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Run of vtach

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domig Find out more about domig
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  • Run of vtach

    Hello, I am new here and will introduce myself soon.

    I have HCM and have had it since I was a child. I’ve been asymptomatic besides the benign PVCs I get. This month, I got a report back from my recent 7-day holter that noted a 4 beat run of vtach, so NSVT.

    My Doctor, who is at a CoE, says that this is not urgent or critical in any way and recommended me to see an electrophysicist at the CoE so they can monitor me over time.

    I have no other “risk factors”. I’’m so scared now that I’’ve crossed a line into NSVT territory. I don’t want to die and I’m scared of getting an ICD. I was sick with a bacterial infection but wasn’t on any medication for it at that point. I am looking for any excuse to not worry about this and hope it’s just a one time thing.

    Does anyone know why my doctor wouldn't think this is of any concern? And what would the electrophysicist be able to do for me?

    Thanks.
    Last edited by domig; 08-01-2018, 12:47 PM.

  • #2
    Domig....Welcome to the forum.
    Please, take a deep breath and hear what I have to say: #1 Knowledge is power.
    #2 Knowing that worrying does nothing to improve your situation....and seeking the knowledge you need to dispel that worry is absolutely the very first step.....and you have taken that step. #3 A single incident of 4 PVCs in a row in 7 days is not an emergency, but does warrant further investigation.....Think of it this way.....there are many hundreds and thousands and millions of people walking around having various numbers of PVCs routinely....this is a fact. Wouldn't you imagine that there are many more than a few that have 4 in a row and never know about it and go on to live long lives?
    You have HCM,you were on a heart monitor and they recorded an episode of NSVT....So it does need follow up to try to determine the frequency and the cause: Is it a regular occurance or a rare occurance? Did it happen as a stress reaction to an illness on a one time basis? Are all your electrolyte values in order? Potassium, Sodium, Calcium, acid base balance etc. can cause a heart to become more irritable than usual and increase the number of arrhythmias.
    So in short....your Cardiologist is correct, Let the Electrophysiologist investigate.....You may need to wear a monitor for 30 days, get some blood work or other tests. An ICD is a big commitment. Trust your HCM COE Cardiologists to walk you through the process of whether it is appropriate.
    In order to diffuse your worry.( which can also increase PVCs!)...write down all of your questions and get an email, phone or in person appointment with your cardiologist and get them answered.
    I feel compassion for your fear....and I encourage you to step up your relationship with your HCM specialist and not try to find all your answers on the internet.....Sometimes googling just increases the fears rather than looking at them one by one and defusing them.
    After years of symptoms:
    Officially Diagnosed HOCM 2006
    Myectomy 3/11/13 at non-COE
    Extended Myectomy 7/23/14
    At Mayo with Dr. Joseph Dearani

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    • #3

      what Jill said!
      Myectomy on Feb. 5, 2007.

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      • #4
        Thanks for the responses.

        I’ve relaxed a little bit, but the anxiety is still really kicking me in the butt.

        I went to the EP and he looked at my medical history for about 1 minute, glanced at my past echo and NSVT run, and told me I was “medium risk”. Luckily he told me to get a cardiac MRI which from my understanding will show anywhere from none/little to significant scarring. If there’s significant scarring, the EP stated I would be “high risk”.

        I’m a bit bummed that this doctor didn’t care to test for anything else, such as the blood tests and other tests you mentioned, as this is the first documented occurrence in my life.

        It may may be worth mentioning that this EP was recommended by my CoE cardiologist but is not in fact part of the CoE in any way. I’m thinking, regardless of what this doctor finds (positive or negative), I should see an EP at the CoE.

        In the meantime, I am scared that I am going to go into vfib and die while waiting for results. Please tell me I’m being paranoid.
        Last edited by domig; 08-07-2018, 11:38 PM.

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        • #5
          You are not parinoid but you are over anxious.....You are doing all the right things but your anxiety is getting the better of you. Do you have a general PCP that you trust and could confide in ? If you do, you might ask him or her for 2 things:
          1) could he check your electrolytes because you have been having extra PVCs. 2) Anviety can increase your arrhythmias.... would he consider you taking an anti-anxiety medication until all this cardiac stuff is sorted out.
          The MRI is exactly correct to give a perspective on scarring. You may also want to meet with your COE cardiologist and ask why he referred you out of the COE for your EP doc and could you see someone in the COE for a second opinion. I am surprised they didn't put you on a 30 day event monitor .... that might be something to ask cardiologist about also.
          Also, you might want to call the HCMA office and talk to Lisa.... both she and her daughter had ICDs and she is familiar with all the COEs......It could ease your mind a lot!
          After years of symptoms:
          Officially Diagnosed HOCM 2006
          Myectomy 3/11/13 at non-COE
          Extended Myectomy 7/23/14
          At Mayo with Dr. Joseph Dearani

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