Suggest Treatment For CPVT Without Syncope And Brugada Syndrome
Question: I and a 64 year old female with a history of recent polymorphic Vtach without syncope. An ICD was implanted in March 2015 for prevention. My Cardiac XXXXXXX was negative for any Cardiac Disease. Apparently my EKG is classic for Brugada syndrome but my EPS for diagnosis was negative.
Although I have had a history of PVC's, Atrial Tachycardia, and uni focal V-tach at times in the past, since I have had the ICD, the PVC's have increased tremendously and are very frequent...Bigeminy/Trigeminy. I have been on Toprol (alone) (25mg bid) , then Sotalol, 80mg bid) and now Mexiletine (150mg tid) and Toprol (12.5mg/day) with no improvement. The frequency of the PVC's are erratic, sometimes make me lightheaded, and slight weakness in my upper legs. I am so frustrated. It is difficult to plan events because I don't know how I will feel. I am afraid to take Amiodarone due to the numerous serious potential side effects. I do not drink any alcohol or any coffee. Prior to this, I ran 3 miles 3-4 times/week. My pacemaker is set at 75/min to hopefully prevent V-tach but my normal pulse runs between 64-68. Any ideas is appreciated.
Update: Medication is Mexiletine 150mg tid plus Topral 12.5mg/day
Although I have had a history of PVC's, Atrial Tachycardia, and uni focal V-tach at times in the past, since I have had the ICD, the PVC's have increased tremendously and are very frequent...Bigeminy/Trigeminy. I have been on Toprol (alone) (25mg bid) , then Sotalol, 80mg bid) and now Mexiletine (150mg tid) and Toprol (12.5mg/day) with no improvement. The frequency of the PVC's are erratic, sometimes make me lightheaded, and slight weakness in my upper legs. I am so frustrated. It is difficult to plan events because I don't know how I will feel. I am afraid to take Amiodarone due to the numerous serious potential side effects. I do not drink any alcohol or any coffee. Prior to this, I ran 3 miles 3-4 times/week. My pacemaker is set at 75/min to hopefully prevent V-tach but my normal pulse runs between 64-68. Any ideas is appreciated.
Update: Medication is Mexiletine 150mg tid plus Topral 12.5mg/day
Brief Answer:
I would advise you to try amiodaron
Detailed Answer:
Dear Mrs,
Your case is a very complicated case, but I'll try to help you as much as it is possible.
In case all above mentioned medications has failed, I would like to advise you to try amiodaron. It has many side effects, but if carefully monitored many side effects can be avoided. But sometimes it helps in cases when everything has failed. So maybe you try amiodaron.
Keep in touch and inform what you decide and the results.
Wishing you good health
In case of further questions don't hesitate to ask
Regards,
I would advise you to try amiodaron
Detailed Answer:
Dear Mrs,
Your case is a very complicated case, but I'll try to help you as much as it is possible.
In case all above mentioned medications has failed, I would like to advise you to try amiodaron. It has many side effects, but if carefully monitored many side effects can be avoided. But sometimes it helps in cases when everything has failed. So maybe you try amiodaron.
Keep in touch and inform what you decide and the results.
Wishing you good health
In case of further questions don't hesitate to ask
Regards,
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar