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VT Triggers - Fever or Alcohol?
Hey everyone,
I'm 22 years old and I have a preexisting heart condition but I developed VT in April 2010. I had an ablation in July 2010 and my doctors implanted my ICD in August 2010. I have received shocks on two separate occasions. The first was in November 2010 when I was out drinking with my friends, where I received one shock. The doctors concluded that my VT was being caused by alcohol, so I stopped drinking and didn't have any problems. The second time was a little over a week ago where I received 36 shocks in the span of 23 minutes. The shocks did not bring my heart rate down for more than about 15-30 seconds. The ER doctor gave me an anesthetic and they tried shocking me with their defibrillator but that did not bring my heart rate down either, so they put me on ammiodarone and that brought my heart rate down. The doctors concluded that my VT was caused by a fever and possibly a couple of infections.
I have developed some anxiety with this recent discovery. It was a lot easier for me before to control my VT by just not drinking alcohol. But now, I'm afraid of getting sick because I do not want to experience that many shocks again, or any for that matter. The doctors put me on Metoprolol and it helps with the anxiety, but I still have my moments and little freak outs where I check my temperature and my heart rate more often than I should. I hate not having control over it like I did before.
I'm wondering if anyone has these triggers? Or what kind of things trigger your VT and how you deal with it day to day? I speak to a counselor once a week and I know that it just takes time to get over these things, but it doesn't change the fact that what I went through was quite traumatic.
8 Comments
Thank you
by ekt32 - 2011-08-19 06:08:45
Thanks for the response! You're right - if I keep checking I will drive myself crazy. I was in the hospital for 6 days after that attack and they were checking my temperature, oxygen, blood pressure, etc. a couple of times a day so I think I got used to that. It was like a sense of security for me and now I'm trying to do it on my own and its tough. I think it would be a good idea to start weening myself off from it haha.
I'm sorry to hear about your daughter, but I'm glad you were able to make an already stressful situation less stressful.
Possibility
by ekt32 - 2011-08-21 05:08:25
I would like to have it done again. There's no doubt I'm going to get another fever, especially once I go back to school and work. And if that triggers an episode like last time then they'll definitely do an ablation. However, they said that they wanted to see how I would do on beta blockers first. The issue is that aside from the VT, I have a pretty complicated heart condition so they're a little iffy about going in there and trying it out. Last time I had the ablation done, they called in a doctor from Montreal that specializes in exactly my heart condition, type of surgery I had, and VT so he aided them through a video feed. But yesterday I had a very bad anxiety attack where I made myself believe I was going into an episode and going to get shocked by my defibrillator (I even got my heart rate up to 145 bpm) so I went to the ER. But once I was given a sedative, my heart rate went down and everything was fine and there was no sign that I was going into VT, judging by my ECG/sinus rhythm.
I'm going to talk to my doctors tomorrow and ask them about an ablation because I can't keep living in fear or taking sedatives to make me feel better. My anxiety is ten times worse now than it has ever been.
settings
by turboz24 - 2011-08-21 06:08:07
Do you know your ICD settings?
My defib is set for 220 for ATP, then 250 for defib.
It monitors starting at 160, but doesn't do anything until 220.
My first VT issue would be initiated when I was cooling down from exertion. MY irregular beat would dissapear after 110-120 bpm, but when I was cooling down from working out, that's when it might hit. This was fine, becuase I was certain about the trigger, but I hated the meds (BP was to low, slows me up a lot), so I opted for an ablation.
The ablation worked great for 3 years, until I had a run of PVC's and just randomly ended up going into VT. It wasn't as fast (my previous VT's were 240-280 bpm). This one would start at 180 then wander up to 220, ignore the ATP then get shocked. I found this one way more disconcerting, since it was totally random.
I just got out of my 2nd ablation 2 weeks ago and except for some pretty bad inflamation (heart was really pissed, which caused a short term issue with VT), I'm much better now. I'm running smoother than I have in 4 years. This time my EP is very certain they got all the issues, at least the electrical ones.....
Now all I have to do is wait until I get my ICD replaced and moved sub-pectorally then I can not be freaky about how bad it looks.... :)
Settings are high
by ekt32 - 2011-08-21 09:08:21
That's great! I really hope they got all of your issues situated. That's what I would love to happen for me, even if it is just for a few years at a time.
I believe mine starts pacing at around 188 and it shocks at either 250 or 260 but my heart never trickles up to a high rate; one minute its a little high, like 90-100 bpm, then it jumps above 250. The highest my heart rate has gotten is 300 which is why my settings are so high.
I think after reading a couple of your responses and other things around here I'm going to really advocate for a second ablation. I mean, my VT went from being minimal (only needing one shock) to being very aggressive (36 shocks and still did not come down). I don't think that I should just try controlling that with medication. I figure that if a defibrillator shock cannot bring that down, why should a measly beta blocker be able to keep it under control? I'd rather have them try and fail then not try at all.
Thank you for all of your responses!
considered an additional ablation?
by turboz24 - 2011-08-21 12:08:39
Have you or your doctors considered an additional ablation?
WOW
by spearhead9399 - 2011-09-27 12:09:13
I received 2 shocks before I realized my lead was broken. For months I was scared to run because one of my shocks occured at the start of one of my runs. I can't imagine that many shocks and the lasting effects. I certainly hope you can find a helpful way to prevent that from happening again.
VT Triggers - Fever or Alcohol?
by slgeagle - 2011-10-15 03:10:26
What a terrible event. I too had 9 shocks in 25 minutes each one getting worse than the previous. Amiodarone stabilized me. I was in the hospital for four days. They ablated my AF Node. A week later I was in A-fib again (but not shocked) and now I am on Sotalol to prevent me from going into A-fib. Physically I am doing ok, emotionally I am having a difficult time. The fear of more shocks even though I probably shouldn't have one due to A-fib, puts me in such a state of anxiety that I can't sleep at night. Especially at 3 in the morning when I wake up and don't feel right. I have a St. Jude CRT-D so with the ablation I am 100% dependent on the pacer. That I can live with, but I fear the shocks.
Good luck to you.
Sue G
You know you're wired when...
You can feel your fingers and toes again.
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Anxiety
by Heidiglassmeyer - 2011-08-19 01:08:36
What you described I think would cause some anxiety for most people. I can understand how being shocked that many times was a traumatic experience! I do not have VT but do have bouts of Atrial Tachy and my trigger is usually lack of sleep for a long period of time and stress.
I tell myself it is what it is... I do my best and move forward each day and take care of myself.
I think it is easy to become obsessive about things such as taking your temp, etc. In my opinion it's not productive nor will it prevent an occurance. If anything it may increase your anxiety. I know it's hard but try not to let it consume so much of your energy.
My daughter has a periodic fever syndrom that causes high fevers that are cyclical every 30 days. When she was first dx'd I was ALWAYS checking her temp. I soon realized all I was doing was making her more anxious and afraid for the next fevers to come. I felt no relief between fevers because I was always waiting for the next one to hit. My behavior was destructive to both of us.
It sounds like you know worrying is an opportunity for you and sought help. I hope you continue to gain strength able to move on and that you have minimal experiences with VT going forward :).
Take care!
Heidi