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is an echocardiogram enough to rule out most causes of sudden cardiac arrest?

I had an echo done 10 years ago which came back normal.  I was told my heart was healthy and I could run marathons without worrying about sudden death, but I feel like that's not enough.  I keep getting couplets, bigeminy and NSVT or PSVT (not sure which, but more likely NSVT).  When I was 12, I experienced something that matched numerous EKG print outs of NSVT runs separated by a sinus beat.  I feel like there is something there.  What tests should I get?  So far, I have only had EKGs, one 24-hour Halter and one echocardiogram.  I am considering asking my doctor a stress test, an event-monitor or a ZIO patch.  Would a heart MRI offer any further insight?
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What do you mean runs of NSVT seperated by a sinus beat? Do you mean you would have a run and then 1 normal beat and then another run and then 1 normal beat?

I am not sure if an echo is enough to rule out you ever having sudden death. I am not sure there is any test really that could do this but having a normal echo and other testing would make it unlikely.

Considering your documented arrythmia's you might consider seeing an EP. They are specialist who specialize in the electrical aspect of your heart. Perhaps they will order further testing or even an EP study.
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Yeah, runs separated by 1 or sometimes 2 normal beats.  When I was 12 (after sprinting) I would get the following:


During these runs, it felt like my heart was about to jump out of my throat.  Also, it felt like the runs started slower (maybe 120-150 bpm) and finished even faster (170-200 bpm).  This actually happened to me only 3 times.  Strange thing is, I  went on to compete in track and field in HS, and did sprints, but it never happened again with THIS severity.  I'm 32 now, and it was just THIS year that I noticed couplets and bursts of 3 or 4 ectopic at rest.  Still nothing on exercise.      

I did notice that I get couplets or bursts when I am very stressed, like for example when I am talking to somebody who is making me nervous, when I am giving a speech and also on climax during sexual activity.  
But sometimes I try to really push myself during exercise.  I ride my bike for 2 hours.  Sometimes I run and try to sprint to the finish, until my muscles feel like they're about to give out.. just to see if I will die.  I actually don't care if I die.  I just hope it doesn't happen when I'm around people, because I do not want to become a viral video and somebody's entertainment LOL.  
I also get an increase of ectopics in times of stress and anxiety, as do a lot of people unfortunately.

If it was me and I wasn't having other symptoms along with my palpitations, I personally wouldn't be very concerned. At some point you will get use to these feelings and will worry less or at least that's the way it was for me. I really dont worry anymore about my ectopics or other arrhythmias. I wont even take meds for them anymore. I am currently getting dizzy spells and that's what concerns me.

If you however cant come to terms with this and its affecting your quality of life and causing you a great amount of anxiety, you could always ask your dr for a low dose beta blocker and see if that helps any.
Anxiety is my worst enemy it seems.  Like I said, I noticed the couplets recently.  The precipitating event was one of my mom's acquaintances being diagnosed with Brugada syndrome after going into vtach (I'm guessing).  That got me researching heart conditions and listening to my own heart again.  Sure enough, I started to notice ectopics more and more.. then the couplets, etc...  

I just need to relax probably lol.  Can't go against the universe.  If I'm sick and I should die in a few minutes, then be it.  If I don't die, then I should just enjoy another day.
Avatar universal
I agree if you are having runs like that you need to see a ep if you haven’t already and definitely get a ep study. A normal echo can help rule out whether you have a high chance of scd but nothing can rule that out completely. If your left ventricle is normal and ejection fraction is good that improves your chances of not having a major event. Ecg can help rule out some genetic diseases like long qt short qt brugadas syndrome etc. a stress test can help rule out coronary artery diesease but a stress test will only show if you have 70% blockage or more so if they think it is abnormal they would do further testing. Do you feel light headed or pass out when you have these runs. I would get a ep study because you might be a candidate for a ablation.
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