Aa
Right Atrial Tachycardia
I am 36 yo female, no known cardiac disease, with PMHx of allergy-related asthma and benign PVCs.
1/02 - Had EPS and RF Ablation for SVT - Dx was Right Atrial Tachycardia.My EP doctor said he was unable to ablate at a higher temp. because the signal causing the arrhythmia was too close to the phrenic nerve. After the ablation he was unable to reproduce the ATach again and felt it was successful. However, 2 hrs postop I had an episode, and then another 2 days later, so restarted on Atenolol 12.5mg BID. Tried Cardizem once for a few days - felt awful and still had ATach. EP wanted me to try flecainide, but I was too scared (I am a nurse - aware of s/e of anti-arrhythmics)and opted for Atenolol. No further episodes for months, so EP doctor suggested it was possible that scar tissue had grown enough to block the signal found previously. So he said I could wean down or even try to d/c Atenolol.Got to 12.5mg/day, then had 2 episodes, so am back to 18.75mg/day. This has wreaked havoc in my life - causing me great anxiety, fears of death, and panic disorder. I have 2 small children and want to return to work. I recently read of ATach pts.using the new Non-Contact Mapping system having success with subsequent ablations. My questions:
1.What is your experience with Right ATach?
2.Would I at all be a candidate for a second ablation in light of the position of the signal near the phrenic nerve?
3.Should I seek other surgical opinions(live in southern CA), if so - where?
4.Do I just need to learn to live with this/long-term medication?
5.What if no medication?
6.Support grp?
1/02 - Had EPS and RF Ablation for SVT - Dx was Right Atrial Tachycardia.My EP doctor said he was unable to ablate at a higher temp. because the signal causing the arrhythmia was too close to the phrenic nerve. After the ablation he was unable to reproduce the ATach again and felt it was successful. However, 2 hrs postop I had an episode, and then another 2 days later, so restarted on Atenolol 12.5mg BID. Tried Cardizem once for a few days - felt awful and still had ATach. EP wanted me to try flecainide, but I was too scared (I am a nurse - aware of s/e of anti-arrhythmics)and opted for Atenolol. No further episodes for months, so EP doctor suggested it was possible that scar tissue had grown enough to block the signal found previously. So he said I could wean down or even try to d/c Atenolol.Got to 12.5mg/day, then had 2 episodes, so am back to 18.75mg/day. This has wreaked havoc in my life - causing me great anxiety, fears of death, and panic disorder. I have 2 small children and want to return to work. I recently read of ATach pts.using the new Non-Contact Mapping system having success with subsequent ablations. My questions:
1.What is your experience with Right ATach?
2.Would I at all be a candidate for a second ablation in light of the position of the signal near the phrenic nerve?
3.Should I seek other surgical opinions(live in southern CA), if so - where?
4.Do I just need to learn to live with this/long-term medication?
5.What if no medication?
6.Support grp?
A related discussion, tachcardia atenolol and aerobic exercise was started.
Am I Having Atrial Tachycardia??
I am extremely tired once I finish my meals at noon, The symptom does not end for hours together. Along with GERD(acid reflux) it worries me whether im gonna have a heart attack. i used Inderal 10 mg, but it is sick drug and I stopped it, Now I take a 250 mg magnesium tablet with my meal and drink 2 8 ounce glass of water half hour and i hr after the meal. I also take a relaxed 15v min stroll after a meal, im so tired at the end of the first hour of the meal, i wait it out for 2-1/2 hrs and then intoxicate myself with 3 to 4 pints of water, miraculously my heartbeats slows down to 60 within 10 minutes of water intoxication and the huge volume of water requires a trip to the restroom, relieving my bowels too! I feel extremely energetic an hour after this 'procedure'.! Any comments? My kidneys are fine and I ve lost a bit of fat.
I am extremely tired once I finish my meals at noon, The symptom does not end for hours together. Along with GERD(acid reflux) it worries me whether im gonna have a heart attack. i used Inderal 10 mg, but it is sick drug and I stopped it, Now I take a 250 mg magnesium tablet with my meal and drink 2 8 ounce glass of water half hour and i hr after the meal. I also take a relaxed 15v min stroll after a meal, im so tired at the end of the first hour of the meal, i wait it out for 2-1/2 hrs and then intoxicate myself with 3 to 4 pints of water, miraculously my heartbeats slows down to 60 within 10 minutes of water intoxication and the huge volume of water requires a trip to the restroom, relieving my bowels too! I feel extremely energetic an hour after this 'procedure'.! Any comments? My kidneys are fine and I ve lost a bit of fat.
