Beta Blocker vs. Ablation

Dear Cardiologist:

My first question was posed to you on August 2nd (Jessica:  high and low heart rhythms).

After wearing the 30 day event monitor, the cardiologist/ electrophysiologist advised me that these events appear to be either an AV node re-entry issue, a concealed bypass tract, or PSVT. He is suggesting an EP study with possible catheter ablation (last resort- pacemaker).

Since I have the factor V issue, could a blood clot occur during or after the procedure? Or, even worse, a pulmonary
embolism? Also, is this invasive procedure the best way to go? He advised me I can try a beta blocker "Sectral" while awaiting
for his schedule to open up for the EP Study (which is 8 weeks away). If the beta blocker works, is the EP study necessary
and can you stay on a beta blocker without any serious consequences for long term use. Can this beta blocker interfere with the Coumadin therapy?

Last, but not least, before doing an invasive procedure, such as this EP study, do you suggest getting another opinion?

Thanks, as always for your comments.

[Cleveland Clinic, MD]

Dear Jessica,

I think trying a beta-blocker is not a bad idea nor is proceeding with an EP study if medication fails.  There is no interaction between beta-blockers and coumadin and you should be at no higher risk for clots during the study (it's a venous study and lower risk than arterial studies - if your doctor is concerned he can use some heparin during the procedure. There are no long term side-effects of beta-blockers.  A second opinion is never a bad idea if you are concerned about your doctors advice or he has failed to answer your questions adequately.

I hope you find this information useful.  Information provided in the heart forum is for general purposes only.  Only your physician can provide specific diagnoses and therapies.  Please feel free to write back with additional questions.

If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter.  The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.