Aa
Defibrillator at 39???
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?
I don't know if v-fib is always fatal. In my case, it sort of was. I collapsed and was saved through CPR and defibrillation, then got an implanted defibrillator which zaps me when I go into v-fib. From what I understand, every time I get zapped my life has been saved by the defibrillator. I think an EP study would be very good for you--either they can induce v-fib or you can feel more at ease with the thumps and pauses of your heart. (By the way, I frequently cannot feel my pulse and they have trouble finding my blood pressure. I find it helpful to quit trying to take your pulse--it just gives you something to worry about. I figure if it's serious I'll know soon enough.)
Zapper (or anyone else in the know)...
I was really interested to read about v-fib in understandable terms. What I've ever read about in medical books describes it as fatal? But here's the case with me:
I was taken via ambulance to the emergency room today. This is the second time that has happened to me in my life (25, F., thin, no drugs or drinking, not any big deal medical problems), although I've actually had around 15 "attacks." I am known to have SVT, but it feels nothing like what I experienced today.
Here's what happened. It's the same as always. The doctors said I had my SVT turn into something more, and to see a cardiologist, or better yet, an ep, BUT they said because of the infrequency of my attacks, the likelihood of ekg findings were like trying to find a needle in a haystack, so an educated guess was the best treatment. They also said my heart was quivering! Which is how you described it, however, they said they didn't catch the actual arrhythmia, other then bursts of SVT on ekg that might have been short a-fib or flutter, too short to see (and I had only a turning feeling in my chest with them, no symptoms). They said it was possible I had v-fib and not a-fib? So I should see an ep to find out, and that it was unquestionably cardiac.
Okay, so here's my experience. I was seated, and just hung up a phone call, drank a cup of black tea, not under any stress, and then I felt I couldn't breath at ALL. I waited a second, and realized my heart felt funny in my chest, and I was starting to pass right out (no dizziness, just going black), so I tried to find my pulse, first in my chest, then wrists, finally jugular, which is usually easy to find a pulse on, and I could feel nothing, this was maybe 5 seconds, I still COULD NOT breath in, and lay on the floor, and tried again to feel my heartbeat in my chest with my hand, and it felt stifled? tamped down? for lack of better words... so instinctively I POUNDED with my hands VERY hard (gave myself bruises) and then my heartbeat came back, very, very, very fast, I would guess around 200 palpable bpm, and I wasn't more then mildly lightheaded and a little short of breath, and called 911. I stayed very calm and still through the attack, because my 2 year old was present and I really didn't want to scare him, but I felt that if I didn't breath shortly or my heart didn't begin to beat I would then black out entirely.
The paramedics came, and took my pulse at 180 (was slower by then) and also said my orthostatic pulse was 40 pts high (whatever that implies... they thought dehydration and IV'd me). My pulse went down to 100 bpm by the time they got the EKG on me, and then I felt totally normal, except it was in SVT, as is pretty normal for me. My blood pressure was, seated, 90/44. Standing, I felt a bit lightheaded, but in a different way then when I nearly fainted before, and my blood pressure went up to 110/70 or something and my heartrate shot up to 140. They said was too fast, just for standing.
I went in the ambulance with an IV for dehydration and breathing oxygen. During the ride, they saw a few runs of tachycardia (laying down my heart was doing a steady 75 or so), and at those times had trouble getting my pulse, and said my bp was really, really low, they couldn't get my bloodpressure to read? They kept trying to take it and saying, "hmm, I still can't hear anything, how you feeling?" to me, "fine."
6 hours in the ER, on IV (which slowed down my standing heart rate), and they did a chest xray, and a continuous ekg, basically normal except runs of SVT (I assume) that they said were becoming afib or flutter, like I said before, or maybe something ventricular. Blood labs normal (metabolics, TSH, calcium, Ph). I felt fine, and left.
Came home, read about about my symptoms, and I don't understand how it could be afib? Or flutter. Or anything atrial really. It seems like people can walk around with those problems a long time and not be effected, but you can have bursts too that aren't usually more symptomatic (they won't make you faint or your heart quiver?? Had trouble understanding what I was reading). However Vfib seemed to fit completely, especially because with one of my attacks I passed out and was only semi-conscious for hours after that, and was dizzy afterwards. But it began the same way, couldn't draw a breath in, couldn't get a pulse. Can SVT incite Vfib? Can Vfib NOT be fatal?? But present with these types of symptoms, of feeling about to die, what with the can't breath at all, keels over, semi-conscious and with no pulse, then faints, all in seconds without warning in a young person with SVT? What about plain old v-tach? Can that be responsible for breathless fainting with no discernable heart rate, in a matter of seconds?
It will be weeks before I see the electrophysiologist. Your feedback will really quell a lot of anxiety I have over this, which won't help any, I am sure:)
In addition, I have a long history of exercise intolerance any finally find I get dizziness when my heart rate exceeds 140 or so. I don't experience too much breathlessness then. So I don't exercise now, but would like to. And sometimes with prolonged mild SVT I get vertigo attacks. With intense sudden SVT I tend to get a sudden vertigo attack that goes quickly, else leaves me breathless.
I've had an echocardiogram, 2 holters for 24 hours, changed my diet and eat well, an exercise stress test where I became presyncopal at 150 bpm after like 2 or 3 minutes, and almost fell off the treadmill, normal autonomic testing 2X. Does electrophysiology sound indicated? Sounds scary! But worth it if it can get to the root of the problem.
I was really interested to read about v-fib in understandable terms. What I've ever read about in medical books describes it as fatal? But here's the case with me:
I was taken via ambulance to the emergency room today. This is the second time that has happened to me in my life (25, F., thin, no drugs or drinking, not any big deal medical problems), although I've actually had around 15 "attacks." I am known to have SVT, but it feels nothing like what I experienced today.
Here's what happened. It's the same as always. The doctors said I had my SVT turn into something more, and to see a cardiologist, or better yet, an ep, BUT they said because of the infrequency of my attacks, the likelihood of ekg findings were like trying to find a needle in a haystack, so an educated guess was the best treatment. They also said my heart was quivering! Which is how you described it, however, they said they didn't catch the actual arrhythmia, other then bursts of SVT on ekg that might have been short a-fib or flutter, too short to see (and I had only a turning feeling in my chest with them, no symptoms). They said it was possible I had v-fib and not a-fib? So I should see an ep to find out, and that it was unquestionably cardiac.
Okay, so here's my experience. I was seated, and just hung up a phone call, drank a cup of black tea, not under any stress, and then I felt I couldn't breath at ALL. I waited a second, and realized my heart felt funny in my chest, and I was starting to pass right out (no dizziness, just going black), so I tried to find my pulse, first in my chest, then wrists, finally jugular, which is usually easy to find a pulse on, and I could feel nothing, this was maybe 5 seconds, I still COULD NOT breath in, and lay on the floor, and tried again to feel my heartbeat in my chest with my hand, and it felt stifled? tamped down? for lack of better words... so instinctively I POUNDED with my hands VERY hard (gave myself bruises) and then my heartbeat came back, very, very, very fast, I would guess around 200 palpable bpm, and I wasn't more then mildly lightheaded and a little short of breath, and called 911. I stayed very calm and still through the attack, because my 2 year old was present and I really didn't want to scare him, but I felt that if I didn't breath shortly or my heart didn't begin to beat I would then black out entirely.
The paramedics came, and took my pulse at 180 (was slower by then) and also said my orthostatic pulse was 40 pts high (whatever that implies... they thought dehydration and IV'd me). My pulse went down to 100 bpm by the time they got the EKG on me, and then I felt totally normal, except it was in SVT, as is pretty normal for me. My blood pressure was, seated, 90/44. Standing, I felt a bit lightheaded, but in a different way then when I nearly fainted before, and my blood pressure went up to 110/70 or something and my heartrate shot up to 140. They said was too fast, just for standing.
I went in the ambulance with an IV for dehydration and breathing oxygen. During the ride, they saw a few runs of tachycardia (laying down my heart was doing a steady 75 or so), and at those times had trouble getting my pulse, and said my bp was really, really low, they couldn't get my bloodpressure to read? They kept trying to take it and saying, "hmm, I still can't hear anything, how you feeling?" to me, "fine."
6 hours in the ER, on IV (which slowed down my standing heart rate), and they did a chest xray, and a continuous ekg, basically normal except runs of SVT (I assume) that they said were becoming afib or flutter, like I said before, or maybe something ventricular. Blood labs normal (metabolics, TSH, calcium, Ph). I felt fine, and left.
Came home, read about about my symptoms, and I don't understand how it could be afib? Or flutter. Or anything atrial really. It seems like people can walk around with those problems a long time and not be effected, but you can have bursts too that aren't usually more symptomatic (they won't make you faint or your heart quiver?? Had trouble understanding what I was reading). However Vfib seemed to fit completely, especially because with one of my attacks I passed out and was only semi-conscious for hours after that, and was dizzy afterwards. But it began the same way, couldn't draw a breath in, couldn't get a pulse. Can SVT incite Vfib? Can Vfib NOT be fatal?? But present with these types of symptoms, of feeling about to die, what with the can't breath at all, keels over, semi-conscious and with no pulse, then faints, all in seconds without warning in a young person with SVT? What about plain old v-tach? Can that be responsible for breathless fainting with no discernable heart rate, in a matter of seconds?
It will be weeks before I see the electrophysiologist. Your feedback will really quell a lot of anxiety I have over this, which won't help any, I am sure:)
In addition, I have a long history of exercise intolerance any finally find I get dizziness when my heart rate exceeds 140 or so. I don't experience too much breathlessness then. So I don't exercise now, but would like to. And sometimes with prolonged mild SVT I get vertigo attacks. With intense sudden SVT I tend to get a sudden vertigo attack that goes quickly, else leaves me breathless.
I've had an echocardiogram, 2 holters for 24 hours, changed my diet and eat well, an exercise stress test where I became presyncopal at 150 bpm after like 2 or 3 minutes, and almost fell off the treadmill, normal autonomic testing 2X. Does electrophysiology sound indicated? Sounds scary! But worth it if it can get to the root of the problem.
