Ventricular ectopic beats - malignant or benign?

[Mb]

Hello everyone:

As some of you might recall, my husband needs a pacemaker, but prior to implantation, they want to repair his severely leaking tricuspid valve. He has two St. Jude valves now, and chronic a-fib. He has delayed the surgery for 6 months. Our last cario visist prompted Holter monitoring. We just received the report.

It states that his lowest heart rate was 36BMP, and his highest was 156BMP with no excercise. Frnakly that is not too scarey.

However, he had a bit under 1400 ventricular ectopic beats. Only one short run, all of the rest were singular. I know in general this is not something to be terribly worried about, but 1400 sounds like a heck of a lot to me. My brief excursion into Google produced a bit of concern, but most studies are for folks who have had a heart attack.

I am wondering if anyone here has had such a report, and if so, what was done, if anything?

Should I be concerned more than I am now?

Marybeth

 

[Mb]

Sorry, pulling this back into New Posts, so it won't get lost!

I could really use anyone's input. - Marybeth

 

[kodi]

I just went on WEBMD and did a search on 'ventricular ectopic' and it located a story of someone in England. It sounds a lot like what you are talking about but I can't be real sure. Some of this heart talk just blows me away. I would have never guessed there were so many different types of problems.
Hope this will help you at least a little.

Sorry, pulling this back into New Posts, so it won't get lost!

I could really use anyone's input. - Marybeth

 

[joanne6]

I have had multifocal PVC's-many, many extra ventricular beats for over 30 years. I was treated back in the day when they gave meds for this. I stopped taking meds about 7 years ago. Generally this is not treated anymore and not usually a problem unless the person becomes symptomatic. If the ejection fraction is low, then it could be a problem.

 

[Nancy]

Hi Marybeth-

I know from looking at Joe's heart monitors for days at a time while he's been in the hospital so much, that he has many ectopic beats, bigeminy, trigeminy and longer runs, even with a pacemaker, and has had them for years. They don't send anyone running into the room, and doctors have generally ignored them, as long as they convert back to normal rhythm.

He hasn't been able to take beta blockers, even though they would have helped him. This last hospitalization, they started him on Metoprolol and he has been able to stay on it. It has helped his heart rate and also the rhythm.

Here are a couple of links:

http://www.healthatoz.com/healthato...hatoz/Atoz/ency/ventricular_ectopic_beats.jsp

http://www.emedicine.com/med/topic2364.htm

 

[Mb]

Thank you for your responses, and Nancy, for the two links. I had read one previously, but not the other. All information is so welcome.

Sometimes I wish the answers were clearer. I think I am most the most concerned with the fact that he went from 89 VEB on the Holter in May, and now he is up to almost 1400. Seems like something has changed.

Marybeth

 

[Nancy]

I would be concerned too, Marybeth. That's quite a change, and could indicate more stress on the heart.

What does his card. have to say about it?

 

[tobagotwo]

Frequently, as valve issues develop, so do arrhythmias in response to them. If his tricuspid is problematic enough for them to want to operate on it, it would be surprising if it weren't affecting his heart in other ways.

Best wishes,

 

[Mb]

Nancy and others:

Well, we saw the cardio a couple of weeks ago, and he ordered the Holter at my husband's request. At that time, he stated "In my professional opinion, there are indications to support implanting a pacemaker." This was prior to the Holter report. I did receive an e-mail from him, and a copy of the report. I intend to email him tonight. If anyone has any add'l information, it would be appreciated.

Marybeth

 

[Nancy]

I guess he is telling you that a pacemaker has to be done. I know it is out there in the future. Have you made a decision as to when this will take place? Does the mitral valve need to be done too?

 

[Mb]

Dear Nancy:

Wayne has not made a final decision yet as to when to have the surgery done. It was supposed to be done in August '06, but when our daughter passed away, he put it on hold. Our other daughter is expecting a new baby (our third grandchild) in about two weeks. The two of them are incredibly close. They have lunch together every day, with the children. He had decided to wait till after the new one is born, then he changed his mind completely for awhile to not having the surgery done at all, but I think he now knows he does need to have it done sooner rather than later. My guess would be January.

The surgeon only does this surgery 5 or 6 times a year, and he is the head of cardiac surgery in Mass General. Wayne will be in the hospital for about 12 - 13 days, so they said. First they do the tricuspid repair, wait three days or so, then insert the pacemaker. According to his recent echo's, his St. Jude mechanical valve does have a leak, but they have been unable to measure due to shadowing. I am assuming they will determine the status of the two artificial valves while they are in there. I cannot imagine he could go through a third surgery.

Marybeth

 

[Mb]

Hello everyone:

I thought I would post an update.

I just heard from Dr. Boucher, responding to my inquiry regarding the significant increase in the ventricular ectopic beats. He has checked all prior Holter reports, and indeed they all show that previously they were recorded at under 100 a day. He says "the significance is uncertain. One explanation could be that there is more strain on the heart muscle with the tricuspid regurgitation. It would be treated with additional beta blockers, which cannot be done until the surgery to repair the tricuspid valve is done, as he has bradycardia already, on a "baby dose" of beta blocker." It is becoming more clear that the surgery has to be done in the more immediate future.

Marybeth

 

[Nancy]

I know that is not what you wanted to hear, but it sounds like it is in Wayne's best interests. Tough thing to face. My thoughts are with you both.