery and I too was terrified. As I am a backpacker and gym rat, my stakes were pretty high. I told my drs I saw no reason to live if I couldn’t do the things I love, which may have motivated them somewhat. (dark humor)
My situation was not exactly like yours in that I never passed out or wound up in an ambulance, but nonetheless it was very serious and I endured a long period of all kinds of testing and also lived in fear, plus depression and anger.
I was first put on medication, first a beta blocker which helped, then flecainide. Later I was on amiodarone, which worked, but started to affect my lungs and thyroid so it was stopped. I have been able to maintain on metoprolol since 2022 somehow. Why did they not try that first with you?
I had two ablations; the first was unsuccessful, the second partially successful. Has any dr done an ep study to see where the errant impulses are originating and whether ablation is an option?
If you think back, what were you doing when the episode started? Had anything in your life or health changed recently?
Were there any warnings, like a lot of PVCs or short runs? Is there any family history of scd?Has anyone mentioned genetic testing? Certain types of vt can be inherited.
My thinking is that there are a lot of unanswered questions here. I would definitely get a second opinion. It seems like you might have other options.
Yes, icds save lives but I’ve read that inappropriate shocks are an issue.
Please pursue this; I wish you the best. This is no way to live.

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@kudzu
Good advice.
There are so many reasons for tachycardia. Many can be treated with medications and or ablations.

I was on Amiodarone for less than a year and read about the toxicity and asked to be weaned off, which they did. I am not on a medication Mexiletine (spell) which really has helped. But is specific to me and I don't want to infer it would be appropriate to others. But it did cut my PVCs in half and have only had one episode of tachycardia in 2 years.

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@jc76

@kudzu
Good advice.
There are so many reasons for tachycardia. Many can be treated with medications and or ablations.

I was on Amiodarone for less than a year and read about the toxicity and asked to be weaned off, which they did. I am not on a medication Mexiletine (spell) which really has helped. But is specific to me and I don't want to infer it would be appropriate to others. But it did cut my PVCs in half and have only had one episode of tachycardia in 2 years.

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Thanks; I try to use my experience to help others.
Glad you found something that worked for you.

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@spittman4962

Yes I did have COVID before the event they did echocardiogram on my heart while in the hospital said my heart looked good and strong….yes when I got to ER on Sunday…on Monday the Dr that specializes in the electrical problems of the heart came in he was called in by my regular cardiologist…he immediately went to implanting the device..no discussion of other options or checking to see what caused my VT or anything just you need this device…I’m having a problem with and wish I had not had the device implanted…pace maker I understand I’ve had one of those since 2018 with no problems….

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I am sorry you went through this, but you are not alone. I too had sustained VT with syncope. The crash cart experience is… traumatic, it takes awhile to process the whole ER experience.
My echocardiogram was normal, and we did a cardio angio and found no blockages. The hospital cardiologist suggested a ICD, but the EP said as likely idiopathic VT is was amenable to ablation. I was released from the hospital on 800mg of amiodarone to protect me while I got more tests. I also had covid-19 about a month before the event, which was a first and doctors said possibly related… so did a cardiac MRI with contrast to check for swelling around my heart just in case and to rule that out - the MRI was normal. Then I agreed to a EP study and potential ablation. They were able to re-induce VT with epinephrine in the EP lab, and found a focal VT in the right ventricle outflow tract (RVOT). I later learned this type of focal vt in RVOT is really a common spot amongst people with idiopathic VT (no structural reason or damage causing it). They think the ablation was successful, i was weaned off amio, had a month long event monitor to determine if needed implanted loop and then get to go live my life normal with just a checkup in 6 months.
I have no idea what is “normal” but hopefully sharing what my tests and doctors thinking pattern and explanations were like helps you ask your own doctor more questions.
And by the way, I 100% got a second opinion (and ended up staying under care of 2nd opinion provider vs initial EP). If the doctors explainations are hard for you to understand, you feel pressured or rushed, I think these are strong tells that a second opinion could help you feel more confident in navigating your own way forward.

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@spittman4962

Yes the pacemaker I’ve had was for the Afib…since I came home from the hospital I have just felt since this event was the first and only one I’ve had ever had…some options should have been presented to try and see if they work and if they didn’t then talk about the implant…when I said I guess I don’t have a choice their response was well you always have a choice but…….then anything else I might choose was bad and dangerous….I just wish I had been sent home with time to process all that had happened before making the decision…instead the awful event happened on Sunday..took to ER by ambulance and shocked in ambulance while still conscious…then on Monday they were in telling I needed to have the device and could work me in to their schedule on Tuesday….it was quick with no thinking or processing time….thank you for your input…

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Going through cardioversion from paddles while conscious sucks. I get the fear of ever having to experience it again. Did your doctor explain that since your implanted icd has wires right next to heart that the amount of shock is likely materially less than what the EMT had to use to your chest in the ambulance? Verify with your EP and medical notes from critical care, but looking at your devices technical stats may help you put this into perspective or help know, IF it ever has to shock you to save your life - even so, it may not be quite the same thing as what you previously went through.

