Defibrillator at 39???

[Tim]

For many years I have had episodes of heart flutters and what felt like quivering.  I went to a Cardiologist four years ago.  After wearing a holter, stress test, and echogram he said, "Sounds like atrial-fib, don't worry about it, it is not life-threatening!"  I lived with this condition for years.  I am a firefighter in Oklahoma and was fighting a house fire in December 2000 when I felt the quivering.  Since noone actually recorded this rhythm, I went to the paramedics on scene and had them hook me up to their monitor.  They said, "I was in V-Tach!", which quit on its own within minutes.  The emergency room doctor diagnosed the rhythm as SVT.  During an Electrophysiology study, V-Tach was induced and an ablation was not possible.  The next day they implanted a Medtronic defibrillator.  One week before my first post-operative check up, I had another episode which I received two shocks at 30 joles.  During this episode, I was conscience and felt ok as usual.  This was the same feeling I have had in the past.  When they read the ICD, I was in V-fib.  They placed me on Sotalol 80mg twice a day.  Since I have been taking the medication, I have not had any episodes.  Although, the heart flutters seem to be constant now.  I have worked out with free-weights and ran most of my life.  I would like to start working out again, but I am afraid!  I have never had an episode from weightlifting, but usually after running I would go into the rhythm.  Also, they thought I would be able to return to work as a firefighter.  I do not see any possible way to return to such a "safety sensitive" job.  What do you think?

[fross]

Hi

I have been reading this line of post with great interest. What you are describing seems very like what happens to me. I am having difficulties with getting a proper diagnosos. I have AF and take sotalol (hopefully for not to much longer). Any way, I too can't breath sometimes during an attack. Was told this was a seperate problem, along with my Dizziness(which they call Menieres Disease). They are all connected I know because it happens to me.

I sometimes faint and convulse. Before it happens I have what I can only describe as breathing through water. It is very very difficult to breath and I have to make a concerted effort. One night I was in bed and I kept waking up with what I thought was sleep apnoea. I would start rasping for breath then after a few times at this I passed out (heart rythm had been fluttering, quivering, missing beats - everything thats not normal but normal for me). Like you the Sotalol seems to give me these arrythmias more than before I was on it.

All my tests have never shown up anything abnormal except for the AF. I have tried to diagnose myself. I have a healthy heart, I was told. I have come to the conclusion myself that it has something to do with the vegus nerve. My theory is that when my nervous system gets over stimulated causing the electrical stimulation in my heart and the very fast flutters etc take over my vegus nerve kicks in and slows the heart right down. Hence why I come out of it. I don't know if my heart stops but I have had near death experiences with it when I am out. (In a long dark tunnel knowing I have to come back or I will be dead) The only thing is that I have been told my QT is slightly long. This can be caused by the sotalol. But I feel the same as before. There are cases of people having V fib or is it Tach that causes syncope when the heart does stop. I have read this in medical papers. These people can naturally come out of it. However it usually becomes fatal. This is why it is important to not stop looking for answers.

Also, I know that before it happens I need some precipitating factor. It seems since I have kept my self well hydrated and upped my salt. I make my self drink a health salt drink (I have a healthy heart I reckoned it would not be bad for me)and lots of plain water that the episodes have lessened. Your episodes when you don't pass out could be what I have read as presyncopal. I get this. I am a strong fighter and you may be too. I feel sometimes it is mind over matter.

Good luck Let me know what you think. Your search could help my search too.

Fran

[heartfull]

