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How to find causes of regular skipped heart beat with history of SVT and MVP to determine if its life threatning?

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Practicing since : 1966
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I am a 53 year old female. I am a non smoker, weigh 124lbs and have a history of SVT and skipped beats, also have MVP and have been taking Tenormin for the SVT since about age 22. I have my heart skip beats all the time, but at times it is worse than others. I have worn the halter and also event recorder several times. It has picked up some PVC's and PAC's and with some runs of two's and three's and pauses at two and three seconds some. I know this can be a marker of something more serious like Atrial Fib or some other thing that can be life threatening. How can I be sure this isn't what is happening? My heart dr. never seems alarmed, but it is doing it more than usual. I can feel it and feels like it is just quivering and when I put my finger on my neck to feel my pulse I can feel it beating like five or six times before it beats normal. s
Posted Tue, 14 Jan 2014 in Hypertension and Heart Disease
Answered by Dr. Anantharamakrishnan 50 minutes later
Brief Answer: May need more investigation... Detailed Answer: Dear friend, Welcome to Health Care Magic If there is a threatening situation, it ought to have been detected by the Holter or Event monitor…and your doctor is unlikely to have missed it… If the problem is bothering to the extent of interfering with life style, there are advanced techniques of investigations of increasing complexity – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. Though the test is the gold standard, it is INVASIVE and hence is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. There are other advanced treatment modalities - like ablation (thermal or radio-frequency), which could be done during EPS with excellent outcome in most people… Some situations like Sick Sinus Syndrome may necessitate a Pacemaker... The treating doctor may suggest them depending on need, based on his assessment of the situation. Good luck Take care Wishing all well God bless
Above answer was peer-reviewed by
Follow-up: How to find causes of regular skipped heart beat with history of SVT and MVP to determine if its life threatning? 48 minutes later
I am very familiar with the ablation and EP study. I was scheduled for it back in 2000 for the SVT, but started having less and less episodes of it so cancelled it. The halter and event recorder has never really picked up the runs like tonite because it only does it at certain times. Do you know what it means when it does the skipping or extra beats in runs of two or threes or even more?
Answered by Dr. Anantharamakrishnan 3 hours later
Brief Answer: Go for EP Detailed Answer: Hi Three or more beats in succession is tachycardia (short run) The event monitor has to be repeated in some people Stimulation studies during EP can localise the focus… There is almost always an underlying structural (anatomical) substrate that needs evaluation / Functional (Physiological) changes like electrolytes – mostly unknown – precipitate. Changing to a drug from a different class may help EP is the the only way and is the gold standard… Regards
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