How likely can a rare episode of tachycardia turn into VF?

[Rosemary349]

Hi guys

If someone doesn't usually have tachycardia, but develops it on rare occasions possibly due to stress and the fact that they are weaning themselves off sleeping pills.....how likely can that sort of thing be dangerous?

As many of you know i initially arrived on this forum to discuss my father, who suffered a fatal heart attack last year, due to heart rupture.

I woke up in the middle of the night last night with a mild stomach ache....i started feeling panicky because i don't like being ill in the middle of the night - i live alone and i always think the worst....my heart started racing and i suppoe in the old days i'd have just thought i was panicking and thought no more of it.....but this time i remembered the doctor saying something about how hearts shouldn't go above 140 bpm - or thereabouts...that this can spill over into VF....?

Or am I missing something?

I don't know if the panick just increased due to my attention on my heart but all i can say was that it was like my heart had turned into a very fast train and there was no stopping it's speed.  I tried slow breathing, etc....and everything you would do for a panic attack....but the heart rate seemed so fast that even checking my pulse was difficult - i could hardly feel it.

After a few mins i panicked completely and decided to leave the house and get into my car and drive to the local emergency room.  Within 5 mins of driving my car my heart rate was slowing down to something far less worrisome.

I parked outside the emergency room til i new i was ok and then drove home and went back to bed  :-(  Witnessing my father collapse means that i still at the moment have flashbacks and all i could think was if i was visible then someone might be able to help if i collapsed.

So, was i panicking unnecessarily?  Can such a fast heart rate spill over into fibrillation and if so how likely is it if you don't usually have heart rhythm problems?  Although it seemed like a panic attack, i think my nerves are a little over active due to weaning myself off zoplicone (other symptoms have been sensitivity to sound, quivering in the jaw, gastrointestinal changes, etc).....so i don't think it was all psychological, but equally i don't usually have symptoms like that out of the blue.

any thoughts?  could do with some reassurance but not false reassurance of course!  Hope i sleep well tonight.  :-(

thanks for listening

[Rosemary349]

I guess i ought to wrap this one up - but just wondered if anyone else has anything further to suggest or whether there's anything worth reading about on the subject that might make things clearer for me...

thanks  :-)

[Rosemary349]

I'm avoiding going to bed tonight because don't want to wake up with that happening again...

[Rosemary349]

It happened again this morning  :-(

I woke up at 5am, it was dark....as i don't usually wake up early i was immediately worried that i was ill.  I only wake up if i'm ill usually and i'm a bit phobic about any kind of illness so i'm usually anxious.....I wasn't aware of a fast heartrate or anything, but then i decided to get out of bed and when i did so i was aware of my heart racing.

I really don't know if it was because i was anxious about being ill or if it woke me because it was going to happen.....

In the old days i'd have attributed the heart racing to me being worried and i would have sat down in a chair and tried to calm down...

Nowadays after what happened to my dad all i think is 'my heart has got to slow down, what's happening to me?'

I tried the valsalva manouvre and i think it had some effect, but it was still going fast...but of course my fear of it going fast was fueling it too.  It gave me some sensse of control over it, then i left my flat again and got to the car.

I KNOW!  I'm not supposed to drive but I can't sit there and do nothing, if i call an ambulance i'm afraid that sitting there in the flat will mean i'm not seen by anyone.  Also i'm just SO afraid.

I had in the back of my mind what you guys had said that it was unlikely to be dangerous and my doctor had said the same....so i think that helped a bit.  Also doing some breathing that i got taught in my martial arts class helped and every so often i would do the valsalva technique.....

I think within about 5 mins my heart rate had started to slow down.

I happened to have an appointment with my doctor this morning and so i told him.  He said he really believes that i'm very anxious, having a reaction to my father's death and that i've had a number of tests done already (basic stress test, 24 hour holter monitor, 3 min ecg, cholesterol check and bp).  He asked how long it lasted and didn't say any more.  He took my bp, 120/80.  He said he thinks exercise is good for me, to manage the anxiety (strangely enough i'd gone to my martial arts class last night for the first time in a long time, but he doesn't see any connection there).  He is a very good and helpful doctor.

I'm just scared.  I don't want it to happen again.  I'm better being busy if it happens because when i'm moving about i don't usually feel any discomfort.....but i keep checking and finding that my pulse is racing.

Sorry for rambling on - I would really appreciate any help anyone feels they can give.  if i can be reassured about this then i will know if it's real or not, because if i feel better mentally but it still happens, then i'll know.  Interestingly i think it happened almost the same time as this last month - i'm premenstrual with 5 days to go....

thanks again for any advice or help  :-(

[is_something_wrong]

Only the rhythm "ventricular tachycardia" can develop into Vfib, and even VT doesn't develop to Vfib without serious heart disease.

If tachycardia otherwise could develop into Vfib, I doubt any doctor would recommend exercise to anyone :-)

[Rosemary349]

Thanks for your responses!