I sure hope that  I am not too late to comment on this subject. It was very interesting to read all the posts here. I want to tell you my story and this is ongoing for me as I write this. I am 36 F and have been having these attacks for years. It was found 3 years ago that I have cardiomyopathy. I have experienced the bumps and flips of a nerve in my heart that kept me in constant sharp pain. I went to an EP and we did a study. I was diagnosed with PSVT and chose to have it ablated. Now, I want to make it clear that I never caught the "big" attack on my recorder. I had a right ven. outflow ablation in Nov.- 2 weeks after it I had 2 of the "big" ones two nights in a row. Finally i had another one, while washing dishes in the morning. Some of them are very brief and just take my breath away and make my head feel queazy, for lack of a better word. The longer, more severe ones make me feel like death is at my door. My chest gets an empy kind of a feeling in it that soon travels to my head. I become very disoriented and pale, and my breathing is shallow. I feel like i cant breathe but my husband has assured me that i am  LOL  it is shallow and weak. I know I am not getting the oxygin to my brain. When I "come to" my heart races and i feel like i have to run somewhere. My EP has me wearing another monitor to try to catch this thing!! This past saturday i had a brief run of it. Not the big one i want my dr to see but i knew it would be enough for him to know what was going on. I saw him today and i have confirmed wide complex v-tach, non sustained. Now get this.....I am to wear this thing for another 8 weeks to see if i become sustained. Now here is what i believe is fact about v-tach and v-fib. v-tach takes many forms but the most dangerous one is UNSTABLE. Unstable v-tach is to be treated as v-fib because it can rapidly turn into v-fib. The only thing i know to tell the difference between stable and unstable is the symptoms you have with it. With me, i have s.o.b., chest pain and labored breathing for days sometimes a week after my episode. I also swell slightly (edmeia) and my left arm aches terribly. Right after a big episode i get to feeling like i'm gonna lose my cookies and the fatiuge takes over every muscule in my body and i just sleep, sometimes for days. Before my ablation it looked like PSVT. It is sometimes difficult to tell the difference when you have so many pvc's and such. Now that they are gone, it has uncovered the true nature of my episodes and possibly the reason or result of my heart failure. An EP study is a good idea for anyone with these symptoms. That doesnt mean you go into a cath lab the first day. The first thing they do is monitor your heart and they must document a reason to send you to the lab. But even then, it is your choice. The only downside of an ablation that i know of is that it may not be something that can be ablated, also that if the area of your heart that is causing the misfire is in the sinus node or natural pace maker, you may come out with a pacer, that will be up to you too. Mine is firing off several times a week now and when i started 9 years ago they were not very often. As they became more frequent and disrupted my life so much, i had to do something to fix it. At this point, i think i would welcome a defibulater. I know people with defibs and i also believe that when they fire, they have saved your life.
  Good luck to all of you and if you are interested in my personal journey, check in here and i will let you know what he says when i show him a susstained v-tach. Hopefully not in the ER <lol>  : )

[JR]

heres the scoop on V-fib...
hankstar is right to an extent. V-fib usually is fatal (about 98%) if not converted no NSR within 4 or 5 min....it can spontaneously convert to NSR by itself, but it just dosent happen very often. like he said, in a lot of cases, patients who "majically" convert from VF were not in true VF to start with, probably another atrial arrythmia that can be hard to distinguish by someone who is not highly trained......
(NO IM NOT A DOCTOR, BUT I PLAY ONE ON TV)

[mai_lin]

It is possible to have short runs of VF - I have the strips to prove it.  It can 'break' on its own, just as VT, SVT do.  Yes, even the best have been fooled - but who are we to tell someone that they weren't in VF if we haven't seen the strips?  

If you feel uncomfortable with the diagnosis I would definitely recommend seeing another electrophysiologist - please do not take OUR word for it - thats just not smart.

Wishing you the best of luck - and no zaps :o)

Jennifer

[mai_lin]

You can stay 'awake' during VF.  I have an ICD for Long QT syndrome, and have been shocked out of VF 6 times (at a rate of 300)- I have never lost conciousness during it.  I got dizzy but never passed out.  It depends on the 'react' time of your ICD.  My ICD fires in about 15 seconds - enough time so that I don't pass out.  I fall down when I'm shocked but I never pass out.  

I know others who this happens to also.  You could have been in VF and not passed out - it is possible.  Many people who are otherwise physically fit/ not withstanding clogged arteries - can stay concious during a short run of VF.  I would take your doctors word for it - if they say you were in VF you probably were...only they are reading the strips.

Good Luck!

Jennifer

[Tim]

Although I have a swimming pool, I have not been swimming this year with my ICD.  I do not think it has happen while swimming, but will keep you informed this summer.  Usually my rhythm happens when I am totally exhausted from exercise (running) or on the golf course when I am drinking, smoking, and having a good time.  I know thats bad, but hey you only go around once!