monomorphic Idiopathic left VT, AV block 3 PM

I am posting this message and my experience with VT in the hope that it might someday help someone else going through a similar experience as what I went through.

My first episode of Ventricular Tachycardia was when I was 18. It lasted around 7 hours. I went home and by the time I contacted a doctor to come to my house the tachycardia had stopped and I was back in Sinus rhythm. My tachycardia was mostly triggered after exercising. I went to a cardiologist and did a stress test but a short 15 min stress test wasn't enough to trigger the tachycardia as I have a high level of endurance. The cardiologist told me it's probably SVT and I didn't have to worry about it. As the years went by the episodes of VT became more and more frequent. The palpitations would mostly last 3-4 hours, however they did last up to 24 hour sometimes.

My profession requires me to perform at a high physical level 6 days a week and if I would get an episode of VT it was incredibly difficult to complete my task. My VT was usually at a rate of 170-230bpm. During holidays i would never get any episodes of VT. It was nearly always after an 8 hour work day that I would get the VT's. When my body was physically exhausted I would be more susceptible to the VT's. If I laughed when I was exhausted it would trigger my VT's so I became scared of laughing. Alcohol was also a trigger post long periods of exercise. To stop the VT's I would go to sleep. Nearly always just before the moment when I drift off to sleep my heart would kick back into sinus rhythm. Valsava maneuver and the other tricks to terminate the VT never worked for me.

I continued working in this condition but the VT started to become more frequent and affected my performance at work so I decided to schedule a cardiac ablation. Before the ablation I was given a holtor monitor for a week in the hopes of being able to catch the VT on the EKG. Sure enough after one tiring day I had a couple of beers and managed to induce the VT. The doctors looked at the EKG and confirmed it was SVT then proceeded and inserted the catheters. They induced the palpitations only to realise that they had entered the wrong part of the heart as the electrical misfiring was in my left ventricle. I had been misdiagnosed for 5 years. (The EKG for idiopathic VT look identical to the ones for SVT.) They had to immediatley abort the ablation. I was asked if I had ever fainted in my life or if I had a family history of heart disease. I have neither. The doctor said that I might be at risk of Sudden Cardiac Death and and ablation was risky. I did an MRI after the first ablation attempt only to find that my heart looked fine, there was no myocardial scarring. The doctors were surprised and diagnosed me with monomorphic idiopathic Left Ventricular Tachycardia. I wasn't at a risk of SCD and thus was able to proceed with the second ablation attempt. After the anaesthesia had worn off on the second ablation attempt, I woke up and my heart started to palpitate irratically, nurses and doctors rushed into my room to try to stabilize my heart to no avail. That night I didn't get much sleep and the palpitation wouldn't stop until 3-4 a.m. After 2 days I was sent home the doctor told me that after an ablation you can get palpitations for up to 3 months that may be caused because the heart is irritated and is still healing. A week later my palpitaions came back and I was rushed to hospital in an ambulance. They did the 3rd ablation attempt I was told it was successful and I was sent back home. A week later I got palptations again that lasted only for 30 seconds just as I picked up my phone and dialled 911 my heart went back into sinus rhythm. I thought perhaps it's just irritated called my doctor who said the same thing.

I was off work for 3 months. As I went back to work the palpitaions started again, only this time my heart was a lot more sensitive and would start palpitating with less physical output. The doctors wanted to wait a bit more to see how it goes with beta blockers and calcium channel blockers. In the following 3 months I would work get palpitations go to hospital try a new medication go back to work get palpitations back to hospital you get the idea. I tried bisoprolol, nebivolol, verapamil and two other beta blocker which I forget what they're called. I had a terrible experience with Verapamil. I couldn't continue that medication longer than 3 days as eveytime I took it an hour late it would trigger the VT.

In December of 2018 it was so bad that just bending over to wash my face in the morning would trigger the VT. I decided to try the 4th ablation. The 4th ablation resulted in AV block 3 and I woke up with a temporary pacemaker. The following day I got my first triple lead PM implanted. After the PM implant I was off work another 3 months but I started doing light exercises in the gym a week after the implant as the doctors said I didn't have to worry about my heart I only had to worry about reducing the load for the left arm until it heals. One month and a half later I developed deep vein thrombosis and had to go back to hospital. Luckily I came early enough and they didn't have to cut open my arm to remove the blood clot. Since then I haven't been getting any palpitations and my thrombosis is fine. I am currently off all the medication. I still get the skipped heart beats and at times 15 heart beats consecutively that feel really hard and heavy. 

If anyone has had some similar experience with idiopathic Ventricular Tachycardia I would very much like to hear their stories as well.

-Sincerely

 


2 Comments

Confusion

by AgentX86 - 2019-10-19 10:39:57

You say it was VT and then SVT.  There is a difference (the opposite things, really).  Were the ablations in the atria (makes sense for SVT but not VT) or ventricles (more serious but so is VT)?

BTW, "idiopathic" means "there it (symptom) is but we have no idea why". DVTs aren't good, particularly with SVTs. A clot could just as easily go to the brain (i.e. a stroke). I assume that you're on anticoagulants now? 

Another thought is that rrhytmias are very commonly caused by dehydration, particulrly the loss of electrolyte (low potssium and magnesium are the most common).  Since your arrhythmia often started after hard physical work, this jumps out at me. Excess potassium can also cause a very dangerous arrhythmia but is also very uncommon (the reason MDs don't like to prescribe potassium supplements).

Clarification

by 23PM - 2019-10-21 04:55:17

Yes I am clear that there is a difference between SVT and VT, however from my understanding it seems strange to call them opposite conditions. Could you explain further?

As the text states the doctor misdiagnosed me with SVT as the EKG of SVT and VT is identical and thus the first ablation had to be aborted because they entered with the catheters in the Atria and not the left ventricle. 

Yes I know what idiopathic means. 

I do not understand what you mean by "DVTs aren't good, particularly with SVTs."

Are DVT's better in other occasions?

Yes I was on blood thinners for 3 months after the DVT. 

I didn't know that excess potassium can cause arrythmias, however I wouldn't say I had a particularly potassium rich diet. As for dehydration that could definitely been a factor.

Thank you for your reply I hope I have answered your questions

Sincerely

 

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