Ventricular and Atrial Arrhythmias?

[Neener44]

I recently  had a second EP Study and ablation for atrial tachycardia. The first was done in December 8,  2000 this one was done in July 3, 2001.  In this EP study the doctor also found and ablated a second pathway that he located in my right ventricle.  Prior to this second EP study my heart rate was rapid most of the time without medication and even with sotalol 80 mg twice a day often was 110 bpm or higher at rest.   My PCP would like me to have a Thallium stress test done because he is concerned that there might be some damage in the lower part of my heart an also because my heart rate still goes quite high when I exercise.  It's so fast it's difficult to get a pulse, but I think around 240 bpm or higher and I have chest pain when walking at approximately a 3 mile per hour pace for 20 minutes on a treadmill. I have been walking for at least 10 years. I  recently turned 45 and my physician says I'm basically healthy except for the "heart thing" which also causes my blood pressure to increase relative to my heart rate.  My cholesterol is borderline.  BP is generally 130 /86  to 170/110 depending on my heart rate.  The pathway in the right atria is located directly below the sinus node and my EP doctor has gotten as close as possible to the sinus node to attempt to ablate this.   My main questions are, would it be unusual to find a pathway in the ventricle of a healthy heart?  Would you recommend a Thallium Stress Test?

[CCF-M.D.-CRC]

Dear neenar,
I think the question of coronary artery disease is separate from that of the pathway.  It is common to find pathways in healthy hearts but this does not mean that coronary disease cannot be present either.  Therefore the question of a thallium stress test must be answered based on other criteria such as symptoms of chest pain, family history, etc.  We do not get thallium tests on all our patients with accessory pathways.

As far as the fast heart rate you may have inappropriate sinus tachycardia.  You can find other postings in the archives on this topic.

[Neener44]

Sorry, I forgot to mention I am female and pre-menopausal.  Echocardiogram was normal except for a constant fast heart rate and a mildly enlarged heart. Thanks for this great forum I have been an avid reader!