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Fear and anxiety seem to be your biggest problem along with lack of information. I had tachy cardia from age 25 to age 50 with basically no treatment available. I have driven myself to the ER for cardio version. I lived in fear for decades. I agree that you would benefit from an anti anxiety medication; however, you could also benefit from joining a support group.
You are not the only person who lives in fear, but you can learn to cope with your thoughts and lower your threshold of fear.
We cardiac patients are usually control freaks. Don’t let fear ruin the pleasures of life.

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My step dad had a defibrillator installed after a heart attack. In the first year it activated three times. The trigger was set at 180 I think. However, over time, he kept feeling worse. He lives most of the year in SE Asia, and several hospitals and doctors could find nothing wrong. Finally he headed back home to see doctors he knew. It was a 40 hour trip. He passed out on the final lap and a taxi driver got him into the ER in a wheelchair.

Oxygen level was at a dangerous 80 level. Sepsis was quickly determined to be the culprit. Staph bacteria covered the defibrillator like moss on a tree according to the surgeon who removed it. As it turns out, the hospital had a terrible reputation for infections during surgery.

I mention this because my dad had no clue even after being checked multiple times. He was in the hospital a month and another month at home with ticc lines of heavy duty antibiotics. He was fortunate to have Medicare in the U.S. as the bill was huge.

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@jc76

@spittman4962
First I did not understand your shock was via EMS not a ICD. Most of the time when EMS have to shock someone they are unconscious.

I want to pass on to you my personal experience with this and hopefully that will help you.
You are not alone in your fear of this happening and causing you axniety and stress. Both anxiety and stress can lead to more medical and mental health issues.

Back in 2016 after 10 years with a ICD/Pacemaker I got my first shock. I fainted but on my way down I felt the shock. My wife called EMS but as I got into ambulance got shocked again. Then in ER shocked, and then again in ICU shocked.

The was caused by EP turning off my pacing thinking I did not need it to reduce battery drain. But this confirmed I did need the pacing. I have a ICD/Pacemaker.

What I want to pass on to you is I developed PTSD and anxiety/panic disorder from this. It was devasting to me like you with the fear of being shocked again. And I also feared the embarassament it would cause me if out in public.

My Mayo doctors referred me to a physicatrist PA who speicalizes in medications. She gave me a test and I scored almost at the top for PTSD. Now what I am trying to say here is I recommend to you to seek out (with coordination with your EP and cardiologist) a physciatrist or psychologist who can prescribe mediations and therapy.

We I went through my consultations and took several tests written and verbal tests I was put on a medication for anxiety called Escitalopram. My medication specialist worked with my cardiologist, HF, and EP as the medication can affect electrical waves in heart but was determined okay for me. This medication really helped me along with the consultations.

Do not feel you are experiencing something others have not experienced. As you can see after my expereince I had same fear and anxiety you had. I would not even leave my home for many weeks and worried about every PVC my heart did. It is not good to have this much axniety both medically and mentally.

Now your fear of it going off. Lets go over what I was told and it influence on me. ICD has almost a 100% success rate of bringing back your heart's normal sinus rhymthm. Now it can't fix a heart attack damage but when it is electrial, like VTAC it is very successful.

Now with information from my EP he said, "Think of your ICD as your own EMS in your chest ready to help you bring back your heart rhymptm and alwasy there to help you in need." Now with that information consider how long it takes EMS to get to you and every minute your heart is not beating properly makes all the difference in damage to your heart and brain. Your ICD will monitor your rhympthm at all times. Think of that as the benefit of having one and it's benefit to your life.

Your feelings are normal and I had the same. Please let your EP know about your fear and asked them about PTSD and can they refer you to a physhiatrist as they usually do not handle PTSD treatments.

Please after you see a phychatrist and asked for medication to help you through this that time does heal. Over time you will start to be more confident and change your mind about the fear of your ICD going off to be glad it is there. I am glad mine is in me as I am only able to write this by me having one.

There are also many medication to address the reason you had the need to be shocked and that also needs to go over with your EP and cardilogist. I am on several medications that have drastically improved my PVCs and irregular heart beats.

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WOW I don’t feel so bad about my recent recurrence of being back in Afib 100% of the time after 14.5 years since my operation to fix it.

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