Is this really worth an EP-study? (Arrhythmia unknown)

[xizzor]

Dear Medhelp. Please take the time to answer my question
at the bottom.

The past 12 months I recall having around 10 episodes where my heart
suddenly started beating very fast for no reason at all.
It's hard to say exactly how fast it beated but I'd guess it was
at least 180.

I got someone to drive me to the ER or a general doctor
to hook me onto a ECG multiple times when these episodes occurred..
but each time they hooked me up the fast irregular rhythm had already gone.

The cardiologist has diagnosed me with PVC's. I think on average,
5 % of my total daily heart beats are PVC. Besides PVC's, there is nothing
the cardiologist could say that is "abnormal" in my heart.
I have had 2 echo's and 2 stresstests.



The tachycardia attacks "feel" sort of like multiple pvc's in a row without
normal heartbeats in between. It lasts around 1 minute maximum.
Perhaps a bit more or less. It's hard to say cause when my heart starts
acting this way - my perception of things get a little "funny" and I
feel mildy like I am about to faint. I've never made an exact measurement of
the duration.

Because it's not yet clearly been recorded which kind of arrhythmia i really have,
my general doctor recommended me to visit an electriophysiologist.
He said that he did not know whether they have "event-monitors" in
my country, and because of the infrequency of these attacks the
Electrophysiologist might want to do an EP-study immediately anyway.

My question to MEDHELP:
Since my tachycardia's are infrequent and they always resolved themselves
quickly, would they really be worth getting an EP-study for?

I think EP-studies are not without risk, and if they start burning electrical
pathways in my heart I might end up much worse than I am now...
As of now: my PVC's don't bother me because I can't feel them,
and my tachycardia's don't cripple me.

[bypeep]

Xizzor,

If you don't push for further testing you'll never know and it'll probably drive you nuts.  I have been complaining about heart issues for 20+ years and always brushed off.  I got sick of it and finally got a diagnosis (or at least one).  

An EP study isn't always going to give you complete answers.  I have documented NSVT and they couldn't induce it during mine on 9/9/10.  But, I guess that that in and of itself is supposed to be good.  

Get a 30-day monitor.  See what it catches.  If it's inconclusive, ask for another one. I think they can even authorize them for like 6 weeks, so between two 6-week monitoring sessions, you should catch it.

I'm not sure that they are keen to do a procedure (EP study) in absence of any evidence.  However, since 5% of your daily beats are in fact PVC's, they might consider that these *could* be episodes of v-tach and that might be worth investigating with capturing the rhythm.  

My personal experience with NSVT is that I cannot under any circumstances feel all of the individual PVC's because they happen so fast - perhaps you're dealing with a less serious condition such as SVT.  This would be awesome, but the only way to know for certain is to push forward and demand a complete evaluation.

Best wishes!

[xizzor]

...Push for an EP-study....
or just wait till the attacks become more frequent?

[xizzor]

2 weeks gone by, haven't had any episodes,
and I haven't made an appointment with the cardiologist yet either.

Between last time and the previous time I had this kind of episode,
there were at least 3 months.

So let's say the cardiologist would give me an event monitor for 30 days
and I don't have an episode to record. What is the next step?

Push for an EP-study....
or just wait till the attacks become more frequent?

[xizzor]

They never captured anything like SVT or something.
The only thing i got diagnosed with is normal tachy-episodes triggered by anxiety.

I just found out by reading this forum that PVC's can trigger SVT.
My doctor said PVC's can't trigger SVT.. lol.

Time to get a new doctor I think.
I am 24, this started a year ago.. suddenly heart started beating really weird one night.
Probably got a little traumatized so i started obsessing about it,
eventually developing panic attacks. Got to a point where I wouldn't leave the house cause anything i did cause me very high heartrate.

When i stopped being affraid i got my low heartrate back and became functional again. But apparently, i am still prone to short bursts of whatever kind of tachycardia this may be.

I guess the good thing is it only lasted for 1 min everytime and I didn't feel super super dizzy, only just a bit dizzy.

[debbier]

Hi,

Who diagnosed you with Tach?  Did they catch that ever on an EKG?  What you describe sounds like SVT.   A consult with an EP might be a good idea and he may have better access to a 30 day monitor.  I would definetly try and capture whats going on.  An EP is not going to immediately going to do an EP study.  They will want to try and capture on monitor.  Also if you choose not to have an EP study an EP could also let you try a beta blocker to keep things calm.  Good Luck.

[bexarooney]

i understand i think!!!! how old are you and when did all this start if you dont mind me asking

[xizzor]

Ok thanks.....
My doctor is probably misinformed about the event monitors not being available here.
It seems a bit crazy to get someone to poke me at this stage already.

-----

Bexa,
I use to have panic attacks and a fast heart rate everyday...
minor exercise made my HR skyrocket because I feared something was wrong.

Since i stopped worrying/panicking i now have a relaxed heartrate everyday,
and can do exercise again.



But yesterday i was totally calm and suddenly my heart started beating very
fast and irregular and it stopped after 1 minute or so. perhaps sitting down
had something to do with it.

I see now that in the beginning, these short bursts of arrhythmia probably inspired me to panic. I thought they wouldn't happen anymore now I learned to be calm,
but they still do.

The panic attacks for 40 minutes and the rhythm felt more regular and not as fast
as these short bursts of what I think might be something like SVT or VT.

So since yesterday I think about having a further study, perhaps a monitor if possible...
I refuse to worry, I have worried so much I don't ever want to worry again in this life..

I hope this makes sense.

[bexarooney]

hey u just told me on my post u dont worry about your heart and u beleive it is benign!!! :-)

[aylish28]

i would ask for a 24 hour monitor even from a neighbouring town if need me before allowing pokeiong and probeing  unless theres a severe arrtyhmia a doc has seen themselves

[xizzor]

*Correction:
I do feel the PVC's sometimes, usually it is only when I have a lot of them.
When I have these arrhythmic tachycardia episodes i feel the instinctive urge to cough a lot.