cather ablation

Posted by Lesley  on July 26, 1999 at 14:09:13
I have been dx with lupus and raynaund's and fibro for over two years now with cns involvment , my heart problems started with rapid pulse rate and very short of breath and chest pains - my doctor sent me for a echo and these are the results :
right ventricle was enlarged( should I worry about this and the cause)
tricuspid regurgitation and mitral regurgitation with thicken walls
transmitral flow patter suggests mild restrictive physiology ( what does that mean ?) and right ventricular systolic pressure at 37 mmhg
They then told me that I had pulmonary hypertension and was sent for a heart cath which they said my pressure where high normal so I don't have pulmonary hypertension . Should I be watched closely and could this just be the beginning stages of it or is it postive I don't have it .
Then they wanted to help the rapid heart rate which now has restrictive my life totally - anything and everything causes my heart rate to go up to 200 and I faint or vomit . After more test I was told I have parosysmal supravent tachacyardia and inapproapriate sinus tach . I have tried all the meds with no helps and one cause raynaunds problems big time . Now I am going to have the cather ablation in August  to help they said they where going to do the sinus node modification -they said my risk of getting a pacemaker is very high in my case they ablation does not bother me - am worried about the pacemaker I am only 25 years old and how will the pacemaker be with having very active lupus being treated with chemo
also should I be concerned about the right venricle enlarged and what could have cause this
Just confused and need to know that I am going about it all right
Should I be watched for PH and what systptoms should I call the doctor about

Thanks in advance

Posted by CCF CARDIO MD JMF on July 26, 1999 at 15:04:08
Dear Lesley,
It sounds as though your case is quite complex.  I would definely seek a second opinion if that is possible to review all your documentation.  It is not normal to have elevated pulmonary pressures at your age and a cause should be sought.  I am assuming that it is secondary to your collagen vascular diseases but cannot be sure.  This should be followed closely by a pulmonary specialist as it may be an early sign of pulmonary hypertension.  You may wish to seek the advice of a second electrophysiologist regarding treatment of you PSVT.
I hope this has been useful. I wish you the best of luck. Feel free to write back.
Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. 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.


Posted by Lesley on July 26, 1999 at 15:13:38
should I be concerned about the right venricle enlargement or is it just something that is normal or will it get worse
also they said my pressures where high normal but normal with cath and that is more accurated but I'm am going to get a second opition cause I have pulmonary function test that too are not normal.
do you think it not good to have the the cather ablation , I'm ready for it cause I'm ready for the problems to stop with or with a pacemaker
Are packemaker okay for lupus (SLE) patients and what could be the risk
What are the possilblies of complication with sinus node modification]
Thanks again

Posted by CCF CARDIO MD JMF on July 26, 1999 at 16:15:49
Dear Lesley,
I would moniotr you pulmonary pressures and your RV dilation, these could represent early primary pulmonary hypertension associated with your collagen vasclar disease.  
Side effects of an ablation are bleeding at the site of the catheterization and causing complete sinoatrial block causing the need for a pacemaker.  There should be no contraindications for a pacemaker in patinets with lupus.