Savannah - I have had a very similar experience to you. This type of episode happens to me once maybe twice a year. Normally day in and day out, I feel heart flutters. (early beats, fast beats etc) I have had these checked out and have had the same cardiologist for over 10 years. He checks me out yearly with a stress test and echo. The one episode I get similar to yours is described like this. I feel something funny in my chest. Like my hear beats out of whack for a second, then I get a very long pause. At least 4-5 seconds. I do the same as you, I search for a pulse in my neck or wrist. I feel like I am fading (not lightheaded or dizzy) just fading and then my heart starts to beat very fast and very irregular. This lasts for another 4-5 minutes and it goes back to a normal beat. I usually take a 1/2 of a 25mg of Tenormin also. It helps to bring the fast beat down quickly. I don't notice any problems with my breathing during that pause. It just feels like I'm fading out. (that is the only way I can describe it). I have described this episode to my doctor. He doesn't feel it is necessary to do a EP study because they happen so infrequently. He thinks it might be a short run of A-fib. I figure that if I can jump up to try to get help and look for a pill that it probably won't hurt me, however I'm telling you when I get that longer pause, it really really scares me. Are your pauses longer than 4-5 seconds. Hankstar do you have any idea what that could be? The pause is worse than the fast irregular beat. Anyone else get this?
Thanks for responding Hankstar. I realize you are not a doctor but you are very knowedgeable. I can tell you this, the pause IS longer than just the pause from an early beat. I know this because I feel something funny in my heart, I reach for my pulse, it is not there and I wait and I wait, to the point where I feel like I am fading out/blacking out, whatever you want to call it.
My doctor also said the same as you, an EP study poses more risk than what is probably happening. And yes, I went 1-1/2 years without it happening, then it happenned last year around July. I ate some cold ice cream and boom, it fluttered, paused and then beat very fast with absolutely no uniformity to it. I wouldn't call it quivering like the other people are, I could definately feel the beats, they were just all over the place. I did feel a little wierd in my head, but I have never felt short of breath or passed out from it. I do take 1/2 of a 25mg Tenormin at night. If I take more, I get really sluggish. If I have an episode of this I just take another half and within 5 minutes, I am fine. Most of my skips/fast beats have been caught on tape. This hasn't and that is why it worries me. It comes out of nowhere. It just doesn't happen often enough to justify wearing a moniter. Thanks for your words of wisdom. It sounds logical. I just HATE that pause and even though you say it isn't as long as I think it is, it is long enough for me to get up and walk into another room before it beats again. And with this scenerio it always jumps into those fast beats for a few minutes. I've read some threads from the doctors on this site that state pauses can be serious. I never get this when I exercise and I work out 5 days a week. I'm very fit, don't do drugs and drink very little alcholol. I have noticed that keeping yourself hydrated does help, HOWEVER one of these episodes happened one night when I drank two tall glasses of water really quickly. You just can't win can you. Thanks again!!
My doctor also said the same as you, an EP study poses more risk than what is probably happening. And yes, I went 1-1/2 years without it happening, then it happenned last year around July. I ate some cold ice cream and boom, it fluttered, paused and then beat very fast with absolutely no uniformity to it. I wouldn't call it quivering like the other people are, I could definately feel the beats, they were just all over the place. I did feel a little wierd in my head, but I have never felt short of breath or passed out from it. I do take 1/2 of a 25mg Tenormin at night. If I take more, I get really sluggish. If I have an episode of this I just take another half and within 5 minutes, I am fine. Most of my skips/fast beats have been caught on tape. This hasn't and that is why it worries me. It comes out of nowhere. It just doesn't happen often enough to justify wearing a moniter. Thanks for your words of wisdom. It sounds logical. I just HATE that pause and even though you say it isn't as long as I think it is, it is long enough for me to get up and walk into another room before it beats again. And with this scenerio it always jumps into those fast beats for a few minutes. I've read some threads from the doctors on this site that state pauses can be serious. I never get this when I exercise and I work out 5 days a week. I'm very fit, don't do drugs and drink very little alcholol. I have noticed that keeping yourself hydrated does help, HOWEVER one of these episodes happened one night when I drank two tall glasses of water really quickly. You just can't win can you. Thanks again!!
I only have a minute before my next class, but I reviewed the medical records I have. I found, what I believe, is the results of the first reading. Under DEVICE PROGRAMMING, DETECTION it reads: X VF 320 ms NID 18/24 RNID 9/12. Also, after reading through other records, I found results of the EPS study (maybe) and under comments: HIS PURINJE SYSTEM: Block below HIS Bundle electrode_seen during arterial pacing, Function ( ) occured. Whatever that means??? LOL. Talk to you guys soon and thanks again for the information.
Ok you guys, you are scaring the hell out of me! I have classes today, but I will call my doctor this afternoon and ask for more records. I trust and appreciate your opinions and concerns. What are the side effects of taking Sotalol?
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