Ventricular Tachycardia

Hi!

I haven't been on the site for a really long time, but I am hoping someone here can help me.

I have had a PM since 2009, but have always had a lot of problems with fast heart rates. Always avoided medication. These rates have always been sinus tachyardia.

At my yearly pacing check today, there is a recording of a 1 second, 8 beat long VT, which spontaneously resolved. This has terrified me, because for me VT means risk of death! My cardiologist does not seem worried, but is going to give me an exercise test, and has put me on a low does of beta blocker.

I am just wondering if anyone can reassure me. I am REALLY panicking.

Thank you!
Genie

11 Comments

too much information

by Tracey_E - 2013-09-30 01:09:58

One second is probably not even enough to be called an episode. You probably never felt it so if you didn't have the pm, you never would have even known about it. In the same situation, one second just once, I would probably skip the tests and meds, just wait and see if it happens again. V-fib is considerably more dangerous than v-tach. Your dr will tell you when it's time to take it seriously, this is not that time.

Not to worry

by donr - 2013-09-30 03:09:45

Genie: BTDTWTTS!!!!!

A lifetime ago, I was lying in a hosp bed minding my own business when my Dr. walked in & asked me if I felt anything funny a few minutes prior. Of course not, was my reply.

Come to find out - I had TWO episodes of V-Tach. One was 1 sec long, the other 8 sec long. Have never experienced it since! That was in Jul 2002.

You do not recall ever feeling the one you had, & it was shorter than my second one. You don't know if it occurred 365 days ago or yesterday. Point being, you could already have survived nearly a year w/ it. If you had them regularly, it would be a different story.

I'd say that you should have a download a bit more frequently now that you have demonstrated that you've had one episode.

Not time to panic. The Doc will tell you when that time comes.

Don

Thank you!

by Genie - 2013-09-30 05:09:02

Thank you both. It's really comforting to know that neither of you would worry, and Don that you had these and they haven't recurred.

This episode was in May. And no more since. I know that at the time I wasn't exercising, or under any stress. I didn't feel it at all.

I am going to be checked again in 3 months.

I have been panicking. A lot. So really appreciate your responses.

Genie.

PM Software Interpretation

by ebfox - 2013-09-30 05:09:07

Genie,

One other thing to consider, when a pacemaker is in sensing mode, it essentially is a 2 lead EKG. As result, software in the pacemaker interprets many non-sinus beats and the PM's interpretation is not always correct. I recall reviewing interrogation reports with my EP and at one point he said basically "the PM says that's a run of V-tach- I think it's atrial flutter..." he pointed out similar runs several times. That was over a year ago and my pacemaker was removed 11 months ago, since then I have had no problems.

If the pacemaker was a 9 lead EKG you would have a lot more reason to believe exactly what the report said.

So don't sweat the small stuff and remember, it's all small stuff-

E. B.

EKG

by Genie - 2013-09-30 06:09:16

I think this one is unfortunately genuine.

I have though, like you, had several before that were judged to be other types of rhythm. I would really like to believe this one was too, but they seem to think not.

Numbers

by Genie - 2013-10-01 05:10:28

Pacerrep, thanks for your comments. They are really reassuring,

I checked the numbers with the clinic today. Apparently, it is 1.5seconds, and 8 beats. That still seems like a lot to me, but that is what they are saying.

They did say they would keep an eye on it but it is not anything to worry about.

I am, of course, still worried!

You will know

by Marie12 - 2013-10-01 08:10:57

I'm not an expert on VT but when it happened to me, I could tell for certain something was wrong. My left arm went to sleep, pain in my neck I felt sluggish and tired. My heart rate was 188 bpm and stayed that way for well over an hour. It took that long to get me to the hospital and then they tried to stabilize me with IV amiodarone. When that didn't work they shocked my heart twice (while awake). First shock put me back into normal rythmn for 15 minutes then needed 2nd one. Now have a defib.

Perhaps you should ask your Dr if you could be checked out every 3-4 months if that would reassure you. You don't want to be worried for another year.

Just the tech in me

by PacerRep - 2013-10-01 12:10:10

But one of your numbers is off. 8 beats can't happen in 1 second. That works out to 480bpm... Not even in the worst of all arrhythmias can that happen.

Now...I am involved in some pretty candid conversations with doctors regarding VT. The general consensus for severity is whether it is persistent or not. Anything less than 30 seconds is considered non sustained and although it's something to look at, typically doctors are not overly worried about these short episodes. They may change your beta blocker's, add some coreg or just do nothing.

You just had a V-burst, it's no big deal. In all honesty, most people have these short runs, you just have a gadget that records it and calls you out on it.

If you have one that's over 30seconds, then it's time to be concerned....expect an ICD at that point.

Why the &^%$#$%^%^...

by donr - 2013-10-01 12:10:56

...don't Cardios tell that to their patients instead of JUST you? It's called treating the patient's head. Mine tells me that "PVC's won't kill you." It's the same thing! Look at all the needless worry that Genie has gone through.

My cardio, good as he is, never told that to me, even years after I had an 8 & 3 second pair of "Bursts" that they were nothing to worry about. Even worse, he did not tell me shortly after they occurred.

It's not like me trying to explain Quantum Mechanics to an Eskimo who lives in an igloo all winter on the Alaskan coast - It's simple standards for when to worry.

Don

Can a heart ...

by donr - 2013-10-04 08:10:40

...physically beat that fast? If it did, no way could it move much blood in a span of 120 ms for a complete cycling through all its functions.

Seems to me that would be in what we would call a "Stall" for a mechanical pump. The heart is a positive displacement pump, so if it goes into a stall, it could damage itself.

AT rates as high as 300 BPM, would it not just be quivering as opposed to beating & actually moving much blood?

Don

Sorry DonR

by PacerRep - 2013-10-04 12:10:59

Didn't mean to piss you off lol.

Genie, that's still pretty darn fast, If it was truly that fast then it's something to keep an eye on, good thing it stopped on it's own. I'm still skeptical on the speed of that arrhythmia because it only lasted 8 beats... your now at 320 beats...which is possible but that's cooking pretty fast for only 8 beats.

Best of luck.

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In fact after the final "tweaks" of my pacemaker programming at the one year check up it is working so well that I forget I have it.