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Heart Disease (Expert Forum)
atrial tachycardia
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atrial tachycardia
by sue, Oct 30, 1999 12:00AM
Hi! I am a 24 year old female who was diagnosed with SVt (a-tach) in oct of '98. At that time a eps lab was done but the rhythm could not be induced. I was placed on tenormin 25 mg/day. In April of '99 I was back in with more episodes and put on Cardizem CD 120 mg/day. I was taken off Tenormin due to possible asthma developing. In Oct '99 I had another EPS which showed possible left a-tach but since the MD was not 100@ positive he would not ablate due to increrased risks. I was then placed on flecanide but I do not wish to take such a potent drug. I have had echos which were negative, stress test with and without thallium which were negative. I have had 2 holters both which showed the a-tach but still it cannot be induced during the ep studies. During my episodes I pass out, get hot and then cold with blurry vision and when my rate goes above 150 I feel it. My heart rate goes from 70 to 190 in 3 seconds and then breaks with a cough. Then ina few minutes to 1/2 hour it goes back up I cough and it breaks again. I also get chest pain, short of breath and nausea with or without an a-tach episode. My MD was going to cath me but since the thallium stress came back negative they are not at this time due to my age. However, the chest pain gets so bad at times I cannot move and they are aware of this. The cardizem controls the a-tach but about once a week I break through it. What would you suggest at this point? esp about the chest pain.
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Doctor's Answer
by CCF CARDIO MD - CRC, Nov 01, 1999 12:00AM
At this point you have several choices. 1) just live with it the way it is (not a very good choice) 2) Try the flecanide and see if it helps. 3) Get a second opinion from another EP doctor with more skill at ablations. I would probably go for #3 myself and would look at one of the major EP centers (e.g. Oklahoma University, Indiana University, Cleveland Clinic, etc.)
Thanks, and take care; try not to worry too much, but it's hard!
The flecanide works, no attacks in 2 weeks but I am concerned over all the other things. Let me know. My bp was always 110/70 my entire life until oct of '99.
Any comments from a cardiologist with special interest in Atrial Fibrillation will be very much appreciated.