If you go into atrial fibrillaiton after eating, I wonder if you have considered sensitivity to certain foods only. You could perhaps determine this by selective elimination of foods and combinations or start the other way and eat only one food, adding another at the next meal, trying various combinations, etc.
The rest of this reply is redundant and you don't have to read it. I ate a bowl of bran flakes with milk before a stress test one day and went into atrial fibrillation. The doctor cancelled the test. I haven't had a glass of milk for two years and eat very little wheat. Chocolate also sends me into fib for as much as 24 hours. My doctor says this is the definition of atrial fibrillation. But by eliminating these three foods, all vitamins and supplements, and much exercise for a day or so I can do a perfect ECG.
I am tempted to ask for a thallium 201/technetium 99 stress test but have heard that such invasive radioactive tracer tests yield correct diagnoses in only something like 52% of cases. It might be fun to see what happens when they make me drink milk and eat a sandwich in the middle of the test. dld
The rest of this reply is redundant and you don't have to read it. I ate a bowl of bran flakes with milk before a stress test one day and went into atrial fibrillation. The doctor cancelled the test. I haven't had a glass of milk for two years and eat very little wheat. Chocolate also sends me into fib for as much as 24 hours. My doctor says this is the definition of atrial fibrillation. But by eliminating these three foods, all vitamins and supplements, and much exercise for a day or so I can do a perfect ECG.
I am tempted to ask for a thallium 201/technetium 99 stress test but have heard that such invasive radioactive tracer tests yield correct diagnoses in only something like 52% of cases. It might be fun to see what happens when they make me drink milk and eat a sandwich in the middle of the test. dld
Thank you both for your kind encouragement. I just continue to be amazed by the sheer power of the internet to create opportunities for communication never present in the past. John
All I can say is Wow! You are so right about not letting this stop or hinder your life, and I totally can relate to how it has hampered yours. I am in the process of seeking a second opinion, and if that EP says he doesn't recommend further surgery, I may then be able to resign myself to coping with this for life. Isn't it hard when you remember the way you used to be?!
I agree with you on the lottery - Cleveland's a top notch facility. There are other facilities that are acceptable - I look for MDs that do research and publish a lot.
I wish you all the best on your hike, and I applaud you for your tremendous courage! You will do fine - from what they say it won't kill you. If your heart speeds up into the non-comfort zone, just remember - you're exercising your heart. I look forward to knowing how things went!
Good luck!!
I agree with you on the lottery - Cleveland's a top notch facility. There are other facilities that are acceptable - I look for MDs that do research and publish a lot.
I wish you all the best on your hike, and I applaud you for your tremendous courage! You will do fine - from what they say it won't kill you. If your heart speeds up into the non-comfort zone, just remember - you're exercising your heart. I look forward to knowing how things went!
Good luck!!
Thank you for your message - it always helps knowing you are not alone with this frightening condition.
As far as the atenolol goes, I use a pill cutter to cut it in half, then cut the half into quarters (sometimes it's not exact, but I do the best I can.) I, like you, am very senstitive to small amounts of this medicine. I may have to go back to 12.5mg twice/day, but I'm trying to hold at approx. 18.75mg/day (12.5 in the morning, 6.25 at night)for now.
I guess one of the hardest things was the disappointment that I still have the ATach and that the surgery was not successful. I spoke with my EP yesterday and he said he would be happy to try it again, but that the area he found the focus was close to the phrenic nerve and he really wanted to be sure not to damamge the nerve, which I appreciate. So, I may (for peace of mind that I have exhausted all options) get a second opinion from someone who does the non-contact mapping. Besides the panic/anxiety, I still have a hard time with "you're going to have to live with this". I can't believe how crippling this has been and I just want to function normally again. I guess that will happen with time.
I really appreciate your feedback. Exercise is definitely not the culprit in my case, but very well could be in yours. I too am fearful of the tachycardia when exercising. My doc said it's okay to exercise, but now that my HR has been so low for awhile, anything 100 or above freaks me out. How about you? Have you been cleared for exercise? Tell me more about your episodes - how long are they - what are your symptoms, etc. How did you get diagnosed with atrial tachycardia as opposed to AV nodal re-entrant tachycardia and some of the other SVTs?
Don't mean to ramble - your post just got my mind going. Thanks again!
As far as the atenolol goes, I use a pill cutter to cut it in half, then cut the half into quarters (sometimes it's not exact, but I do the best I can.) I, like you, am very senstitive to small amounts of this medicine. I may have to go back to 12.5mg twice/day, but I'm trying to hold at approx. 18.75mg/day (12.5 in the morning, 6.25 at night)for now.
I guess one of the hardest things was the disappointment that I still have the ATach and that the surgery was not successful. I spoke with my EP yesterday and he said he would be happy to try it again, but that the area he found the focus was close to the phrenic nerve and he really wanted to be sure not to damamge the nerve, which I appreciate. So, I may (for peace of mind that I have exhausted all options) get a second opinion from someone who does the non-contact mapping. Besides the panic/anxiety, I still have a hard time with "you're going to have to live with this". I can't believe how crippling this has been and I just want to function normally again. I guess that will happen with time.
I really appreciate your feedback. Exercise is definitely not the culprit in my case, but very well could be in yours. I too am fearful of the tachycardia when exercising. My doc said it's okay to exercise, but now that my HR has been so low for awhile, anything 100 or above freaks me out. How about you? Have you been cleared for exercise? Tell me more about your episodes - how long are they - what are your symptoms, etc. How did you get diagnosed with atrial tachycardia as opposed to AV nodal re-entrant tachycardia and some of the other SVTs?
Don't mean to ramble - your post just got my mind going. Thanks again!
My tachycardia is not "episodic" in the sense that it just "happens". So far it has never just happened unless prior exercise or eating was involved. The anxiety condition has triggered high pulse rates in the past due to adrenaline dump but it is not the tach condition itself.
Like you I can no longer emotionally tolerate knowing or perceiving that my pulse is over 95 or 100. I spent over a decade and a half aerobically exercising at rates of 140 to 175 or higher with no problem.
This is where the ativan comes in and also TIME and predictability so that I can trust that the tach is actually controlled. Have I been cleared for exercise? Well, my HMO cardiologist told me to get all the exercise I could. That is the extent of the advice...no warnings I guess are present.
He sees basically nothing wrong with me that is life threatening. It is a matter of my "accepting" the condition. The attenolol is prescribed by my HMO GP and NOT the cardiologist.
They have not suggested or offered an EP study. I am certain, though, that I could not emotionally tolerate anything invasive at this time without general anesthetic. They have shown no interest in finding out the source or exact nature of the inappropriate pacing of my heart in some circumstances. I don't know what AV nodal re-entrant tach is but will find out.
I spent my career in computers and electronics and I find myself capable of understanding just about anything related to heart problems if I take the time.
My episodes are caused by exercise. The duration and degree of pulse elevation is always directly proportional to the duration and degree of aerobic exercise preceeding the episode. Without attenolol if I take my evening walk ( I live in a hilly area at some elevation ) of one hour results are much different. I will run a pulse of 85 to 105 which is totally appropriate for my condition and demands of the walk.
Without attenolol my pulse will stay at 85-90 for several hours and then gradually go down to my ( non attenolol ) healthy rate of 66 to 68. This is NOT tachycardia by definition. The problem is if I want to do MORE.
A moderate hike of 2-6 hours with a sustained pulse of 95 to 120 will result in a pulse rate of 110 or 115 for 2 to 4 hours then very gradually coming down. A really strenuous aerobic session can result in rates of 125 plus for 3 or 4 hours even as I sleep. It gradually comes down over the next 12 to 18 hours.
For 15 years the HMO has had NO desire to do anything to understand why this is happening and I have , as a result, cut out most exercise. I became so sensitive to the condition that the elevation of pulse to only 90 or 95 freaks me out totally.
It took years for the HMO psychs to comprehend how adversely this whole thing has affected me.
Eating a normal meal takes my pulse from 68 or so to 100 or 110 for hours. Not bad tach as tach goes but it freaks me out and they cannot explain it. Now , with the little attenolol I can eat a meal and a few hours later take a strenuous walk of an hour or more. My pulse will almost immediately go to 72 or 74 and in an hour will be 66 or lower. Sometimes it makes me cry I am so happy for just this normality.
My GP had cleared me to use more attenolol "as needed" and push to higher levels of exercise. The barrier is not physical it is emotional. Deeply emotional. I am going slowly.
