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Re: curious tachycardia
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Re: curious tachycardia

Posted By CCF CARDIO MD - DLB on November 18, 1998 at 17:08:12:

In Reply to: Re: curious tachycardia posted by Denise on November 18, 1998 at 16:57:56:







: : : Hi Dr. DLB,
I went to my electrophysiologist Monday and he told me he ablated because of SVT and it was because of Sinus Node re-entry.  I had a lot of questions he answered for me, but silly me didn't ask what Sinus Node re-entry is or what causes it.  Can you tell me about it?
Also, I am wearing the event-monitor to try to catch the arrhythmia I had after the ablation.  After speaking with him Monday, he stated I would have to be on beta-blockers (now 50 mg Tenormin per day) indefinitely because of sinus tachycardia I have.  In order to catch the arrhythmia, he said I would have to go off the medication.  I've done that before and it worked, but now if I have to take the beta-blocker indefinitely, do you think there is any point in doing that?
He said in some cases 1 or 2 out of 100, there needs to be another ablation in people with my situation.  He didn't seem to anxious to do another ablation, neither do I?  Since I have the monitor for 2 more weeks, do you think it is better to keep on the medication and see if I have an arrhythmia on it and record it if I do, or go off and see if something else is going on?  I am really torn between this decision.  He said it is entirely up to me.  What do you think?
He also said he can't understand why my resting heart rate went from 62 bpm before the ablation to 102 bpm after the ablation.  He said where he ablated, if something went wrong, would result in a lower resting pulse.  I am still puzzled on that whole situation.  Basically, the reason my regular cardiologist put me on the Tenormin now is because of the high resting heart rate.  Do you have any opinion on this?  HELP!?!  It is really hard to say what the ablation done for me because I've been on Tenormin (25 mg to begin with and now 50) since the ablation.  This may be another good reason to go off the medication and see what the ablation has really done for me.  The electrophysiologist who did it is excellent and I don't question his ability at all.  The main problem I would have before the ablation is the "big arrhythmia" happening once in a while, but also when I would go up a flight of stairs, my heart rate would jump to 160-170 no problem.  I'm not out of shape either!  Can the Sinus Node re-entry problem he ablated take care of this?  I don't have any problem with the stairs now, but it is hard to say what the Tenormin is controlling.  Would the Tenormin control this or was the ablation successful at taking care of that?
Thanks
Denise
Dear Denise
Sinus node reentry is a particular type of SVT that occurs in the sinus node, the part of the heart from which the heartbeat originates. This type of SVT is often treated with ablation. AS a complication some patients require a pacemaker for a slow heart rate. The procedure should not result in a faster heart rate. Sometimes a repeat procedure is necessary if the SVT comes back.
I think either course of action is reasonable. Perhaps it would be best to go off the medicine (if your cardiologist agrees) and see what the event monitor reveals. That way you and your doctors can know for sure if the ablation was successful.
I hope this is useful. Feel free to write back with further questions. Good luck.
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.

Hi Dr. DLB,
Yes, I think that would be the best thing to do.  Thanks so much for your advice, I always appreciate it!
Denise
:-)
Dear Denise
You are very welcome. I hope the event monitor provides some answers. Good luck.
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.


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