Yes i agree that driving was a stupid thing to do......i was in a panick, but i think at the back of my mind part of me thought this was just panic, the doctor keeps telling me this is anxiety....and i knew that if it was anxiety, then concentrating on driving would work...and it seemed to.  After five mins my heart rate was fast, but it was nothing to worry about....

I still agree it was stupid, but the streets were clear and i knew that i could drive real slow, as it was the early hours of the morning.  My main concern would have been harming anyone else...and from the doctor's perspectice of it being panic and the fact that no one was on the road i took a calculated risk....but i was prepared to stop at any point and call an ambulance.

I've only ever had one other episode of this and it too was when i lowered the dose of zoplicone and it was immediately after my dad died.  I've had a holter monitor and basic stress test...no idea what type of tachycardia.....no real idea what my heart rate was, i was too scared to take my pulse...i tried but couldn't really feel it.

Thanks for the advice about the valsalva manouvre....it gives a sense of having some control.  It's also helpful to hear that it's not as simple as in my head - where i thought a fast heartbeat could lead to VFib....but from what you guys have said it's not that simple.

thanks for your time  :-)

[is_something_wrong]

Hi,

I'm a little confused here.

Do you mean ventricular tachycardia or just tachycardia (atrial, sinus, etc).

Ventricular tachycardia CAN in some cases develop into VF if you have existing heart diseases such as old MI's, severe angina or other severe heart disease.

Tachycardia that is not ventricular in origin can't develop into VF no matter what. Exceptions are atrial fibrillation with extremely high conduction (like in WPW syndrome).

140 BPM doesn't seem very high (it depends on your age, however). When I work out, my heart rate is 170-180 BPM and it's just healthy!

[Mom2four85]

here's a thread about VT and an answer from one of the CC dr's

http://www.medhelp.org/posts/Heart-Disease/Idiopathic-Ventricular-Tachycardia-Ablation/show/1327314

"If your heart function is normal, there really isn't any danger from having the VT runs.  The only thing worth assessing is the number of PVC's in a 24 hour period.  If it's greater than 15% of all the heart beats than there is a small risk of developing a PVC induced cardiomyopathy."

"We typically don't ablate PVC's unless they are symptomatic or if they are very numerous (great than 15%).  The VT isn't ablated unless it's sustained or very symptomatic with episodes of passing out or nearly passing out.  Sometimes it's difficult to induce the Vt in the lab but becasue the PVCs typically look like the VT we sometimes go after them"

"This is very unlikley to progress to VF or SCD.  If the PVC's/NSVT is really bothering you then you should have it done to relieve your symptoms, not to prevent SCD or VF"

[Mom2four85]

Rosemary, I'm so sorry about your father. I would def be seen by a cardiologist if you haven't since your father died of a heart problem and do a full workup.

PVC's in frequent continuous episodes can become a form of ventricular tachycardia (VT) and can become dangerous (V-Fib).  Typically, if 3 or more PVCs occur in a row it is indicative of ventricular tachycardia, but NOT ALL VT's are dangerous.  

I was told by my EP that only 1% of pvc's are considered dangerous, although I've read 1%-5%. Dr's typically treat between 6,000 - 8,000 pvc's with meds and anything above 15% - 20% of a total 24 HR they treat with surgery.  

At higher continuous amounts, it can damage the heart and lead to cardiomyopathy.  Although, follow up research has shown this can happen at much lower thresholds of continous pvc's - http://emedicine.medscape.com/article/761148-followup

I've suffered from frequent pvc's and vtach for awhile and it's something I still question - what triggers v-tach to become something dangerous?  Dr's use a scale to categorize which ones they think will be dangerous; but it's debatable [the article expands on this method]. LV function and where your PVC's originate is more important then your where you fit on the scale - it's in the medscape article, I think page 3.

I've had too many runs to count of VT with hr's in the 150's - 180's; and if it's continual you need to have yours checked.  You can have many different arrythmia's originating from different areas, but for them to be dangerous they have to have the morphology that stands out (your cardio or EP will know).  

You can have VT, but doesn't mean it's dangerous, there's certain things they look for that points to danger like with mine - I have polymorphic VT; but even then, they didn't find mine until an EP Study.

good luck and hope you find a doctor that will give you some comfort of knowing what's going on with your heart

[tiggercat513]

i too had to go off of sleeping pills and it was rough. I had stomach problems too. You may want to talk to your doc about weaning yourself off of them. And yes, Vtach in anyone can be dangerous.

BTW, driving yourself to the er is a STUPID thing to do. VT can cause you to pass out and you definitely don't want to do that while driving!! If you feel that you need to go, call an ambulance. The dispatcher will normally stay on the phone with you until the paramedics get there. If this happens again where your heart rate soars there is one other thing you can try. Hold your breath and bear down as if you are having a bowel movement. This can slow your heart rate down.

to answer your question, yes vfib will result in death without intervention,

let us know what happens, Lynne

[Rosemary349]

also, does ventricular fibrillation always means collapse and death without intervention?

sorry!  thanks again!  :-)