I got "diagnosed" with atrial tach because I figured out that was probably what it was and the docs did not disagree. They are just ho hum about the physical side of it.
I feel now that I am getting good care for my emotional recovery. Finally, I now understand the anxiety attacks and feelings I have been having for years. I respect the cardio docs a great deal but they are not shrinks or psychs God bless them.
I feel that I am not really being followed medically. I feel that none of the docs really know what is going on with me and as I push to higher aerobic levels I feel a great anxiety wondering if I could be heading, unwittingly, for some bad result. Intellectually I strongly doubt that this is the case. But then there is the emotional side which I now fully acknowledge.
I am trying to push now to be able to get into the mountains again and I plan to hike to 8000 or 9000 feet within the next month. I am scared senseless by this which was once such a perfect pleasure.
I will have along the attenolol in 1/8th sections to take as needed. I feel like I am acting as my own cardiologist. I don't feel good about it.
When I occasionally buy a powerball lottery ticket I don't daydream of cars, homes, or vacations. I dream of walking into the Cleveland Clinic and saying :"I have millions of dollars and only HMO insurance. Here's a million deposit. Tell me what is wrong with me . Give me the knowledge. I must know why this has happened in my life. Why does my heart behave this way?
It's gonna take a lottery win to get me to Cleveland. If I had been a couch potato all my life instead of following dreams of fitness I probably would have never noticed the tachycardia.
I will put up a post on this question if I make it to 8 or 9 thou. My rate will be in the 160's. I don't know how the tach will behave, I don't know how more attenolol will affect my ability to stay on the trail or if I will even remain conscious.
But I have decided that I have given up my life for way too long now and I am going to try to get it back. If it kills me at least I will die in the mountains. That's all.
Regards and good luck. John
Like you I can no longer emotionally tolerate knowing or perceiving that my pulse is over 95 or 100. I spent over a decade and a half aerobically exercising at rates of 140 to 175 or higher with no problem.
This is where the ativan comes in and also TIME and predictability so that I can trust that the tach is actually controlled. Have I been cleared for exercise? Well, my HMO cardiologist told me to get all the exercise I could. That is the extent of the advice...no warnings I guess are present.
He sees basically nothing wrong with me that is life threatening. It is a matter of my "accepting" the condition. The attenolol is prescribed by my HMO GP and NOT the cardiologist.
They have not suggested or offered an EP study. I am certain, though, that I could not emotionally tolerate anything invasive at this time without general anesthetic. They have shown no interest in finding out the source or exact nature of the inappropriate pacing of my heart in some circumstances. I don't know what AV nodal re-entrant tach is but will find out.
I spent my career in computers and electronics and I find myself capable of understanding just about anything related to heart problems if I take the time.
My episodes are caused by exercise. The duration and degree of pulse elevation is always directly proportional to the duration and degree of aerobic exercise preceeding the episode. Without attenolol if I take my evening walk ( I live in a hilly area at some elevation ) of one hour results are much different. I will run a pulse of 85 to 105 which is totally appropriate for my condition and demands of the walk.
Without attenolol my pulse will stay at 85-90 for several hours and then gradually go down to my ( non attenolol ) healthy rate of 66 to 68. This is NOT tachycardia by definition. The problem is if I want to do MORE.
A moderate hike of 2-6 hours with a sustained pulse of 95 to 120 will result in a pulse rate of 110 or 115 for 2 to 4 hours then very gradually coming down. A really strenuous aerobic session can result in rates of 125 plus for 3 or 4 hours even as I sleep. It gradually comes down over the next 12 to 18 hours.
For 15 years the HMO has had NO desire to do anything to understand why this is happening and I have , as a result, cut out most exercise. I became so sensitive to the condition that the elevation of pulse to only 90 or 95 freaks me out totally.
It took years for the HMO psychs to comprehend how adversely this whole thing has affected me.
Eating a normal meal takes my pulse from 68 or so to 100 or 110 for hours. Not bad tach as tach goes but it freaks me out and they cannot explain it. Now , with the little attenolol I can eat a meal and a few hours later take a strenuous walk of an hour or more. My pulse will almost immediately go to 72 or 74 and in an hour will be 66 or lower. Sometimes it makes me cry I am so happy for just this normality.
My GP had cleared me to use more attenolol "as needed" and push to higher levels of exercise. The barrier is not physical it is emotional. Deeply emotional. I am going slowly.
I got "diagnosed" with atrial tach because I figured out that was probably what it was and the docs did not disagree. They are just ho hum about the physical side of it.
