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different arrhythmias in normal hearts


Posted by jamur34

I have frequent pvcs, my 24hr holter showed 14,000 of them (only felt the occasional odd sensation in my chest during those 24hrs). I also had an echo this month that came back normal. My big concern is at times i experience these really terrifying palpitations that have not yet been captured on any monitoring. Could i be having a different type of arrhythmia, and if so what other types may i be experiencing. Since I had a normal echo does that mean i have a structurally sound heart. If my heart is structurally sound would all arrhythmias be 'benign' or am i assuming too much. Im just worried that i may be having signs of a fatal arrhythmia. thank u for any advice

 
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Sounds like you have lots of concern and rightfully so as we all hear of a "friend of a friend" who had a dangerous arrhythmia that they didn't even know about.

 Any beat that comes in too early or takes over the natural rhythm of the heart beat is an arrhythmia.  Not all arrhythmias are dangerous.  As we get older, just like we get wrinkles on our face, our heart gets "wrinkles" or irregularities that just come with age.

The cardiology group I was with, followed the general concensus adopted in the last 15 or so years, that single PVC's (not strung together in multiple beats) that did not produce symptoms (light headedness, drop in BP etc)no matter how many times they occurred,  did not warrent medication ot treatment.

To help visualize the heart and evenything it does, I like to use the example of a house. Your heart is a house. The walls, floors, and beams are the "structure" or muscle walls that form the chambers of the heart.  The wiring is the electrical system  or the pathways in the heart that transmit electrical impulses that regulate heart beat and have to do with extra beats and arrhythmias, and the plumbing is the coronary artery system that carries blood to the muscle. The windows are the heart valves. 

Sometimes there is a valve disorder that can cause the PVC's. Since your echo was normal, that is not the cause.  That said, just because you had a normal echo does not mean it translates to a healthy "electrical system". The walls and windows can be sound, but you can still have a short in the wiring.

Without catching that episode of "terrifying palpitations" we just don't know what is going on. You may want to ask your doctor for an "event monitor". Unlike a holtor, that has you wired up for 24 hours, and event monitor is the size of a credit card and you carry it with you. When you feel something weird, you hold it to your chest and push a button and record the episode like an ekg. You can store many epiosodes as digital data in the card. Then, when you have something on the card, you call a number and transmit the info over the phone. They transmit it to your doctor for him/her to read. You can keep it up to 30 days (I believe that is what most insurance comapnies pay for) This would be a good way to know what your heart is doing during those feelings.

Sometimes an exercise test is done aslo to see what happens when the heart is made to speed up.  Less serious PVC's go away with exercise. 

I hope this helps! Please let me know whow you do! 

PS. I'm sure your doctor checked your potassium level as this could be the cause of PVC's, but sometimes, it's just the way you were "wired" when you were built! 

hi savvy sister, thank you for the information. My doctors have always gave me the impression that since my 'structure' was good then the arrhythmias were not a concern, they of course never included the fact that that may not be true about my electrical system. I am going to inquire more on that issue with my next cardio appointment right after xmas. Im going to have to nag him for an event monitor. The last time i saw him i briefly mentioned the event monitor and he said you wouldnt need one due to your echo results, but as u said thats just my structure not my wiring. It almost seems like he didnt even consider an electrical system issue. U mentioned an exercise test, i did have one a few days ago and the doc. that was doing it didnt see any funny beats. I was suprised ! I am pretty sure my doc did a potassium test, i had a ton of blood taken out of me twice in the last few months.  If my other odd beats (other then the pvcs) happen to not get picked up on an event monitor would the next option be an EP study or are those only done in specific situation. I remember on one of my 24hr holters they mentioned several SVTs were recorde, but didnt say what kind or any other info on them.  How would one find out what kind of SVT one was having ? thanks again

I'm glad you have a few more answers!

An EP study is an invasive study, and while it is a commonly done test, it does have all the risks of any invasive test (death being one as it is in any invasive test).  That said, it would only be done usually (and this is up to YOUR doctor) if a serious and dangerous arrhythmia problem was identified to see if it could be reproduced in the lab and treated.

The fact that the PVC's did not show up on the treadmill is great news. 

Your symptoms have a lot to do with how and if it's treated.  If you're not passing out from these beats or having chest pain, depending on the info they find on other tests, it's possible that nothing is needed.  (Again, this is up to your doctor as I am not your medical professional and don't have access to all your test results).

SVT is SVT. There can be many variations...lasting 5 beats or lasting 5 hours....110 beats per minute or 190 beats per minute....all of these can be classified as "SVT".

I, personally have PVC's and SVT (in the form of an "alternate pacemaker" which means there is a bundle of nerves in the upper part of my heart that "takes over" the regular rhythm of my heart (60 beats per minute) and beats around 115 beat per minute.)  I don't pass out and the episodes last about 10-15 minuites.  I know this happens, and I know it won't kill me, so I just wait until it passes.

It may be the same with you.  Flutters are "un-nerving" sometimes, but if your flutters aren't stopping you from doing your daily routine, and you're not having any symptoms, it may just be something you live with...you didn't mention your age, but as we get older, there are more and more things we  have to "live with" LOL

Keep me posted on your progress! 

Hello Savvy Sister, I finally got an appointment with an EP doctor  (its just not for another 2 months- ahhh!!) Even if i dont go with an ep study at least i can get some concerns out of the way, i never did get that appointment with my cardiologist after xmas . He called me and said he didnt really find a need to see me again since my stress test came back fine. I tried to ask him those questions on electrical heart issues (over the phone-which i really didnt feel comfortable with) but was meant with rudeness and kept telling me 'your fine, your fine'. I told him to send/referal me to the ep doc. to get my questions taken care of. He seemed really against my going to the ep guy.

Is it possible for very short bursts of svt to occuring several times daily on some days, and by very short bursts i mean just several seconds long per episode.  Im just wondering if this is what i may be feeling when i lay down. I got a rapid beating for just 5-10 secs when i laid down last night. It happened twice and scared the ^&*^ out of me. When i sat up quickly both times it went back to normal beating almost right away. And when i lay on my right side i get like 2-3 back to back beats that are just abit more faster and forceful feeling when taking my pulse then the rest of mybeats feel. The rate goes back to feeling normal again after these beats but this can sometimes do this off and on several times before it stops for the night. So darn it im getting funky beats no matter what side i lay on. This odd beating when laying down is new for me. I seem to be getting different feeling beats all the time, something new always seems to pop up daily on me now. My family doc. doesnt seemed concerned however, but i certainly am.

How did u get your arrhythmia finally diagnosed.

I did some reading up on electrical system disorders that can occur in structurally normal hearts -not just the svt- but ones that can still lead to v-tach or v-fib  . Any advice on those. I think they were ion channel issues with the heart.

Can svts ever be dangerous. Sorry for the extremely long post, i just had alot floating in my head. (ps in 34yrs old)

Thanks, Jackie

I think the EP doctor will clear up a lot of concerns for you. As I said, this may be nothing as every heart has it's quirks.

I would advise you not to read too much about different heart problems until you see the EP doc.  You'll just worry for nothing.

 "can SVT ever be dangerous"...in a 34 year old usually not. You are usually just dealing with bothersome symptoms.

 

Good luck with your appointment and let me know what they say! 

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