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History of heart attack. Having ventricular premature beat. Will I get cured with amiodarone?

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Cardiologist
Practicing since : 2004
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Question
On XXXXXXX 25 I had a heart attack in Macau. I currently live in another Chinese city, Nanyang, Henan, China, where I teach English. Unfortunately, within the past few weeks a doctor said that i have a ventricular premature beat. She is going to put me in the hospital for a week and treat me with amiodarone. If that medicine does not stop the problem, she said i will need an Implantable Cardioverter Defibrillator put in my chest. Does it sound like she is following the correct strategy? Also, if the medicine fails to correct the problem, i cannot afford to have the implant until January or February after I return to XXXXXXX Is it adivsable to wait that long to have the ICD put in my chest?
Posted Thu, 14 Nov 2013 in Hypertension and Heart Disease
 
 
Answered by Dr. Benard Shehu 5 hours later
Brief Answer:
Please follow the suggestions below....

Detailed Answer:
Hi,

I have read your concern carefully, and I would say that, yes this is a good conservative strategy (only medication without any invasive procedure) and if the problem of ventricular arrhythmia persist you should go for invasive cardiology.

If i were your doctor i will probably recommend invasive cardiology (especially angiography) immediately after the heart attack, but now that four month has passed away, you can probably wait another 3-4 months without any major complication to do the invasive procedures.

I also recommend that you should live a healthy life style take all the medication, avoid hard physical activity till you return in USA.
Hope it answered to your inquiry!

Dr.Benard

p.s. if you have other concern, do not hesitate to write back to me!
Above answer was peer-reviewed by
 
Follow-up: History of heart attack. Having ventricular premature beat. Will I get cured with amiodarone? 53 minutes later
Your words are encouraging; however, I want to add that doctors put two stents in my lad artery about a week after the heart attack in Macau. The lad was 95 percent blocked and the D-1 artery 99 percent. Can I still wait 3-4 months for the implantation if the medicine treatment here is unsuccessful? Thanks a million. XXXX
 
 
Answered by Dr. Benard Shehu 4 hours later
Brief Answer:
yes, you can wait

Detailed Answer:
Hi!

I have read the second part and I am happy that you have done angiography and stenting.

Now that I know, you have done this, I am sure that you can wait 3-4 months for the implantation if the medicine treatment here is unsuccessful.

Hope it answered to your inquiry!
Dr.Benard

p.s. if you have other concern, do not hesitate to write back to me!
Above answer was peer-reviewed by
 
Follow-up: History of heart attack. Having ventricular premature beat. Will I get cured with amiodarone? 11 hours later
Doctor, I apologize for taking so much of your time, but I want to ask one final question. If the medicine is unsuccessful and an implant is recommended, I assume that it's ok to wait a few months for the implantation because I am not facing imminent death and the implantation of a defibrillator is a safety measure to prevent death in the long term. Is that correct? Also, is it typically essential to have such an implantation for someone like myself? I assume it is essential if the ventricular premature beat continues. I do not want that device in my chest if not absolutely necessary. Thanks again for all your time, XXXX
 
 
Answered by Dr. Benard Shehu 7 hours later
Brief Answer:
Please follow suggestions below...

Detailed Answer:
Hi and welcome back!

Yes you can wait for some months because you have only one ventricular extra systole (premature beat), because in your case it's more a precaution for the long time (to avoid sudden cardiac death and more serious ventricular arrhythmia like ventricular tachycardia and fibrillation associated with chronic ischemic heart disease) than a immediate need.

For this reason the ICD isn't absolutely necessary.

In this case if you don't want the device in your chest you should take the medication and continue with periodic follow up examination (every six months if everything seems normal; no chest pain, no dyspnea) with ECG, Echo-cardiogram, 24 hour ECG monitoring Holtter, stress test) till the moment that implantation of ICD become necessary.

Hope it answered to your inquiry!
Dr.Benard

p.s. if you have other concern, do not hesitate to write back to me!


Above answer was peer-reviewed by
 
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