I feel now that I am getting good care for my emotional recovery. Finally, I now understand the anxiety attacks and feelings I have been having for years. I respect the cardio docs a great deal but they are not shrinks or psychs God bless them.
I feel that I am not really being followed medically. I feel that none of the docs really know what is going on with me and as I push to higher aerobic levels I feel a great anxiety wondering if I could be heading, unwittingly, for some bad result. Intellectually I strongly doubt that this is the case. But then there is the emotional side which I now fully acknowledge.
I am trying to push now to be able to get into the mountains again and I plan to hike to 8000 or 9000 feet within the next month. I am scared senseless by this which was once such a perfect pleasure.
I will have along the attenolol in 1/8th sections to take as needed. I feel like I am acting as my own cardiologist. I don't feel good about it.
When I occasionally buy a powerball lottery ticket I don't daydream of cars, homes, or vacations. I dream of walking into the Cleveland Clinic and saying :"I have millions of dollars and only HMO insurance. Here's a million deposit. Tell me what is wrong with me . Give me the knowledge. I must know why this has happened in my life. Why does my heart behave this way?
It's gonna take a lottery win to get me to Cleveland. If I had been a couch potato all my life instead of following dreams of fitness I probably would have never noticed the tachycardia.
I will put up a post on this question if I make it to 8 or 9 thou. My rate will be in the 160's. I don't know how the tach will behave, I don't know how more attenolol will affect my ability to stay on the trail or if I will even remain conscious.
But I have decided that I have given up my life for way too long now and I am going to try to get it back. If it kills me at least I will die in the mountains. That's all.
Regards and good luck. John
I have posted previously about my atrial tach. It is caused by extended periods of aerobic exercise, alcohol, caffeine, and , of all things, eating a meal. The docs finally stopped telling me to ignore it when my resting pulse would run 125 for hours following a moderate 6-8 mile hike for which I was in perfect shape. My rhythm is normal sinus but inapprop. fast.
I am using attenolol and it controls the tach though I am not yet exercising at pulse rates above 100. Like you, I am VERY sensitive to attenolol. I know people who can take 50 mg once a day for BP and not even notice it. 25 mg. at one time floors me. Confusion, panic, low pulse 55-58, cold etc. So I take 1/4 of a 25 mg tab 4 times a day and am experimenting with using a bit more as I increase exercise. They say this is OK.
How are you able to precisely control the dose? I find it difficult to cut the tabs.
I am taking ativan now since they tell me I developed , over a number of harrowing years, a conversion reaction from all the stress of the inappropriate tach. episodes. Being very sensitive to drugs I am taking very little .5mg 3x/day and sometimes 4x. Whether placebo or for real it seems to help me avoid panic over higher heart rates when I exercise.
So far I have not considered ablation as long as this therapy allows me to live somewhat normally. I just wanted to share that you are not alone in having profound and frightening side effects to what they say are low doses of attenolol. But it is wonderful to be able to eat a meal and not have my resting pulse go from 68 to 100 or 110 for hours for no apparent reason.
ps. from age 21 to about 36 I was addicted to running, biking, and things like mountaineering. A very high aerobic guy. Now I am 52. I have seen some posts that suggest that physical changes to the heart as a result of extreme levels of aerobic conditioning might cause ectopic atrial pacing sites to develop.
None of the docs here have any opinion of this possibility and tell me to exercise as much as I can for the sake of my heart. They also found slight insufficiency in aortic and pulm. valves in echo but tell me it is very very slight and not to worry. Of course, I worry given my history.
Perhaps this was caused by all the exercise. Like 18 hours on a climb at 150 + pulse rate and feeling GREAT. Maybe I did it to myself?
Good luck, I know I am rambling and , as a medical person yourself, you know a lot more than I about the subject. But our human reaction to the symptoms and side effects of drugs made me want to comment. John
I am using attenolol and it controls the tach though I am not yet exercising at pulse rates above 100. Like you, I am VERY sensitive to attenolol. I know people who can take 50 mg once a day for BP and not even notice it. 25 mg. at one time floors me. Confusion, panic, low pulse 55-58, cold etc. So I take 1/4 of a 25 mg tab 4 times a day and am experimenting with using a bit more as I increase exercise. They say this is OK.
How are you able to precisely control the dose? I find it difficult to cut the tabs.
