Question: Hello-
I have talked to a few cardiologists here and have gotten much helpful advice and information and reassurance. However, soon after talking to someone, I start to need to ask the same questions again because doubt sets in once again.

I was diagnosed with idiopathic dilated cardiomyopathy in October 2014 and told my life would be shortened and that I was likely to die suddenly of cardiac arrest. Because I was having 65,000 PVCs a day, I sought the opinion of an EP and EP thought, as I did, that PVCs caused cardiomyopathy. I had an ablation in December 2014 and heart size and function were back to normal within 4 weeks.

I was hospitalized when diagnosed, and the doctor there grabbed the water out of my hand and said I would not be able to process the water. Since then, I've been preoccupied with fluid input and output. Sometimes it seems I'm drinking much more than I urinate and I get terrified I'm going into CHF again. I had almost no symptoms even with EF of 25-30, so I feel without tests from doctors I will never know if I'm getting sick again.

I have had serial echoes, and they usually show EF of about 60. Last month one showed EF 55-60 and my most recent a week ago showed EF 65-70. I don't know if EF is fluctuating or if that's normal variation. I just know I'm terrified of EF going low again. PVCs are contolled and I'm being slowly tapered off of carvedilol.

I am trying to believe I'm recovered and to get back to my normal life but I have so much anxiety, I just seem to worry about my heart all day long.

Do I need to worry about fluid so much? Is my EF stable? What is prognosis for PVC-induced cardiomyopathy? I'm so scared of a recurrence, with or without return of arrhythmia.

Is this all purely psychological? I am seeing a psychologist and psychiatrist but I am still terrified all the time. I keep fearing I will drink a lot and have sudden heart or kidney failure and suddenly have edema and stop urinating. The thought dominates my brain constantly.

Also- my EP said fewer than 20,000 PVCs will not harm me. Do you believe that is true? Echoes since ablation have shown 20, then 900, then 50 PVCs/24 hours. I now have very few PVCs but do feel a few on occasion and I'm always afraid 1 or 2 will quickly turn to 65,000 again.

Thank you so much,

XXXX

Thank you Dr Shehu,
Is it impossible for me to experience sudden heart or kidney failure without warning? Can I truly just relax about fluids and go back to life as normal?

Does PVC-induced cardiomyopathy specifically have a good prognosis once cured?

I want so badly to feel normal again but feel perhaps I have PTSD. I still feel like I am in constant danger.

Thank you, dr. Is it normal to have had echo show 55-60, and then 65-70 just 3 weeks later? Did EF go up or is just interpretation? By that measure couldn't it also either go down or be interpreted as 45-50 next time? I am so scared as I had essentially no symptoms with EF 25-30. As nuclear stress 3 months ago showed EF 63, would you think that is most accurate figure? I know I need to control my anxiety but I was so sick and never knew so I'm so scared it could happen again.

Thank you, dr.

Thank you, Dr Shehu! Do you mean my EF would not go down again unless I had a recurrence of continuous PVCs? One's EF does not randomly drop without a disease process?

Is it quite irrational to think I would instantly relapse without any signs or symptoms? I wish I had had more noticeable symptoms when I was sick because now I focus on fluid retention because it is at least something I can monitor.

I will continue my therapy and keep reminding myself that my last echo was just two weeks ago and my heart is still strong and my kidneys are good.

Thank you so much, doctor.