Re: Numerous PVC's
From: Andrew B. Chung, MD/PhD (andrew_at_heartmdphd.com)
Date: 03/17/05
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Date: Wed, 16 Mar 2005 19:03:47 -0500
Ed wrote:
>
> On Wed, 16 Mar 2005 07:00:08 -0500, "Andrew B. Chung, MD/PhD"
> <andrew@heartmdphd.com> wrote:
>
> >Ed wrote:
> >>
> >> I recently ( Feb 21 ) had a Medtronic EnPulse E2DR01 pacemaker
> >> implanted and I'm experiencing numerous PVC's . 17,000 within the
> >> first 24 hours following surgery . Another 143,000 PVC's from February
> >> 22 to March 1st at which time the cardiologist changed my medication
> >> to 50 mg of Atenolol twice daily and 5 mg of Enalapril Mal ( Vasotec )
> >> daily . Prior to this I was taking 5/10 mg of Lotrel to control
> >> moderately high blood pressure . From March the 1st to the 9th I had
> >> another 79,509 single PVC's plus 2,844 repeats . My energy level has
> >> pick up but I'm still feeling these PVC's at various times of the day
> >> and night . The doctor and pacemaker rep don't seem to be overly
> >> concerned about the quantity of PVC's . I guess my questions are ,
> >> does this seem like to many PVC's
> >
> >It is.
> >
> >> and is Atenolol ( a beta blocker )
> >> the drug of choice for controlling them ?
> >
> >It has helped some. I am curious about what led up to the pacemaker
> >being implanted. Iow, what did your doctor(s) see on the holter
> >monitoring that was done prior to the implantation?
> >
> >> Any insight would be
> >> appreciated .
> >
> >You are welcome, Ed :-)
> >
> >
> >At His service,
> >
> >Andrew
>
> Sir ,
>
> Thank you for your reply .
Again, you are welcome, Ed :-)
> To begin with I'm 56 years old and in
> fairly good physical condition . My heart related problem began in
> January of 2003 during dental surgery . I was having all my upper
> teeth pulled and the gums had to be opened up and some bone removed .
> During the surgery my heart started beating irregularly and they had
> to wake me up before the surgery was quite over . I had a physical a
> couple of months before the procedure which included an EKG which was
> normal . I went to my doctor after the dental surgery and another EKG
> was done which showed that I now had a left bundle branch block . I
> was then sent to the cardiologist and a echocardiogram and a nuclear
> stress test . The stress test was negative and showed no blockages ,
> the echocardiogram showed a loss of heart function with my heart
> pumping 40cc of blood per pump . I had another echocardiogram done six
> months later which showed no changes .
It sounds like you have developed a cardiomyopathy which along with
decreasing your systolic function, may explain the frequent ectopic
beats. Would suggest you ask your cardiologist about switching you from
atenolol to carvedilol which has better data backing its use for
improving heart function.
> On February 1st I was experiencing flu like symptoms and coughing up
> yellow/green mucus so I went to our family doctor on February 2nd and
> he put me on Ketek for five days . During these five days my feet ,
> ankles hands and wrist started swelling up . My blood pressure started
> fluctuating from 103/60 with a pulse of 31 to 160/119 with a pulse of
> 100 .
Sounds like you were having sick sinus syndrome (aka tachy-brady
syndrome). This would be an indication for implanting a permanent
pacemaker.
> I was feeling tired all the time but I couldn't sleep much and I
> felt like I could faint several times a day . I went back to our
> family doctor on the 7th and the x-ray showed that I had bronchitis
> and pneumonia in my right lung . I was placed on Levaquin for seven
> days at that time . I told the doctor about my symptoms and we decided
> I should follow up with my cardiologist .
>
> I called the cardiologists office on the 8th and a appointment for
> another echocardiogram and a nuclear stress test was made for the 11th
> . After the test I was told they would call me early the next week
> with the results . On the 15th I called the cardiologists office and
> asked for the results of the test but was told that they hadn't been
> read yet . Again on the 16th I called the cardiologists office and
> told them my symptoms were getting worse and that I was having some
> chest pain . I asked for the results of the test but was told that
> they still hadn't been read so I firmly requested that someone look at
> them now if possible . They called me back a few minutes later and
> told me the results we positive and that I should go to the emergency
> room . While in the emergency room my pulse dropped to 30 .
>
> I was in the hospital from the 16th through the 18th during which a
> heart catheterization was done . It showed no blockages but that I was
> having electrical problems . The cardiologist ordered a nuclear scan
> of just the affected area of the heart and it was decided that I
> needed a pacemaker . I was allowed to return home for the weekend and
> returned to the hospital on the 21st and had a Medtronic EnPulse
> E2DR01 pacemaker implanted and I was released on the 22nd . I'm pacing
> at 44% atrial and 1.5% ventricular . I'm experiencing numerous PVC's .
> 17,000 within the first 24 hours following surgery . Another 143,000
> PVC's from February 22 to March 1st at which time the cardiologist
> changed my medication to 50 mg of Atenolol twice daily and 5 mg of
> Enalapril Mal ( Vasotec ) daily . Prior to this I was taking 5/10 mg
> of Lotrel to control moderately high blood pressure . From March the
> 1st to the 9th I had another 79,509 single PVC's plus 2,844 repeats .
> My energy level has pick up but I'm still feeling these PVC's at
> various times of the day and night . The doctor and pacemaker rep
> don't seem to be overly concerned about the quantity of PVC's . The
> medications I'm taking are Atenolol 50mg twice a day , Enalapril Mal (
> Vasotec ) 5mg and a Buffered Asprin 325mg once a day .
>
> I'm currently walking three miles in the morning and another two
> miles in the evening .
Excellent.
> I have a appointment with the cardiologist on
> March 22nd .
Good.
> I copied and pasted this from a letter I just wrote for our company
> nuse explaing my history and current condition .
>
> Thanks again !
You are welcome, Ed :-)
At His service,
Andrew
-- Andrew B. Chung, MD/PhD Board-Certified Cardiologist ** Suggested Reading: (1) http://makeashorterlink.com/?L26062048 (2) http://makeashorterlink.com/?O2F325D1A (3) http://makeashorterlink.com/?X1C62661A (4) http://makeashorterlink.com/?U1E13130A (5) http://makeashorterlink.com/?K6F72510A (6) http://makeashorterlink.com/?I24E5151A (7) http://makeashorterlink.com/?I22222129
- Next message: Andrew B. Chung, MD/PhD: "Re: OT: Unhealthy Diet - Lose Weight on the "Super Size Me" Diet"
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