NSVT- looking for reassurance

Hi everyone! 
 

At my most recent pacemaker checkup in September I was told that I had had 1 'episode' of 'asymptotic VT',which I have realised is another wording for NSVT. I am only 16 years old, with a pacemaker from birth for complete heart block. 
 

I have extreme generalised anxiety disorder and suffer panic attacks, and hearing I have had an episode of NSVT (in august) has really increased my anxiety. I have no structural heart disease or any other problems other than the heart block, but I am worried that NSVT can develop, even though I have only had 1 episode and it was short 

I hope I can find some reassurance from some of you, you are usually really helpful,

 

thank you

Hayden  


10 Comments

NSVT (Non sustained ventricular tachycardia)

by Gemita - 2020-11-01 12:57:31

Hello Hayden,

I do recall your earlier, first post and our chat on this subject which seems to have been deleted from the system?  I won't go over old ground because you will probably want a fresh pair of eyes to help you.  All I will say is if you are still worried, I would have a word with your doctors about getting some additional, maybe longer term monitoring to see whether you are getting any further runs of VT.  Alternatively, if you have home monitoring and have any symptoms, ask your clinic if you can make a recording and transmit the data to them to assess what may be happening at the time.

I recall you are having CBT (cognitive behavioural therapy) for your anxiety.  This is really effective treatment but it does take time to change the way we think and behave.  I hope you can unload all your fears onto the therapist. Anxiety takes away our lives if it takes hold, so I hope you can find relief from your symptoms soon.  Good luck

Thank you gemita

by PacerPrice - 2020-11-01 13:21:33

Hello again,

My post was deleted from the forum, I'm not quite sure why but I do remember our conversation. I have the knowledge that the non sustained VT is not a concern, but the anxiety is definitely still there. 
 

thank you for replying again, just getting that extra reassurance and message really does help so thank you. I have a home monitoring system that I can get them to check when I am feeling really anxious,

Thank you 

hayden 

lost post

by Tracey_E - 2020-11-01 16:36:03

It wasn't deleted but it looks like it disappeared when you changed your username. I don't know why it would have done that, but that's the only thing I can think of

 

We talked about CBT?

by crustyg - 2020-11-01 17:39:52

The post may have vanished, but I'm hoping that your memory of it, and the replies, hasn't?

You recall that in CBT you have to make an effort to use your strategies to produce a more positive state of mind.  No-one here can make you stop imagining the worst if that's what you choose to do.  You have to make choices which are good for you.

The physiology of your heart isn't the main problem here.

G.

Don't Accept Anxiety and Panic Attacks

by Swangirl - 2020-11-01 18:25:02

I'm a psychotherapist who also has a pacemaker and I've seen hundreds of people over my long carrer overcome severe anxiety.  There might be some organically based anxiety but more than 90% is caused by your thinking.  For more than thirty years the most researched treatment for anxiety is Cognitive Behavioral Therapy which is practiced by just about every counselor.  There are many do-it yourself programs online if you don't have insurance and can't afford a therapist.  CBT has better results long term than medication.  If you are on medication you need to get off eventually.  Long term use of SSRI's and Benzodiazepines have very bad side effects.  It's not easy but with some work and practice you can learn how to identify and restructure your negative thinking.  Get this $10 book from Amazon and it will show you what to do and help you understand the value of the "hard work miracle" of healing from anxiety, panic, and probably depression which follows suit usually after anxiety.  

Cognitive Behavioral Therapy Made Simple: 10 Strategies for Managing Anxiety, Depression, Anger, Panic, and Worry Paperback – May 22, 2018

by Seth J. Gillihan Ph.D  (Author)

"asymptotic VT"

by AgentX86 - 2020-11-01 20:45:10

I remembered your post from before because of the use of the word "asymptotic".  Someone asked but I don't remember the answer but did you mean "asymptomatic"?  ...as in "without symptoms", rather than "approaches a limit"?

If you don't have symptoms, your EP appears to be watching it using your PM as a recorder.  Apparently he isn't too concerned, I assume because it resolves itself very quickly.  One episode doesn't seem like a big deal either.

As others have said, your problem isn't so much your heart but how you deal with it.  CBT is certainly something to turn to but IMO, my way of dealing is to ignore the past (been there) and think about where I want to go (haven't been there yet).  Perhaps they're the same thing (CBT to and taking charge of the future).

Thank you

by PacerPrice - 2020-11-02 06:45:06

Thank you very much everyone, it seems to me that the main problem here is the anxiety and not the 1 non-sustained vt episode I had. Thank you all for your reassurance. I live in the UK and am undergoing cognitive behavioural therapy, it helps but I think it will just take a bit more time. 
 

swangirl, it is really interesting to here that there are people in the same position as me and have gone on to do amazing things (become a psychologist) I would like to be a doctor so that is cool. Thank you for your messsge, CBT is something that I am undergoing now and I think it helps, but it will take time. 
 

AgentX86, yes it is asymptomatic VT, sorry for my spelling. I have only had one episode of this in august, and my doctor does not seem at all concerned, he didn't even mention it too me, jt was on his report to my other doctor and I just happened to see it on the computer. 
 

thank you everyone! 

ventricular tachycardia

by Selwyn - 2020-11-02 10:05:50

When to be concerned?

