juctional and atrial rythm 5 years post ablation

[shans 52]

I wrote a little earlier in the week about my heart, I had 2 ablations and now am in a j unctional and atrial rythym. I had an ekg done fri which was 48 and junctional, tues it was 62 and my cardiologist said it was atrial because my pr was very short. I had an echo yesterday and have a halter on now. While watching the stip at the bottom of the echo i noticed alot of my complexes either did not have a p or I did see one where the p was on the qrs. I am taking my pulse alot and find my resting rate in mid 40"S I think a pacer would make me feel alot better. My cardiologist would like me to see an electrphysiologist and I would like to come to cleveland clinic, I called yesterday and the gave me an appt with dr tchou feb 10th, is that too far away? I have chest pains, sob, extreme fatigue. my ablations were over 5 years ago.I hope to find out the results of the echo and halter very soon. Thank you very much for your time

[CCF-M.D.-MJM]

Hi Shans,

That is a tough question to answer without seeing you in clinic first.  It depends on the severity of your symptoms, if they are progressing or stable, and the cause of your chest pains.  I don't think I can safely answer that question on the internet.

The EKG on an echo machine is reliable for image triggering but should be used for interpretation of rhythm--there is usually too much artifact.

If you are concerned that you cannot wait, you should be evaluated by your doctor sooner.

Dr. Tchou is fantastic.  He is one of our senior electrophysiologist, has both procedural and clinical experience, and most importantly has sound clinical judegement.  He will take great care of you.

I hope this helps and good luck.

[uptowngirl]

Hi.  Good question.  I believe, however, that you are only suppossed to post a question once every 3 months according to the forum rules.
Thanks,
Uptown girl

[shans 52]

I guess I need to read the rules a little better, by the way I forgot to mention that I am a 31 y/o female.

[pms_barbie]

Uptown is correct.  Do a search in the archives under Med Help.  You will get several replies back.  Read the ones that have the heart forum beside them.  They will clearly state the rules of the forum.  Good luck

[Neener44]

Hi Shans 52
I think I am starting to experience some problems similar to yours. I had ablations in Dec. 2000 and July 2001 for IST. The rapid heart rate returned after both, but lately my resting heart rate seems to be quite low at times 30's to 60's and I am having episodes of pre-syncope,sob, dizziness, etc. Also, my heart rate is very erractic during exercise either too low or too high. I am scheduled to see my EP in March, but may see him sooner depending on holter monitor results.  Please keep us updated on your findings. Thanks. Here's a link that dicusses junctional rhythms and sick sinus node (of course you probably already know all this stuff, but it was interesting to me)http://www.emedicine.com/med/topic1212.htm
Take care,
Neener

[KAD]

I posted a comment on your earlier question.  I also had 2 ablations for IST.  After 2nd one I dropped into junctional bradycardia in the 30's-40's.  Had similar symptoms that you have minus the chest pain. They put in AAIR pacer b/c on a exercise stress test I could not get my rate past 50bpm.  They call this chronotropic incompotence.  Did they do an exercise stress on you?  You might want to consider getting one done b/f you take the big step of a pacer.  Anyway, it's very interesting b/c it's turning out that my IST is returning again.  HR is back up 120-140 and obviously not using the pacer.  Cardiologist is floored that my sinus node recovered from all the ablations.  Now the question is what to do with the pacer and whether or not to have another ablation or not?  I hope things work out for you.

[shans 52]

I would like to first say thank you all for your time.  I wore a halter monitor the other day and my doctor called me this am and said i definaltely need a pacemaker. He said my heart rate went down to 33 and I had greater than 2.5 second pauses. I am scheduled next thursday. I haop this gives me the new found energy I am searching for and gets rid of these bothersome symptoms.

[Clenn Camp]

Don't count on a pacemaker solving your problems.  However, on the other hand it can be set to a minimum pacing beat to restore a higher 'resting' rate.

[Neener44]

Good luck with the pacemaker. Hope it helps. By the way, during your second ablation did they attempt to modify your sinus node? My EP was planning to try and modify mine, but then decided it would be too risky and ended up doing burns all around the lower half of the node using the carto mapping system. Take care.
Neener