I am taking ativan now since they tell me I developed , over a number of harrowing years, a conversion reaction from all the stress of the inappropriate tach. episodes. Being very sensitive to drugs I am taking very little .5mg 3x/day and sometimes 4x. Whether placebo or for real it seems to help me avoid panic over higher heart rates when I exercise.
So far I have not considered ablation as long as this therapy allows me to live somewhat normally. I just wanted to share that you are not alone in having profound and frightening side effects to what they say are low doses of attenolol. But it is wonderful to be able to eat a meal and not have my resting pulse go from 68 to 100 or 110 for hours for no apparent reason.
ps. from age 21 to about 36 I was addicted to running, biking, and things like mountaineering. A very high aerobic guy. Now I am 52. I have seen some posts that suggest that physical changes to the heart as a result of extreme levels of aerobic conditioning might cause ectopic atrial pacing sites to develop.
None of the docs here have any opinion of this possibility and tell me to exercise as much as I can for the sake of my heart. They also found slight insufficiency in aortic and pulm. valves in echo but tell me it is very very slight and not to worry. Of course, I worry given my history.
Perhaps this was caused by all the exercise. Like 18 hours on a climb at 150 + pulse rate and feeling GREAT. Maybe I did it to myself?
Good luck, I know I am rambling and , as a medical person yourself, you know a lot more than I about the subject. But our human reaction to the symptoms and side effects of drugs made me want to comment. John
Thanks for your msg. My doc said we are born with this, and that usually some type of trigger gets it going. I don't know if they really know, but the most challenging part is learning to live with it (if you can't have it surgically cured). Have you had an EP study? Are you on medication? Or do you just deal with the episodes? Hope you are well!
Hi,
I also suffer from atrial tachycardia or I guess PAT. I always wondered if we born with this electrical problem, how come it does not effect most of us until later on in life and why can't it go dormant again?
I'm still trying to get a good answer from my Dr...
Hope you are feeling better!
I also suffer from atrial tachycardia or I guess PAT. I always wondered if we born with this electrical problem, how come it does not effect most of us until later on in life and why can't it go dormant again?
I'm still trying to get a good answer from my Dr...
Hope you are feeling better!
Hi! I have some of your same sit. and live in your area: if you are interested you could contact me at ***@**** I am especially interested in your ep and where you had your ablation done in our area. (I also opted not to do tambocor for similar reasons, but on "bad" days get tempted.)
jw24,
Sorry to read of your troubles. I'll answer your questions in order.
(1) I am a general cardiologist, and so have experience treating Atach with medications. Your situation requires expert consultation from an electrophysiologist at a major medical center.
(2,3) I do not know if a second ablation procedure would be possible. I suspect that the only way to know would be to undergo a second EPS with mapping. If a site could be found, and was not thought to be in a dangerous location, then a second ablation could be possible. If you are interested in staying in California for a second opinion, then try UCSF, Scripps Clinic, or UCLA. If interested in coming to the Cleveland Clinic, then start with Dr Natale, Saliba, or Schweikert.
(4,5) I certainly am not going to tell you to just live with it; especially given the limited amount of information about your symptoms that you provided. If you had infrequent spells, that lasted seconds to minutes, and were associated with minimal symptoms; then yea live with it. Otherwise, attempts at therapy make sense.
(6) A support group makes good sense to me. Perhaps our readers/commenters can provide some information or other chat rooms they have found of interest?
Hope that helps. Good luck.
Sorry to read of your troubles. I'll answer your questions in order.
(1) I am a general cardiologist, and so have experience treating Atach with medications. Your situation requires expert consultation from an electrophysiologist at a major medical center.
(2,3) I do not know if a second ablation procedure would be possible. I suspect that the only way to know would be to undergo a second EPS with mapping. If a site could be found, and was not thought to be in a dangerous location, then a second ablation could be possible. If you are interested in staying in California for a second opinion, then try UCSF, Scripps Clinic, or UCLA. If interested in coming to the Cleveland Clinic, then start with Dr Natale, Saliba, or Schweikert.
(4,5) I certainly am not going to tell you to just live with it; especially given the limited amount of information about your symptoms that you provided. If you had infrequent spells, that lasted seconds to minutes, and were associated with minimal symptoms; then yea live with it. Otherwise, attempts at therapy make sense.
(6) A support group makes good sense to me. Perhaps our readers/commenters can provide some information or other chat rooms they have found of interest?
Hope that helps. Good luck.
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