Advice sought re meds and sports

I have posted a version of this in the meds category but I figure put it here as well. I'm a Brit guy in London. 45, previously very fit swimmer and triathlete. Competed at age group level for GB. I had an episode of VT, non sustained, over a year ago. I had a Medtronic icd fitted, 4 months ago, it's been dormant. I take 1.25mg of Bisoprolol every day. I was originally taking 40mg of Nadolol / Corgard. I found the Nadolol made me feel like a zombie, the bisop less so. I have been swimming about 15km a week, steady, without any incidents. No running or bike. I just wondered if anyone has come off meds entirely and how you they are finding it? The docs here seem fairly adamant that meds will be required for ever, but in general they take the most conservative approach. Any views out there? Many thanks. Alastair

6 Comments

Basics

by Steve2 - 2015-05-06 04:05:27

It seems strange to me that they have you a Devon device for one spell of tachycardia. Nothing you said indicates a defibrillator device was needed. I've had plenty of A-Flutter and double speeds A-Fib and my doctors never thought I needed a defib PM. What was your heart rate during the VT? If you went to 4X normal rate, a defib device probably would be warranted. I'm 70, not an athlete but can handle double speed just fine running 120-180 or so, depending on exercise level. I just had an AV node ablation but using a CRT, not the -D version.


Re the meds, are you fully off of all heart irritants such as caffeine, energy drinks, decongestants and the like? That's step #1 for anyone with any history of arrhythmia.

Excess stress, excess alcohol and lack of sleep (less than 7 to 8 hours) also need to be eliminated. Address any of these first before considering reducing or eliminating meds.

For me, Tikosyn was the only med I was willing to use that reduced my VT without side effects, but it is one of the tougher drugs because of many interactions with other drugs. I shied away from Multaq after the FDA stopped the Pallas study because people in the Multaq group died from liver failure.

Views, Yes, BUT...

by donr - 2015-05-06 06:05:20

....through a very dark glass.

You did not give a very full description as t why you got the ICD some 8 months post VT episode. I, & anyone else,. will have to guess a lot. But I'll start the discussion.

Meds are an item that works in tandem w/ the PM/ICD. All ICD's are PM's. You did not say whether the device has been pacing you at all & if so, for what condition. If VT is your only condition, be thankful that it has been dormant, because it is there ONLY to prevent a condition leading to potential sudden cardiac arrests. You may (Hopefully) NEVER use its capabilities.

You say the leads (plural) needed to be repositioned, which implies to me that something just isn't working properly, as opposed to a lead failure or lead becoming dislodged. Which also implies that your ICD is trying unsuccessfully to pace you.

I read Snitch's comment & agree that most problems w/ leads are due to them not being adequately placed originally.

No one knows if meds will be needed forever - but it is an experience call & a prediction. Most likely, they will - BUT - the only way to learn is to back off of them a bit at some point to see what the effect will be. At 45, you have the rest of your life to figure that out, & that should be a very long time. The meds you took/take include a Beta Blocker, notorious for the "Zombie" effect. Very disconcerting. At one time I was on 800 mg per day of Acebutolol that did that to me. I convinced my Cardio to allow me to cut back to 600 to see what would happen - nothing! I stopped shuffling along & talking slowly, & sounding like I was living in a dream world. My heart continued to act reasonably normal.

Some of us have been able to cut them out, but the only way to find out is to be patient for a while, establish a baseline for meds' effects & then back off a bit to learn if you can do it.

We are all different in this area. Generally the docs are correct, but after all, they only "Practice" medicine. There is a lot of art to it in addition to the science.

Donr




Hey

by Alastair - 2015-05-06 07:05:31

Thank you for your comments. I had various challenge tests, genetic tests, stress tests over the 8 months. All negative. I also dragged my heels for 2 months over the device. Last week the atrial lead was replaced with a new one, that lead had headed north and the vent lead had straightened. Prior to that the Device had been working well. It's shocks me at 214bpm and paces me at 40bpm, as I said the machine has not registered any pacing or shock therapy to date.

to med or not to med

by Dawnie - 2015-05-06 09:05:09

I have a dual lead meditronic pm for heartblock and bradychardia. I take nebivolol every day. I was taken off my bisoprolol a month after pm was implanted and landed in A&E 3 weeks later...thought I was having a heart attack but was just heart racing at 129 beats a min. I'd love to be off all meds but am happy to stay put after that episode. I suppose we are all different. On a positive note im back in the dojo training again for karate and coping well.
Good luck

Thanks

by Alastair - 2015-05-07 12:05:52

Steve,
My heart rate was 250 over a minute, I was doing an stress test at the time so we have the ECG trace.I have had other episodes before,similar in duration, out with the hospital. I haven't had any episodes in the last year. My icd has not done any shocking or pacing, it's been inert. As you suggest I stopped stimulants like coffee and booze and I eat and rest well. I think the decision to go with an icd was a marginal decision. It does give me confidence and a chance to be active still. I had hope given the icd and my history of episodes I might come off by Beta blocker bisoprolol which at 1.25mg is a low dose anyway. Alastair

Meds

by Gatsey - 2015-05-08 04:05:43


Hi Alasdair

I am on Bisoprol 1.25 mg how do you find these? I was on Ramipril but I could not get on with these at all so consultant took me off of them

I feel more normal off the tablets , but long term I will always been on them I am bradicardic.

I struggle to exercise every time I run after 5 mins I become dizzy and I feel like my head is very heavy so I have to stop have you ever experienced these symptoms?

Adam
From Essex

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