ventricular tachycardia

[Jim47]

Everything seemed to be going fine until yesterday. I wore a holter monitor for 24 hours to make sure my A fib was gone, which it was. Then the nurse called and said I had an episode of ventricular tacycardia.

I saw the electrical specilaist today and he confirmed that I had one episode of 10 rapids beats then it stopped. He said the best test would be an EP although there are non evasive procedures that he could also do. I do not have any symptons and didn't know I had an episode. I scheduled a T wave Study and I am going to wear a monitor foor 30 days before aggreeing to an EP. He doesn't want to see me for 2 months. by the way I am 10 weeks post op. any thoughts?

 

[AgilityDog]

I have v-tach intermittently, maybe twice per month, for which I have an ICD (implantable cardioverter defibrillator). I've probably had them ever since surgery 18+ months ago, I'm told it is probably because of scarring.

I've never been cardioverted or defibbed in the 5 months I've had it. I usually don't feel any episodes unless they are prolonged, and they are unrelated to activity level. I've had only one serious run, which lasted about 30 beats, 13 seconds, and caused me to all but pass out while driving on the highway, and one possible one last month (haven't had the meter read lately) that made me dizzy for a split second, again while driving. The fear is that one of these times I won't self-convert, hence the ICD.

While I think wearing a monitor may be appropriate, and is certainly the least you should do, please be aware that even ONE run that is not self-limiting can be fatal, and it could happen during this 30 day period. It is your risk, if you choose that over the faster, more invasive evaluation.

FYI even though I had a pacemaker at the time, it took the ER staff 3 hours to get someone to read the durned thing, during which period they thought maybe I had low blood sugar. Duh, I walked in the door and told them to interrogate my pacemaker! So you can't count on a quick evaluation or diagnosis if you have another run of v-tach that self-limits, even if you have symptoms, unless you are still in v-tach when the ambulance arrives. In which case, see above re sudden cardiac death.

I'm not sure what an EP is, but some serious evaluation sounds appropriate. An ICD, and perhaps antiarrythmic drugs (I'm on sotolol), may be in your future, too. It is significant that your run of v-tach occurred during the very 24 hours you were wearing the monitor. You may be having many more runs than I have, or you may have just gotten "lucky" that it showed up that day.

 

[Susan BAV]

I had "some V-tach" on my 24 holter monitor pre-valve replacement (a few brief episodes of it) and the cardio that I had at that time (who was a bozo) told me it was nothing to worry about. I don't know if he was right about that because he was wrong about everything else he told me.

On the other hand, my dad had a lot of V-tach before and after he got a new pacer and the cardiac nurses literally ran wild-eyed down the hallway to his room each time it showed up on their monitors at the nurses station, afraid he'd be passed out or something.

So, from his experience, I think it could be a serious issue. What did your doctor say? If he/she didn't say, can you press him/her for a direct comment? And can you let us know how it goes for you? Take care.

 

[marky]

I had an episode of V-tach that almost killed me a few years ago. I have a condition called Long QT, apparently it is hereditary.
Anyway my doc put an ICD (defibrillator) in me immediately.
I do pass out when I have an episode..my heart stops each time.
mine is not related to my MVR.
I hope that you can get to the bottom of it, and that it not require more treatment.

 

[Kathleen]

Jim
I am sure the last thing you want to do is deal with more heart stuff just as you are getting your sea legs back. I only have my opinion but it does come from been there done that. First the afib is gone for now but coupling a bout of it with vtach is not a good mix. Wearing a holter for 30 days and seeing the doctor in two months just sounds like a bad idea to me. You have already had issues with afib and now the vtach which means the holter will just re-enforce the findings. My afib led to vtach which led to vfib. I would get the EP study done now before more episodes occur. This issue is much different than the valve surgery. The EP doctor can make the rhythms happen and it can be taken care of during the study which would be an ablation. They can also implant a defib which would protect you if you go into the vtach. I have had 5 ablations and two implants and knowing what I know now the defib is the best way to go. Just don't wait to long since it can get urgent rather quickly. Kathleen

 

[Jami]

Ok, your story sounds all to familiar. In my personal experience and opinion go for the EP Study. I went through all of the other tests like MRI and Stress Test before the EP Study and they still wanted to do it in the end. luckily the test came back negative and they couldn't induce the V-Tach. Unfortunately I still get it anywhere from 2- 7 times a month. They put me on Toprol and I have never heard from the EP Doc again. (Kind of a soar subject!) Any way best of luck to you and I hope your tests come back negative as well!

 

[Jim47]

thanks for the reply. I will talk to my doctor thursday. my wife and I agree the EP study would be the best and if I need an ICD that is what has to happen even though it will probably end my 24 yr career as a police officer.

As a side note, the doctor was not as concerned because I have no blocked arteries and my ejection fraction is normal. also I have no symptoms. He did say that if my ejection fraction was below normal or I had blocked arteries it would be a different story.

 

[alpha 1]

ep study

ep study

Could somebody please tell me what an ep study is?
alpha 1

 

[tcopel]

An EP study is a diagnostic test to delinate the electrical pathways of the heart. To the patient, it seems similiar to a cardiac catherization in that the catheter is introduced through the groin and threaded under Xray to the heart. Once there, the catheter stimulates certian portions of the heart in attempt to find where the "irritated" part of the heart is that is inducing the V-tach or any other rhythm disturbance.

If the doc can find the focus of irritation, they can "sear" the area with the tip of the catheter and ablate it. I had one about 3 months ago after going unconscious while driving (got a fractured right wrist from the accident). It didnt seem to pose any problems to me in terms of side effects or complications.

The test should be done only be a cardiologist well trained by a specific fellowship after the usual cardiology training.