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Heart & Cardiology/Skipped heart beats flutters

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QUESTION: Hi, I'm 41 years old and had skipped heartbeats with anxiety and panic disorder for atleast 20 years. I have seen several cardiologist during that time and had yearly echos done as well as holter monitors. The echo has show LVH from 1.2 to 1.5 to 1.3 I am 6/2 285lbs and my doctor also says that the lvh is mild and is most likely normal for me do to body size. The last 5 years palpatations have ruined my life, my last holter monitor showed 8500 pvcs and pacs with some couplats, runs, bigenemy. I am now To the point where I have pvcs or pacs ateast a couple times a minute. I sometimes get a huge sense of fluttering sometime and it kinda takes my breath away and for the time I'm experiencing this flutter if I check my pulse my heart seems to be beating slow with long pauses in between , it then stops and my pulse goes back to normal. I know that they have gotton a lot more frequent lots of  Every other Beat. I take xanix as needed and antennol. Is there something else I should be doing or taking?

ANSWER: Hi, http://myheart.net/articles/pvc-heart-beats-are-they-dangerous/ http://myheart.net/articles/afib-with-rvr-when-the-heart-races-out-of-control/

Ive written several answers about pac's and pvc's before, if you want to know specific answers regarding those then let me know.

In terms of treatment steps, i would say since you have pac's and PVC's, they are relatively frequent and importantly affecting your quality of life, i would certainly see an electrophysiologist to discuss your options. They will be able to look at the specific features of your premature complexes and determine treatment strategies. there are medications available that can help as an initial step particularly if your quality of life is affected. In some cases, particularly if medicines fail then certain procedures such as ablation may be an option.

Hope that was helpful,




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

QUESTION: I have taken my current test to an electro doctor. They say because my pvc pacs are multi and not on one part of the heart they would not do an ablation. I guess questions in general may be in your opion would bigenemy on and off as well as some runs still be Considered benign? Also this symptom of long a weird sense of fluttering lasting 5-6 seconds that when I check my pulse its irregular slow and when the fluttering stops my
Pulse goes back to normal this really scares me cause I'm always thinking what if does not stop. The only symptoms I generally get from any of this is a head rush maybe also a sense of warmth and not to mention anxiety and panic that has got me to the point where sometimes
I'm afraid to leave the house. I am not sure if years of dwelling on this has just caused my anxiety to become worse which has made the pacs pvcs worse. Ironically my wife went to a cardio because she had a fast heartrate, they did a 24 hour holter and she had runs and close to 10000 pvcs pacs and she does not fell them. Thanks in advance for your time

Answer
Hi, http://myheart.net/articles

I still think its worth you obtaining a second opinion from an electrophysiologist given that your symptoms affect your quality of life. There are some medications that can suppress the arrhythmias that may be useful. That is not a first line approach, but is reasonable in the setting of a patient with reduced quality of life from the arrhythmias. In terms of is it benign, PVC's themselves are typically more worrying than dangerous. Of course its better to not have them than have them, but having them does not in any way mean you need to worry daily about something bad happening. In the absence of structural heart disease, and if they have been reviewed by a cardiologist and determined not to be dangerous, then you probably don't have much cause for concern. If the PVC's caused weakness of the heat muscle and reduced pumping function then the need to treat them is much more pronounced.

Hope that was helpful,  

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Mustafa Ahmed MD

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Cardiology, Interventional Cardiology, Cardiac Surgery, Hypertension, Pulmonary Embolism, Structural and Valve Disease

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Board Certification Internal Medicine and Cardiology Interventional and Structural Cardiology

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http://blog.myheart.net

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Multiple Publications In High Quality Peer Reviewed Journals. Internationally Recognized.

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MD from The Royal Victoria University of Manchester, England Medicine, Cardiology, Interventional Cardiology, Research Training - University of Alabama

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