Ventricular Bigeminy

[Blackwolf_7619]

Hi all!

I hope someone can help.

After years of telling my doctors that I have regular PVCs, sometimes constantly all day for literally weeks, and they all just told me that wasn't happening, I finally saw a cardiologist who says I have idiopathic RVOT and advised me to get a Kardia 6L. (Which is amazing by the way!)

So 4 weeks ago I started my episodes again and I caught them on the Kardia. It turns out I have ventricular bigeminy coming from the RVOT. He says they seem benign and shouldn't cause me trouble. How is this possible? First of all, I have a lot of tachycardia and am out if breath constantly, even though I do some form of exercise daily! 2nd of all, I can't do what I normally do and the PVCs are becoming painful. How can my heart not have a negative outcome from this if it carries on?

I know ventricular arrhythmia are more dangerous, and I've heard v.bigeminy is also dangerous.

Is my cardiologist not bothered about it like most doctors, or do I perhaps need a 2nd opinion?

[Captain_Birdseye]

If the PVCs are idiopathic (no known/obvious cause), that may be why the doctor doesn't appear concerned - PVCs are often benign. However you've not said if you've had any other tests to investigate further.

However if you also have a fast heart rate (not sure exactly what you define as tachycardia) and shortness of breath this should get checked out as it could be caused by something else. The PVCs could be a symptom rather than an isolated condition.

If your symptoms are concerning then ask for a second opinion.

[Blackwolf_7619 in reply to Captain_Birdseye]

So literally sometimes just walking down the street (no hills) often sparks a hr of around 160.

2 days ago I went to aqua aerobics. I was fine there. I walked there and back and I could barely move. PVCs were firing off on the way there. On the walk home, my hr spiked to 170.

Cardiologist says I'm unfit, but I exercise every single day do I don't know how that's possible.

I'm having an echo on the 27th - one that I paid for myself, and see if that brings any answers.

He told me he knows where its coming from, so why is ablation not an option?

He said my haital hernia might be causing some of the issues, but no medication helps with that despite trying all of it for a lengthy time.

[Captain_Birdseye in reply to Blackwolf_7619]

Fitness can be subjective so I can't comment on that. For heart rate you say spike... does this mean it jumps up then back down again, causing a spike? Or does it climb steadily and then decrease, with a peak at 170?

Hernias are a known cause for some of the symptoms you describe as they can compress the cardiac wall, causing flutters, palpitations, chest pain and shortness of breath. As far as I'm aware most of the medication for this are to help with the gastric side of things - but I don't know for sure.

I think they'd only offer ablation if there was confirmed cardiomyopathy - but I could be wrong there. It comes with it's own risks and isn't always successful. And if the hernia is the cause then it may not help.

If you've an echo coming up that will offer some insight one way or the other. See what comes out of the echo, and take it back to your medical team.

[MikeThePike in reply to Blackwolf_7619]

Hi there, I don't wish to scare you but you definitely need a second opinion. Here's why. Idiopathic PVCs should DECREASE in number when you start exercising and then start INCREASING again when you stop exercising and your heart rate slows down. It seems that the opposite is happening with you. Insist on a treadmill stress test while your heart is being monitored. Its possible that you have Ventricular Tachycardia which can be life threatening. PVCS are the underlying mechanism for this arrhythmia. You definitely need a second opinion asap. Best wishes.

[LittleElf]

I have idiopathoc VT and SVT.

I caught the VT on my heart monitor and my cardiologist was understandably worried, so sent me for a MRI scan. This scan was to make sure that my heart was a normal size and shape and that there was no scarring on my heart. This means that there is no particular reason for the VT, making it idiopathic and as my cardiologist assures me, this means it shouldn’t cause me any harm.

An echocardiogram can only look at the outside of the heart and can only show so much. It may be worth requesting an MRI or even having one done privately to reassure you that there’s nothing more serious or if there is, find out sooner and be able to deal with it accordingly.

I hope you feel better soon x