EP study report/ atypical AVNRT

Hi,I'm female,34y old,started w/palp 5 months ago.After,stress-echo,H-monitor,blood tests,(8)ekg's showing a short PR,chest ct scan,chest x-ray ,all normal,and a 14 day Event monitor showed some PAC's,PVC's(just once),ST and PSVT (max.155bm)I finally had an EP study done which results were: 1.sinus node function:normal.2.AV node function:normal/retrograde dual AV node pathways noted.3.Acc.pathways:none/VAconduction concentric&decremental.Despite short PR,no preexitation noted.4.AH interval:66msec/HV interval:31msec.5.Inducible arrhythmias:No tachycardia was induced.6.W/ ventricular stimulus, short(1-4beats)runs of long RP tach were noted.This most likely represt "atypical AVNRT".This finding was not reproducible.7.Given the lack of sustained arrhythmia & no clear endpoint of ablation ,no RFA was performed.Plan for medical therapy w/b-blockers/////?Quest: 1.Do I have an electric problem in my heart or not? 2.What does point "6" and  non reproducible mean? 3.Why there were no ablation?not possible/too risky to ablate? 4.Can atypical AVNRT be ablated?Is risk of pacemaker high?6.Do I have AVNRT then?It is a chronic condition? 5.Can this be caused by anxiety as my cardio said? 6.Do I have to be on b-blockers for live?7.Can B-blockers caused fatigue,dizziness and tigling/needle sensations on hands even though blood pressure avrg is 100/65 (low?)?Thanks.

[CCF-M.D.-MJM]

Hello,

1.Do I have an electric problem in my heart or not?

It sounds like they did not think you had an electrical problem.  We come across these cases occassionally that we cannot induce a tachycardia during the case.


2.What does point "6" and non reproducible mean?

It mans they awere able to induce several beats that were consistent with a "reentrant" tachycardia. By definition, however, reentrant tachycardia should be inducible with the same series of stimuli.  They were not able to restart or sustain the tachycardia -- this is referred to as non inducible.



3.Why there were no ablation?not possible/too risky to ablate?

It sounds like they could not prove that one existed.  In some cases like this where there is a possible tachycardia and their are dual pathways, the slow pathway is ablated and presumed to be AVNRT.  Not everyone practices this way.

4.Can atypical AVNRT be ablated?
Yes it can be ablated.


5. Is risk of pacemaker high?
It is low risk for a pacemaker.



6.Do I have AVNRT then?It is a chronic condition?
It is unclear from this study but it is possible that you have it.  It can be a chronic condition unless ablated or treated with medications successfully.  People do not die from this. It is safe to treat with medications and wait to see if it recurs.


7. Can this be caused by anxiety as my cardio said?

SVT can be caused by anxiety.


8.Do I have to be on b-blockers for live?

It depends on if the arrhythmia recurs.  You may have to be on beta blockers for life.  At some point you may need a repeat EP study/ablation.


9.Can B-blockers caused fatigue,dizziness and tigling/needle sensations on hands even though blood pressure avrg is 100/65 (low?)?
fatigue yes
dizziness, not usually
tingling needle sensation in the hands is usually related to anxiety and hyperventilation.

It is tough form me to say exactly what you have.  It could be anxiety, it also could be an arrhythmia that they were unable to induce on that day.


Thansk for posting and good luck.