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967168 tn?1343732745
questions about Treadmill stress test
Is anyone familiar with what happens during excerise with HCM and the heart? I've been reading the past few days and do not find any info on it and I haven't found the right time to get a post into the expert forums :P

I've been trying for a year to find out what this means because my doctors told me they did not know, but it was probably due to my "quirky" ANS/Heart connection :confused:

7/6/2009 Stress test:  4:55 min test
Resting - Sinus rhythm with slow R wave progression in the precordial leads
Stress - Frequent pvc's - 2 PVC couplets and 1 PVC triplet in recovery
Sinus Tachycardia with no signifiant ST-T wave changes
[COLOR="red"]QRS segment of PVC's narrowed substantially with exercise, widening again in recovery (180 ms to 80 ms) [/COLOR]
BP - 130/70 - 150/90

Heart rate response: resting 74 bpm, peak 154 bpm, 87% age predicted maximum. 1 min into recovery heart rate decreased to 121 bpm
Functional aerobic impairment of 35% 6 mETS achieved
Increasing Dyspnea was noted with exercise stress as well as increasing dizziness.  Nausea was noted in recovery.

I'm told they've never heard of the QRS doing this during any exercise test; could this be related with problems of HCM?  I have an ICD and when I've had it interrogated, usually it shows where I've been paced back down from VT episodes when I'm shopping, walking abit and can pinpoint it to days/times I've been out doing things.

I will ask the dr when I go, but that may not be for a month or two and I want to make sure I get all my questions in order and have knowledge of what I'm asking :p
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367994 tn?1304957193
Q: "Functional aerobic impairment of 35% 6 mETS achieved"

>>>>>A stress test measures metobolic equivalency (METs) at different levels of exertion.  Your test was discontinued due to shortness of breath...If I remember correctly from my stress test 6 mets is about 6 minutes of a 15 minute test.  May indicate you have coronary artery blockage that prevents adequate blood flow to the heart at the level of stress noted.

QRS is the wave form of the electrical impulse that contracts your lower chambers to pump blood.  It indicates the amplitude of the impulse as well as the time.  With HCM the impulse may have taken longer to contract and that was shown on the EKG strip.  Would need more info to be precise.

Exercise may cause shortness of breath, dizziness, or lightheadedness. An abnormal heart rhythm may cause the symptoms that your ICD system is not programmed to treat. Is this what you mean by pacing back?
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967168 tn?1343732745
sorry for some confusion; I shouldnt have added the info about my pm/icd - sometimes I tend to ramble

That's all of the stress test there was - 1 page test results.  What more info do you need? I have 70 or 80 pages of tests/results but nothing else on the treadmill test - I've seen others have alot more detail in theirs.

The dr ended the test at 4min 55 seconds because of the pvc couplets, sob, and I passed out as she stopped it and had the 1 pvc triplet in the 1 min cooldown stage (recovery)

About a month after the stress test, I had a cardiac cath that showed no clots, kinks, blocks or plaque. That week I also had an RF ablation, MRI and had to have the PM/ICD implanted due to polymorphic VT.

Since I've had my implant, I notice that when I have VT runs it's usually when I am doing something - walking; shopping or doing something  and I can feel it pacing back down from VT, so maybe the stress test points to my problem with exercise/exertion and vt runs?
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367994 tn?1304957193
I am not entirely famiiar with the technology of a pacemaker-mediated tachycardia but it can be defined as any condition in which a pacemaker paces the ventricles at rates that are fast walking, shopping, etc. and should not envoke a rate response unless there is a medical problem.  Or it can be a rate response setting that is too sensitive, or some outside interference to the elcetrical mechanism, etc. It may be a good idea to have the unit checked and reprogrammed if necessary.
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When you say "pacing back down from VT" do you mean that your ICD is pacing you out of a VT episode and back into a normal rhythm and pulse rate? If this is the case then your ICD is doing what it is supposed to do, monitor your heart rate and rhythms, detect rhythm problems, and then treat them.

One thing I have found is that the nurse or tech checking my ICD is a very good source of info concerning my device. You might try asking them too.
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967168 tn?1343732745
yes that's what I was describing with my pm/icd and pacing me back to NRS from Vt episodes

I wish the techs I've had over the past year were good at explaining things - I wouldnt have to question or ask about them - even the Boston Scientific ones who have interrogated me have been like this - it took over 9 monts to even get my rate response turned on because some had no clue how to do it :(
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