Dr. Fett -- Slow Vtach

[jennifer]

Hi, Dr. Fett. Thank you for being faithful to be available to answer our questions. A week and a half ago, I found out I was having some episodes of slow ventricular tachycardia. I am on a 30 day heart monitor, and "accidentally" caught the rhythms on there. Salvos of 5 to 7 pvcs each went on for at least an hour. I was having no symptoms outwardly at the time. Is "slow" vtach considered a lethal rhythm? My EF is 30, and I am on Coreg 6.25 twice daily. None of my doctors seem to feel a pressing concern about this. Of course, I am very concerned. I have an appt. with an electrophysiologist in 2.5 weeks. Do I need to press for something sooner? As far as I know, I haven't had any episodes since then (that I have known about). Thank you for spending your precious time anwering my question.

~Jennifer

[JAMESFETT]

Hi Jennifer. Yes, I consider that serious. You are in touch with all the right people who know how to proceed, both as to conditions that are responsible for such rhythm changes, and also how best to evaluate and treat; so I assume they are doing the necessary investigations "with due deliberate speed." Thoughts and prayers. I often think about how such things happen to our patients in Haiti, when neither we, the physicians, nor they, the patients, are aware of what is happening. It's a different world, and often an unfair world.

JD

[jennifer]

Dr. Fett,
Thank you for your quick response. Some days I think I am overreacting about the seriousness of my condition, and "dreaming it all up". I must say that this is encouraged by the slow responses by my doctors. However, in the office, once I finally get there, I feel that I am shown proper attention. This "hurry up and wait" game that I seem to be trapped in with my doctors drives me crazy! I never know how to respond emotionally to all of this. I was originally scheduled to see electrophysiologist Friday, but receptionist called yesterday to reschedule to Feb. 15. I suppose all will be well until then. It is so helpful that you can help us get a perspective on our condition. Thank you.

[JAMESFETT]

You are faced with incredibly momentous happenings, it is not unusual to have a lot of anxiety; in fact, that's normal. I have to express confidence that if your physicians felt you had a life-threatening rhythm problem they would not wait until Feb 15th. Ventricular tachycardia is a life-threatening arrhythmia, so I assume that what you had was not v.tach. Please tell me this is the case. True v-tach might lead to a change of medications, careful monitoring, and perhaps an implantable defibrillator. You're not on digoxin are you?

JD

[jennifer]

Dr. Fett,
I am not on digoxin. But, I am certain that I did have slow ventricular tachycardia. My doctor's nurse told me this on the phone. My doctor mentioned radio ablation and/or possibly an ICD. I am not sure that doctors are even aware that my appointment has been changed. Apparently, this was an office decision, not a medical one. I am very uneasy about the change of appointment, but was assuming that I was overreacting due to exaggerated self-concern. You seem concerned as well. Should I call back and press for answers?

[JAMESFETT]

Absolutely I am concerned. If one has an already documented v tach, can one's doctor then assure someone that she is not at risk of cardiac arrest from ventricular tachycardia/ventricular fibrillation? If so, waiting is OK. If not, evaluation and intervention are indicated as soon as possible.

JD

[jennifer]

Dr. Fett,
These are my feelings exactly. But, I thought I was overreacting, because no one else at the doctor's office seems to share my concern. I thought my sense of panic was uncalled for. I am going to call and press for answers. Thank you for clarifying this for me.

~Jennifer

[jennifer]

I called my doctor's office back and explained the situation. Nurse called me back and after I bent her ear for a little while, she rescheduled my appointment with the electrophysiologist for Tuesday, Jan. 31. I am so tired of having to convince people that serious things are going on inside me because I look to be so healthy on the outside. I feel like a fool to have to practically beg to be seen by the doctor, even when I know I'm experiencing something serious. I was experiencing salvos of 3 pvcs off and on all day today. I live 70 miles from any hospital. It's not like I can just run into the ER if I experience dizziness or fainting. It's all so frustrating!

[SarahsMom]

Good for you!!! Take control of your healthcare. I've always been like you....thinking I'm over reacting and letting the "office staff" dictate my care. NOT ANYMORE....I never let these guys push me around and I call and bug them until I get the answers I rightfully deserve.

I'm proud of you for getting that appointment changed to 1/31. Let us know how it goes.

Kari

(PS - A friend of mine had a radio ablation about 4 months ago...she said it was the best thing that ever happened to her...if you want I know she'd be happy to talk to you about it if that's the route you end up going)!!!!

[jennifer]

Kari,
Thank you for your reply. I am so glad that I got my appointment changed. I have been experiencing several more episodes of vtach, and am very concerned. Thankfully, due to the heart monitor, they are documented. One run of pvc's lasted 15 or more beats! Talked to my doctor Friday, and she said to hang in there. That my body is tolerating these episodes very well (I experience no outward symptoms), and if I feel faint to call 911 or go to emergency room immediately. So, if I can just hang on until Tuesday, I'll be okay. Thank you for the info about your friend. I've heard that it is a relatively noninvasive procedure, and is usually done on an outpatient basis. I'll keep you posted. Thank you for caring.

Love,
Jennifer