Expert: David Richardson - 11/22/2009

Question
QUESTION: My dad was diagnosed for arrhythmia ectopic. He is 58 years old,173 cm tall, 75 kg weight, and normal blood pressure. He went to two different doc. One gave him Sotacor 80mg, this med makes his heart pounding slower and hard. The other gave him Rytmonorm 150mg, this one has worse effect than the first. It makes his heart pounding faster and severe dizziness. My dad didn't take those med anymore but his arrhythmia's symptoms are so nuisance: palpitation,cold sweat over neck and feet,pounding heart beat,light-headed,dizziness,shortness of breath,chest discomfort,feeling very tired.
What I need to know:
Is there any med for this disease with no side effects?
Are these symptoms commonly happen to anyone with arrhythmia?
Is it a life threatening condition? For your info, my dad has a normal ECG results. Although it has one lack in a row beat, the doc said it's fine and no need to worry about.

ANSWER: Dear Agnes,

Is the ectopic rhythm premature beats, not atrial fibrillation?  Premature beats don't usually cause sweating and dizziness and shortness of breath.  They just pound.  Beta blockers like metoprolol and atenolol have very few side effects and are effective in some people with ectopic beats.  Flecainide is effective in reducing ectopic beats in many people and has few side effects.  One needs an echocardiogram before taking flecainide or sotalol, so I presume he's had an echo already.  Atrial fib may require radiofrequency ablation, a procedure done with a cardiac catheter.
Send me an EKG if you wish, by giving me your email address.

Please write back if this note doesn’t answer all your questions.

David Richardson

---------- FOLLOW-UP ----------

QUESTION: Dear doc,
Continuing from my previous question. Right now my dad takes Neovasc, Kyolic, and Cardio Actin. They are herbal med. Is it okay?
I send you the EKG result for your further diagnosis. If you have assured that this is an ectopic rhythm premature beats, then where all these symptoms (cold sweat over neck and feet,light-headed,dizziness,shortness of breath,chest discomfort,feeling very tired) come from?
Last questions, what kind of food that should be avoided?
And what kind of exercise is best for my dad?
Thank you for your kind attention and answers.

Answer
Dear Agnes,

I don't know anything about those herbal meds.  I suggest stopping all of them.  If his symptoms improve, start back one at a time until you see which ones cause the symptoms of fatigue, shortness of breath, dizziness etc.

The EKGs show premature ventricular ectopic beats. nothing worse.  PVBs should not cause his symptoms.  I agree with his docs that PVBs are usually not harmful and don't cause any symptoms other than feeling a skipped beat.  Do the symptoms occur only when he's feeling ectopic beats?  If so, the symptoms might come from anxiety and over breathing.  Ask him to pay attention to his breathing and breathe slowly and shallowly and see if that helps the symptoms.

I think he should have an echocardiogram to be sure his heart's structure and function are okay, since he has all those distressing symptoms.

Please keep me informed about what he finds out, and of course write back any time.

David Richardson