Re: Holter monitors

Posted By sah on July 14, 1999 at 09:23:00
What is the adhesive on holter monitor patches made of?  Is it a silicon base or water based?  Also what is Lown-Ganong-Levine syndrome?

[Cleveland Clinic, MD]

Posted By CCF CARDIO MD - CRC on July 14, 1999 at 11:28:46

Dear sah,
Thank you for your questions. I'm not sure what the adhesive is made from.  Let me know if you find out.
Lown-Ganong-Levine syndrome (or LGL syndrome) is a syndrome that is characterized by tachyarrhythmias, a short PR interval and a normal width QRS (findings on an electrocardiogram). It used to be thought that LGL was caused by atriohisian tracts (electrical short circuits) in the electrical system of the heart. The thinking has changed somewhat and the term LGL is not commonly used. Instead we call this an enhanced AV nodal pathway that may be due to a "short circuit" or just a normal variant.
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.

[sah__0]

Posted By sah on July 14, 1999 at 11:43:35
LGL a problem for those diagnosed with it?  I asked about the patches because I am slightly allergic to silicon and I have been itching like crazy, not a comfortable thing at all.  No one seems to know, not even the nurses I talked to!  If I find out I will let you know!

[Cleveland Clinic, MD]

Posted By CCF CARDIO MD - CRC on July 14, 1999 at 12:20:58
Not generally a problem.  Hope your itching stops.
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.

[sah__0]

Posted By sah on July 14, 1999 at 19:40:18
It's not generally a problem, when does it become a problem?  Can it cause dizziness or dizziness after exercising?  Got rid of most of the adhesive now (nail polish remover)!

[Cleveland Clinic, MD]

Posted By CCF CARDIO MD - CRC on July 15, 1999 at 09:04:24
LGL dosen't usually cause dizziness but other arrhythmias may cause dizziness.
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.

[sah__0]

Posted By sah on July 15, 1999 at 17:48:26
What other types of arrythmias cause dizziness?

[Cleveland Clinic, MD]

Posted By CCF CARDIO MD - CRC on July 16, 1999 at 09:24:39
afib with rapid ventricular response, Supraventricular tachycardia, ventricular tachycardia, ventricular fibrillation, bradycardias are some.
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.

[sah__0]

Posted By sah on July 16, 1999 at 11:38:50
one more question, what does short P-R interval mean?

[Cleveland Clinic, MD]

Posted By CCF CARDIO MD - CRC on July 16, 1999 at 13:47:04
The duration between the P wave and the R wave on the electrocardiogram.  It is related to the amount of time that a heart impulse takes to go through the AV node.
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.

[sah__0]

Posted By sah on July 16, 1999 at 15:05:23
Is a short P-R interval bad or good?  What does it implicate if anything?

[Cleveland Clinic, MD]

Posted By CCF CARDIO MD - CRC on July 19, 1999 at 10:33:45
It depends on how short.  A very short PR interval is indicitive of an accessory pathway in the AV node that can be cured with ablation.
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.

[sah__0]

Posted By sah on July 19, 1999 at 13:58:10
Is a PR Interval of 96 short?

[Cleveland Clinic, MD]

Posted By CCF CARDIO MD - CRC on July 20, 1999 at 10:23:56
That's pretty short.  Has your doctor considered WPW syndrome?  Below is some information about WPW.
Wolff-Parkinson-White (named after the three doctors who first described it) is a hereditary condition.  It may not be diagnosed until adolescence but the underlying cause is present at birth.  More information concerning ablation may be found at: http://www.heartcenter.ccf.org:8080/patinfo/patguide/p_ablate.htm
Good luck.
Q: What is the normal condition?
A:In a normal heart the atrio-ventricular or A-V node is the only path for electrical conduction between the atria and the ventricles .
Q: What is the Wolff-Parkinson-White syndrome?
A: If an abnormal conduction pathway runs between the atria and the ventricles, the electrical signal may arrive at the ventricles too soon. This condition is called Wolff-Parkinson-White syndrome (W.P.W.). It is recognized by characteristic changes on the electrocardiogram that indicate that an additional pathway or shortcut from the atria to the ventricles exists. Many patients with the syndrome do not have symptoms or episodes of tachycardia (rapid heart rhythm).
Q:  First of all, what is the cause of WPW? Is it something you 'get' when you over exercise?
Is it genetically rooted?
A: WPW is a congenital condition.  It is not induced by exercise or any other "strain" on the heart.
Q:  How common, in the general population is WPW?
A: The incidence is about 1 in 1000.
Q: How is the Wolff-Parkinson-White syndrome treated?
A: If a person has episodes of tachycardia , often they can be controlled with simple **************. However, sometimes such treatment doesn't work. Then the person will need to have further tests of the heart's electrical system. The procedure most frequently used to interrupt the abnormal pathway is radio frequency ablation. (http://www.heartcenter.ccf.org:8080/patinfo/patguide/p_ablate.htm)

