Robert’s Heart

So, on 12/30/07 I finally caught an SVT on the monitor (ECG: 12/30/07 SVT), that’s great. The problem is, that evening, I kept having them. While it was a bit uncomfortable it did give me an opportunity to capture some good information. Later in the evening on 12/30 I was monitoring myself when I caught a complete SVT and more… This SVT was particularly painful and had a feeling of significant pressure in my chest in addition to the usual light headed feeling. At about three and a half minutes into the SVT the pain and pressure went away, but I still had the arrhythmic feeling in my chest. The ECG still showed an arrhythmia, but it wasn’t regular like the SVT. The next morning my mom identified the irregular rhythm as Atrial Fibrillation. FYI My mom is a retired cardiac care nurse who has been a big help for me to understand (in a novice kinda way) what I’m looking at on the ECGs.

This strip (Click Here For The ECG) shows the beginning of the SVT. At about 14 seconds on that strip a “glitch” in the SVT causes it to speed up from what was 190 BPM to 232 BPM. That’s when the SVT became particularly uncomfortable.

This strip (Click Here For The ECG) shows the conversion from SVT to AF. It is pretty noisy because I was moving around at the time. After a few minutes the AF settled into about 140 BPM (Click Here For The ECG) and lasted for at least 15 minutes when I stopped monitoring. It did eventually, spontaneously, convert to a sinus rhythm.

I had my first noticeable arrhythmias about 18 years ago. One quiet night I had sat down after work with a beer in hand barely had a sip when I noticed what felt like a hiccup. I knew it wasn’t really a hiccup, but it still felt like one. A few minutes later I felt another one. And another. They were my heart skipping a beat, and that scared me. So after some typical male hesitation I headed for the Emergency Room (which was about 2 blocks away). They didn’t actually record anything of interest on an ECG, but I now know that these were PVCs or PACs (without an ECG it’s hard to tell which). Either way they were palpitations.

In that same general time frame, give or take a year, I remember playing racquetball with my dad and brother when I felt my heart racing, light-headed and no pulse. Very similar to what I feel now when I have supraventricular tachycardia (SVTs).

After those two incidents I didn’t really feel anything for many years. I do remember occasionally feeling the palpitations, but never more than a few here or there.

Fast forward to maybe 2006 (probably earlier). Occasionally when I would wake up in the morning I would notice the palpitations. Usually they would go away quickly and not be an issue. Then I had them occur for a couple days in a row. So I decided one morning (August 2006) that I should go by the doctor’s office and run it past him. They took a chest X-Ray and an ECG. The ECG did reveal a PVC/PAC. So that was the diagnosis. During that day I continued to have the palpitations. All day long. Several per minute. At about 4:30pm I decided that I needed to make sure these were benign. So I called the Doctor’s office to find that he wasn’t available. So after some thought I decided to play it safe and went to the emergency room. They hooked me up to the ECG and found some PVCs. They explained that these were truly benign and that I should not worry about them, but follow up with my doctor.

So PVCs/PACs are benign. I’m good with that. After this day I did on occasion have more of these, but they rarely lasted more than a few hours and I really don’t have an issue with them now that I knew they are benign… That is until July 3rd 2007.

I’ll post more later… this is where it gets more interesting.

My Nuclear Stress Test (earlier post) was prompted by an emergency room visit where I appeared (by my own account) to have short runs of ventricular tachycardia (VTAC). It had been my understanding that any VTAC was dangerous.

On Wednesday (7/16/08) I had been having some rather strong arrhythmias some felt like Supraventricular Tachycardia (SVTs). In the mid afternoon I had a few of these which caused me to have a light headed feeling. This has happened before when I’ve had SVTs. So, I hooked up my little 3 lead ECG and monitored my heart for a few minutes when I had a run of PVCs. At first it was 3 in a row every couple of minutes and occasionally it was 4 in a row. I ran these past my mom who is a retired cardiac care nurse. She confirmed that these were technically VTAC. She also indicated that I should be concerned. Moderately concerned I attempted to contact my doctor for an opinion (yeah right… just try to get a doctor on the line at 4:50 pm). A few minutes later I had a run of 9 beats of VTAC (3 seconds) (Click Here For The ECG). Now I’m concerned. If it can run for 3 then 4 then 9 beats… it can continue. “I’m going to the ER.” So I printed a copy of the ECG and headed there in earnest.

When I arrived in the ER the triage nurse took a look at my ECG and said “looks like VTAC.”

…skip a few hours of being hooked up and monitored plus blood tests…

ER Dr. says we want you to stay over night for monitoring. Ok… they agree this is concerning. I usually get “Benign Palpitations. Have a nice day.” With the tone: “Don’t let the door hit you in the ass on the way out.”

…skip being awakened every two hours for blood tests DOH!…

The next day my Cardiologist eventually came by to see me (about 1:30pm, and yes that’s an annoyed tone in my typing). He indicated these too were benign, but that I should probably be on a higher dose beta blocker and we should do a few more tests. Specifically a Nuclear Stress Test and a Cardiac MRI. He did confirm that technically this is VTAC. But it isn’t dangerous unless it becomes prolonged (i.e. I pass out). So if I pass out I should dial 911. Yeah right

I’m not so certain about the beta blocker thing. About 2 weeks ago I started a daily extended release beta blocker and this is the first time I’ve seen runs of PVCs. I monitor my heart whenever I have strong feelings of the arrhythmias. I would know if I had seen these before, and I haven’t. The cardiologist wants to basically double that dosage. I’ll discuss the beta blocker thing next time we talk.

Had several SVT’s yesterday (7/23/08) so I hooked up the homemade 3 Lead ECG to see what was up (I know I’m a freak). Monitoring Lead II for a short period of time I had an SVT and noticed something new today: Inverted P waves after the SVT converted to a sinus rhythm. I’m not certain what that means… but it’s new. I’ll have to print that one for my cardiologist.

At between 16 and 17 seconds on the ECG (Click Here For The ECG) the P wave inverts.

Come to think of it the SVT in this strip doesn’t really follow the normal pattern I’ve seen in the past. Hmm.