Here we are down to the use of terminology rather than seeing an ECG/EKG. I am not sure the terminology of ventricular tachycardia, non sustained ventricular tachycardia, and asymptomatic tachycardia relate to the same event. Tachycardia is the medical term for a heart rate over 100 beats per minute.

As I see it:

Any increase in heart rate greater than 100 bpm is a tachycardia. Anxiety etc. can cause a release of adrenalin/ephedrine  and cause a tachycardia. Only an ECG/EKG will tell you what is the cause of the tachycardia, however there is no doubt that anxiety can drive the heart so you experience palpitations - my last 'panic attack' was at the top of a very high ladder in mid-air ( I don't do heights!) - the heart was thumping away and there was hyperventilation- the real thing!

To diagnose a ventricular tachycardia you need to have an ECG/EKG - Ventricular tachycardia is a pulse of more than 120 beats per minute with at least three irregular heartbeats in a row ( ie. a failure of proper sino-atrial  conduction, the origin of the contraction is due to an abnormal electrical focus in the ventricles).

How you diagnose asymptomatic tachycardia is by taking your own pulse or with an ECG/EKG, any symptoms you experience by definition means this is no longer asymptomatic. 

A tachycardia, with a few ventricular ectopic beats, especially on a background of anxiety-tachycardia, may be acceptable. Non sustained ventricular tachycardia is the same but lasting less than  30 seconds. Certainly, if this was recurrent, I would be worried, and the same if sustained ( as this can be fatal).  

So, it all comes down to what was seen and terminology. The odd ventricular ectopic, even multiple, as associated with anxiety,  may produce a tachycardia of ventricular origin.  This is not a non sustained ventricular tachycardia which must have three such abnormal beats in a row.  Over 30 seconds of this and we are talking a ventricular tachycardia. 

Palpitations are a  very common symptom of anxiety, as is a sinus tachycardia ( only diagnosed on ECG), Betablockers not only relieve the symptoms of anxiety ( such as tremor, heart rate, sweating, help calmness), they also  will help stop palpitations from this cause. 

I think I would want to know what people saw on the recording before reaching any conclusion as to use of a diagnosis as terminology can be used casually.

 

 

 

 

 

 

Are you on any medication for anxiety or palpitations?

by Gemita - 2020-11-02 13:33:41

Hello Hayden,

After reading through your posts it did make me wonder which came first for you, the anxiety or the palpitations?  I know we have all been here, but the question needs asking even if the treatment for both will still be the same.  I would still advise CBT as an effective treatment for all stress related illnesses and as an exellent treatment for learning how to live our lives effectively.  However, I would ask whether you need some additional help for your palpitations, the extent of which may not yet be fully known?    

After reading the last contribution from Selwyn, it reminded me of my EP's suggestion to try a low dose beta blocker first to try to calm everything down.  A low dose beta blocker can be used for anxiety too, so it might have a double benefit for you.  I am aware though that our therapists prefer to treat us without the help of medication initially, so that they see us as we really are and are able to quickly assess our needs.  If we take medication, this may influence our mood or camouflage our deeper feelings which would not help us to express what is really troubling us.

You could still ask your doctors whether a low dose beta blocker might help you (unless you are already taking medication).  Additionally as mentioned earlier, longer term monitoring would give your doctors more of an idea what is happening on a minute to minute, day to day basis if indeed you are getting rhythm disturbances contributing to your anxiety?  If you have home monitoring, use this to send transmissions when you are having symptoms, although it may not be as good as wearing an event/holter monitor for say a week to 10 days or longer.  Our pacemakers are not great at storing ECGs unless there is an important event recorded.  My non-sustained VT was picked up by my pacemaker and an ECG produced, but it had to be read and confirmed by my EP before it was reported as an episode of NSVT.  This event occurred during a period of very high atrial heart rates.

Don't blame yourself for any of this.  Palpitations can cause anxiety as I and many others well know.  Anxiety however can cause palpitations, so which comes first?  But let us not go round in circles.  Let us try to deal with both difficulties if we can and get you to a better place very soon.

Thank you too you both.

by PacerPrice - 2020-11-03 04:02:55

After reading your comments I have been given some great advice and reassurance, thank you. 
 

I am not on any medication for the anxiety, so perhaps a low dose of beta blocker may help, but I have been told by my GP that at my age they try to steer clear of medication for as long as they can. Maybe this has gone on long enough and some additional help via medication is needed. I am having CBT and have done for around 4 months now, I am definitely progressing and getting better, but the anxiety has ups and downs where the ups and really good and the downs are really bad anxiety. 
 

In regards to the VT, my cardiologist told me that I had had normal palpitations and heart rhythms. He was not at all concerned by his findings at all, it was only only on the monitor screen while writing the report that I saw the words " asymptomatic VT" which was reported as one episode in august. He didn't even mention this too me, so I guess he can't have been bothered or worried or he would have brought it up to me and my dad, he also encouraged me to exercise so he can't be too worried about my heart's rhythm I guess. 
 

thank you to everyone for their help! 

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