Most patients with the syndrome can lead normal lives with no restrictions on their activities. This is true even for those who have episodes of tachycardia.
Q: How safe is the ablation? What are potential problems that may arise either during the ablation or afterwards?
A: Ablation is a routine procedure that uses high powered frequency waves to "burn" electrical short circuits in the heart.  As with any medical procedure there are potential risks and your doctor should discuss these with you prior to the procedure.
Q: Is there any kind of a rating system for the doctors which perform this type of procedure, simply put are some doctors better than others at this procedure and how may I find out who is the best?
A: There are no rating systems per se of individual doctors.  You can ask for success rates of the same procedure in other patients.  There are ratings of hospitals that are published by independent groups such as US News and World Report that give a ranking of programs.
Q:  How common is this procedure and how many are performed daily, weekly or yearly?
A: This is a routine procedure. The number will depend upon the individual group.  The electrophysiology group here does 2 to3 ablations a day.
Q:  Is it common for a cardiologist to recommend the ablation after only reviewing blood tests, and ekg, and an echo test of the heart?
A: Yes.  The diagnosis of WPW is made from the EKG.
Q:  I am currently taking the drug Diltiazem which seems to be controlling my heart problem. Therefore, if I were to postpone the ablation procedure could I possibly be putting myself in danger of further heart problems?
A: This would depend on your specific case and you should discuss this with your doctor.
Q: Are there famous celebrities or scientists, doctors, et
cetera, who have survived this infliction?
A: Not that I know of.  Anyone out there know?
Further information can be found at:
http://www.heartcenter.ccf.org:8080/patinfo/patguide/p_ablate.htm
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.

[sah__0]

Posted By sah on July 20, 1999 at 11:45:24
The 96 I was refering to was about 9 years ago.  I was 12 and had a resting pulse of 78.  I do not know what the interval is right now.  I suppose I will find out when the dr does the stress test next week.  Thank you so much for the information though.  At least I will know what questions to ask.  I do have palpitations every once in a while and they are not all that bad, just bothersome really.  What I hate the most is when I exercise and feel dizzy afterward.  I also look cherry faced.  Hate it.  Thank you again for the informaiton.

[Cleveland Clinic, MD]

Posted By CCF CARDIO MD - CRC on July 21, 1999 at 10:39:48
If you do have WPW it may show up on the ECG.  Be sure to let your doctor know there is a history of a very short PR interval.  Good luck.
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.

[sah__0]

Posted By sah on July 21, 1999 at 17:23:21
I just called the office and my holter monitor came back ok except for a resting heart rate of 155 at one point.  I want to know, can one small cup of tea with milk cause such a rise?  I don't think the dr. thinks that it is WPW.  He has not said anything about it at least.

[Cleveland Clinic, MD]

Posted By CCF CARDIO MD - CRC on July 22, 1999 at 09:05:27
No a cup of tea wouldn't cause that.  WPW may or may not cause it depending on what the rhythm looked like.  It is not so high that I would be very concerned but I think you are doing the right thing by following up with a cardiologist.
CRC

[sah__0]

Posted By sah on July 23, 1999 at 11:39:26
Thank you for the kind words, I hope I am doing the right thing.  God knows it is costing me enough.  Being a student, it is hard to afford it.  I just want to find out what it is and deal with it.  I mean, the palpitations do not bother all that much, but the dizziness does.  Thank you again for this forum and for the kind words and encourgement.  Have a good day!










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