Posted By Ann Ibrahim on May 28, 1999 at 09:47:26
Thank you for your reply to my question relating to AV Node ablation and implantation of pacemaker for inappropriate sinus tachycardia. Your comments were very reassuring. I have since been informed however that there is another condition with similar symptoms to IST , its called Orthostatic Intolerance or POTS. How could these conditions be differentiated? I want to be sure that I have not been misdiagnosed before I go ahead and have my AV node ablated! For years now my only symptom has been tachycardia, 190 bpm with the absolute minimum of exertion. However I do often have a raised resting pulse of between 100-120 despite beta blockers. Recent symptoms which developed over the past few months include visual disturbances, throbbing headache and dizzyness upon standing(occasionally). My doctor has put these symptoms down to an increase in medication as my BP was up a bit and I was prescribed Irbesartn (ace inhibitor).
An EPS and sinus node modification were carried out in February but symptoms still persist. My electophysiologist wants me off beta blockers sooner rather than later because of the effects they have on my breathing (I'm asthmatic). The ablation is scheduled for 7 July at the Royal Brompton Hospital , London. What if this condition is POTs ? Would I still need the ablation to control the tachycardia when the beta blockers are withdrawn? No other drugs control the arrythmia, this is the major problem.
Thank you so much for your help. You all do such a wonderful job!!
Posted By CCF CARDIO MD - CRC on May 28, 1999 at 13:16:50
The test of choice for the diagnosis of POTS is a tilt table test. However it dosen't sound to me as if this is what you have. the increased heart rate with POTS is only at the same time as the decreased blood pressure. I would suggest discussing it with your doctor before proceeding with the ablation.
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