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Suggest Treatment For Recurrent Bouts Of Palpitations

Posted on Tue, 14 Mar 2017

Question: I recently had a cardiac event monitor fitted for a week to try and capture palpitations that have been plaguing me for years. Finally I caught these episodes on 'tape', as I experience them in sort of fits and starts, sometimes they are very bad and then they disappear again for weeks. I downloaded a copy of the readings for myself and when I looked (although no expert) it looked much like trigeminy and bigeminy (and huge runs of them). My GP took one look at my readings and just dismissed them as fine without so much as an explanation. I know that these are not dangerous in themselves, but they are causing symptoms and I think I'd like a little more reassurance! Is it ok to have very long runs of trigeminy? (it can go on for over an hour or more). Thank you.

Answered by Dr. Rishu Saxena (13 minutes later)

Brief Answer:
Should be taken seriously if run is more then 30seconds.

Detailed Answer:
Hi
Thanks for choosing HCM
As per your query no long runs of trigeminy for more then 30 seconds is called as sustained ventricular tachycardia snd can even be fatal.However Ventricular premature beat runs less then 30 sec is called non sustained ventricular tachycardia and is not that fatal.
Most of the time trigeminy or bigeminy denotes underlying cardiac pathology like coronary artery disease.Hence detailed investigation should be done to rule out the cause.
Thank you!

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Rishu Saxena (3 hours later)

Thank you for your answer. I'm now just a little bit worried! That said, I should clarify that the 'episodes' of palpitations last over an hour, but that the event monitor obviously only took small snapshots over this period. So I don't know that the trigeminy was sustained for over 30 seconds each time. Of course, I could be completely wrong in saying it was that at all, I only have very vague knowledge of ECG reading. I did have a a stress test some years ago and this was all ok. I have never had an echocardiogram, is this something I should ask for?

I will try and upload the ECG I saved.

Answered by Dr. Rishu Saxena (7 hours later)

Brief Answer:
Follow up answer!

Detailed Answer:
Hi again,
Firstly try to upload the snapshot of ecg you have.Only after going through it i could suggest you whether you need 2d echo and other tests or not.Fistly i need to confirm whether it was trigeminy or not.
Thanks

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Rishu Saxena (3 days later)

Dr Saxena, I've uploaded a snapshot of the event monitor. Sorry the quality isn't great.

Answered by Dr. Rishu Saxena (8 hours later)

Brief Answer:
follow up answer.

Detailed Answer:
Hi
They are single PVS's Premature ventricular contractions.
Premature ventricular contractions (PVCs) are extra, abnormal heartbeats that begin in one of your heart's two lower pumping chambers (ventricles). These extra beats disrupt your regular heart rhythm.
Most common cause of PVC is Coronary artery disease,However other causes are-
mineral and chemical imbalances in the body, medications, alcohol, damage to the heart muscle from heart disease or high blood pressure, elevated levels of adrenaline (which could be caused by caffeine, exercise, or anxiety).
I would suggest you to go for some of the baseline tests of cardiology like
Stress test-A standard exercise stress test uses an EKG (electrocardiogram) to monitor changes in your heart's electrical activity. Imaging stress tests take pictures of blood flow in various parts of your heart.Abnormal test results may be due to coronary heart disease.
2D echo-Echo test or echocardiography is a diagnostic procedure with which you can determine the systolic and dystolic function of the heart (in layman words: What is the efficiency of the pump). In addition, we can also check the heart valves and can diagnose stenosis or insufficiency.
Combined together efficacy of 2d echo and tread mill test to rule out coronary artery disease is 85%.
Lipid profile
Serum electrolytes
Fasting and PP blood sugar.

Follow up with reports.
Thanks

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Kampana