Ventricular Tachycardia - trying to find cause

[kwtmom]

I started developing palpitations (3 or 4 in one minute) after seeing a cardiologist who said I had a new heart murmur.  He set me up for an echo and treadmill test, but because he was to be out of the office for his daughter's wedding for almost two weeks, I had to wait for the tests.  During that time I developed the palpitations and had periods of lightheadedness.  I was very stressed because he was out of the office.  I went to another doctor for the echo (which was normal).  Finally, when he returned, during my treadmill test I went into ventricular tachycardia.  He said I "scared him to death".  I experienced a few ectopic beats at first, then went into the VT.  He had taken me off the treadmill because of the ectopic beats and then I went into VT.  The run was about 8 seconds, but I almost passed out while walking to the table.  The next day I had a heart catherization (20% in two arteries) and was turned over to an EP.  I was put on Verapimil (for arrhythmia) and wore a heart monitor for a month.  It showed no VT but during periods of lightheadedness my pulse was as low as 40 - I'm not sure if this was result of the medication.  The EP said "I have V-tach.", because I couldn't do what I did on the treadmill if I didn't have it.  He also said he thinks I have had it all my life, I just didn't know it.   He felt the medication was controlling the VT, but it was causing severe fatigue, and he said I did not have to take it.  He also said it would not "prolong my life".  He said he could try ablation and we had about a 60% chance of finding it and correcting it, or I could take the verapimil on the days I have the palpitations.  He also said I had a less than 1% chance of dying from the VT.  I felt, how does he know?  
I went back to my cardiologist, who pushed me to not let this drop.  I asked my cardiologist if he would do another treadmill test.  He said he would not, again because I "scared him to death".  He set me up for a second opinion.  This EP told me he felt there was a 0% chance of finding the arrhythmia during ablation.  He also felt I have not had it all my life.  I asked for another treadmill test, this time at a hospital where I would be safer.  I developed "frequent ventricular ectopy" but I walked as long as I could.  I never went into VT.  The doctor didn't like the results.  He mentioned the word "catecholemineric", which I know means arrhythmia with exercise.  He ordered a cardiac MRI, which was normal.
He has not set up another appointment, but after a week and a half I am pressing his office to ask him if he wants to see me again.  I have read that with some forms of VT you have normal heart function, normal cath., etc.  My cardiologist at home wants me to get to the bottom of this.
In the past, in my early twenty's, I had a grand mal seizure.  The doctor couldn't determine the cause of it.  I have also experienced episodes of lightheartedness, again of undetermined cause.  The first EP said the grand mal seizure could have been VT.
I would appreciate any input.  Has anyone found much later in life that they have VT?   Also, has anyone experienced seizures, or periods of lightheadedness at times during their life before they found they had VT?  I am also concerned because I have 3 grandchildren who run cross-country, and if this could be an inherited form.  
The first EP said I would not know if I had VT unless I had symptoms.  The symptom during the first treadmill when I went into VT was lightheadedness, and almost passing out.  I also had lightheadedness before I went into the grand mal seizure.  I was out for several hours that time.

[kwtmom]

Thank you, kalim 123

I am looking forward to your response.

[kwtmom]

Hello Is something wrong

Thanks so much for your reply.
I guess I have more research to do and questions for the doctor.  Although I have spent weeks researching on the computer, I didn't come up with that.  I really appreciate your info.    
Could you please tell me how they determine if you have the heart muscle inflammation or the cardiomyopathies.  I guess I thought I had all the testing, with the Cardiac MRI and the heart cath.  Are those determined with a heart biopsy?
When the doctor said I "scared him to death" I think he was possibly trying to make me understand the gravity of the situation and get the help I needed. Although I agree, he could have toned it down a bit.  That frightened me.  And I didn't know that all labs have a defibrillator.  He wanted me to have the treadmill test done at the hospital.  Next visit I will ask him. :)    

[is_something_wrong]

Just to add, I do NOT say that you have this diagnosis, but it should be investigated. There may be other reasons as well, but you have open coronary arteries and no signs of CAD from what I can see (and that's by far the most common reason for VT).

Other possibilities are:

- Heart muscle inflammation (acute or chronic)
- Electrolyte imbalances
- Cardiomyopathies (hypertrophy, dilation, etc)
- Benign right ventricle outflow tract tachycardia

What the doctor told you "scared your doctor to death" is fairly weird. All stress test labs have a defibrillator within 2 meter range, so you should be safe there no matter what rhythm they are able to reproduce.

[kwtmom]

Thank you, Is something wrong, for your response.

My grandmother supposedly had epilepsy.  She died of it.  My first EP thinks my seizure in my early twenty's could have been caused by VT.  Both EP's said my lightheadedness throughout the years "could have" be caused by VT, there was no way to be certain.  Both EP's say they don't think I have an inherited VT, but from what I read, other people have been misdiagnosed and found out too late when they lost a loved one, or they had a near death experience themselves.

I had VT on the first treadmill test, frequent ventricular ectopy during the second treadmill test.

[kalim123]

kwtmom , it is too late night here I will be able to answer you tomorrow night

[is_something_wrong]

The fact that you have fainted a few times, along with the word "catecholaminergic" may indicate that your doctor suspects you have a specific disorder named "catecholaminergic polymorphic VT" (CPVT). However, this will manifest as follows:

1) Frequent ventricular ectopy with exercise
2) Usually a specific form of ventricular tachycardia at high heart rate named "bidirectional ventricular tachycardia".

This disease is often misinterpreted as epilepsy.

But this is a genetic disease; you are born with it. It should usually have caused more problems earlier.

The lightheadedness you experience can be caused by frequent ventricular premature beats (PVCs) and you should definitely be followed up by your doctor. I'm not saying you have this, but you should ask your EP if that's what he suspected.