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Posts (6)

Sat, Mar 28 10:34am · Premature ventricular contractions (PVCs) in Heart Rhythm Conditions

The first step is usually a 24 hour holter monitor. They will note the average number of PVCs by hour, as well as whether they might be coming from one or several areas.

Get a 12 lead, not one with fewer leads as they can see more based on the 12. And keep those results with you. Even if you are ok, it’s a good baseline.

I had a certain PVC for 20 years. At the base of the papillary muscle that attaches to the Mitral Valve. Used to drive me crazy. A few good burns from an ablation killed that little monster

Sat, Jan 4 12:46pm · Mapping vs EP study in Heart Rhythm Conditions

I was wide awake and alert for two of my EP studies and one ablation. I think of the study and the mapping as one in the same, but perhaps that’s not technically true. In my case during the study the doctor introduced rapid extra beats to try to initiate an atrythmia. The doctor was able to put me in v fib, and then shocked me with 200 j just when I felt was was about to pass out. I had not been hit that hard since my days of football. In this instance the doctor was not able to determine a pathway giving rise to my arrythimia. In a second instance the doctor found an area and ablated. This removed a bothersome palpitation i suffered with for most of my adult life. It felt like ‘heartburn’ as the ablation was being performed, but in this case it actually was. It was quite fascinating to watch the many screens and follow the progress as the ablation was being performed – but it was a bit unnerving as I worried about things that could go wrong. The Branch of medicine continues to evolve rapidly. The mapping tools, the ablation techniques, even the meds used to keep we awake but unconcerned during such a procedure are amazing. What I would offer is my opinion that ablation is part art part science. Some doctors specialize in certain complex cases, or in certain types of procedures.

Dec 16, 2019 · Atrial fibrillation (AFib) and medication side effects in Heart Rhythm Conditions

I’ve been on it close to a decade now. I would have to say very effective in my condition. I take it with a beta blocker. It is hard to opine on just this medication without considering the beta blocker. I would also have to qualify any assessment based on dosage. All that said this type of medication does slow me down. I also have to be careful of taking meds with some food. But it does result in far fewer PVCs and I don’t have any non sustained VT anymore. There may be other Meds that do the same that you could tolerate better.

Jan 7, 2019 · Heart Rhythm Conditions – Welcome to the group in Heart Rhythm Conditions

A Premature Ventricular Contraction seems to be fairly easy to observe. It is physical. One can even observe them by taking a pulse. When hooked up to an EKG or monitor it appears to be possible to speculate the location based on the image it leaves on the recording device (sometimes referred to as the morphology). Doctors often classify the PVCs according to how many PVCs are observed versus normal beats ( often expressed in term of percentage of PVCs vs normal beats, or ectopic burden). PVCs in succession or combination are also noted, as would be any evidence of other abnormal beats.

Doctors also look to see if pVC activity coincides with time of day. Sometimes PVCs are more common during periods of stress of exertion, seeming to suggest a Adrenalin like trigger.

So even if the problem is anxiety, it’s still a problem to be looked into.

Jan 6, 2019 · Heart Rhythm Conditions – Welcome to the group in Heart Rhythm Conditions

Sorry to hear of your problems. This is rarely a medical condition with a quick fix. PVCs can often be thought of in oversimplifjed terms as an electrical signal bouncing off a zone of bad tissue. The signal can often be rerouted by destroying the related path, but only if a specific location giving rise to the pvc can be observed. This is often done by observing the number and types of pvcs recorded on a 24 hour test, or when mapping during a study when an ablation is to be attempted.

Then there are meds

Doctors will almost always start with safe medicines that might not be as strong. They can often rotate through medicines, or combinations, to see which work and what you can tolerate. It’s always about balancing the risk of the PVCs vs the side effects of the meds. In some cases they will not start a new med unless you are in the hospital hooked up so that you can be observed

Jan 5, 2019 · Heart Rhythm Conditions – Welcome to the group in Heart Rhythm Conditions

Thanks, my story – I’m 56, I’ve noticed palpitations since early adulthood. They grew more frequent and bothersome by my 30s. There were a few times I literally felt like my heart was stopping and I would often feel light headed when this happened. It was quite scary and I would relay to doctors that I thought I was in serious danger. They would check me out and tell me everyone has palpitations, and perhaps I was just anxious. At age 39 I passed out while swimming in the ocean and woke up underwater. I eventually was monitored and a short run of V Tach was noted. Then during an EP study the doctor was able to induce Vfib. I got an ICD and it went off over the years, but the device also noted other short runs that stopped on their own. To be honest, the ICD shock itself was never much of an issue for me, but the idea that the device was trying to treat a life threatening emergency most certainly was. I also had worsening mitral valve prolapse. I eventually had a mitral valve repair which helped with symptoms, though I still had more events during exercise. The puzzle with me was that exercise (catecholamines) was a trigger, and as my valve got worse, it became easier to observe VT on a treadmill test. I eventually got a sympathetic denervation, and then a second EP study, which included an extensive ventricular ablation. The doctor confirmed tissue / electrical abnormality around the mitral valve, which was giving rise to the malignant arrhythmias. Since this procedure I have not have an event though it is still worrisome and the medications take getting used to (toprol and flecainide). I seem to be one of the few people with bileaflet mitral valve prolapse that coincides with malignant arrhythmias. My guess is more will be learned about this condition (my honest guess is that this condition may result in more unexplained sudden deaths than documented today). I also suspect that more research and more advanced mapping and ablation techniques may offer more treatment options in the future.