Ablation vs Pacemaker

[chicky2001]

I had a stress test which came back with possible blockage.  My cardio did a cardio cath and I am fine in that regard.
The thing is, I was laying in the cath lab for 4 hours of recovery and my nurse kept looking at the monitor.  She told me my heart was doing all kinds of things and pausing.  She said she has seen many monitors and it looks like a need a pacemaker.  She called my cardio and kept strips for my records.

Today, my EP's office calls and said they are setting me up for the EP study and possible ablation after speaking with the cardio.  I'm wondering why the EP study and ablation?  I mean I've worn two monitors and am wearing one right now the EP ordered.  I know my heart is beating bad because I feel so bad.  I feel all the skips ect.  Does an EP have to do an EP study and ablation or can they just look at the monitor readings and put a pacemaker in?  Who does the pacemaker?  An EP or cardiac surgeon?

I hate to go through an EP study if it really isn't necessary.  I'm very tired of feeling so bad and want to cut to the chase without waiting much longer.

I'd much rather have a pacemaker than mess around with ablations that may or may not work.

[LJW831]

An ablation is NOT a permanent solution.  Sometimes they don't even WORK!   You obviously should not be giving medical advice.  And a pacemaker is a relatively easy procedure!  I had a friend that had FOUR ablations, THREE cardioversions  and still was not "cured" from A-fib.  She got a pacemaker and is doing AWESOME!  So, please refrain from giving medical advice unless you know FACTS.

[longbeachcambo]

Hello to everyone. First, I am a nurse and agree that NO lvn, RN, or NP should ever give that type of medical diagnosis to any patient. We are trained to educate, assist and evaluate ( within the scope of practice). With that said, the nurse may have not had bad intention. We are trained to evaluate what we see and ask patient questions. It is normal for a patient to ask us, "whats wrong?' or what do you think? The nurse may have educated this patient on what her condition looks like on the screen or possibly explained what she could anticipate. Nothing is worse than a patient looking for some answers and a nurse saying, "I cant say anything. Wait for the doctor". If the nurse gave this patient education then its within the scope of practice. If the nurse gave a diagnosis or prognosis then I agree that person should be punished.

[ksig]

What I gathered through the string, you have not be given a diagnosis but have been sent to the EP by your cardio for an eval for possible pacemaker due to irregular HR and slow HB.  I agree with cindy 707 in that it is inappropriate for a nurse to give you a diagnosis before the doc does.  You seem to be worried about the ablation process and want to go with a pacemaker instead.  I would backup.  The pacer may not be your best bet.  Wait until the doc does the EP study to determine the next course of action.  He may be able to do the ablation and fix the problem and not implant the pacer.  
ksig

[chuparosa]

I didn't have a diagnosis until after my ep study. I had 2, 30 day monitors over the course of a year but my doctor was still unsure as to my problem until the ep study was done. A couple of times I have been to the er and docs reading the ekg always say my problem looks more like a reentry problem and not atrial flutter so I guess doctors cannot rely soley on ekg. Ep study is the best investigation for some people.

[chicky2001]

I find it odd I don't have a diagnosis like everyone else here.  I mean why can't the EP tell whats wrong looking at the monitors.  I know this EP is dead set on the EP study.  I guess it is an exploratory EP study.  Geez

More than one nurse watched the monitor and said my heart speeds up a little and slows back down.  It is pausing.  I also had some EMTs pouring over my strips at one time a few months ago trying to figure out what my heart was doing.  One said it was a little weird.  

[chicky2001]

The EP hasn't told me what my diagnosis is.  At this point my heart is beating slowly and with many skips.  It goes on all the time.  I feel really bad.  The EP is setting up an EP study for me as soon as she can get it past insurance and scheduled.  Not more than about 2 weeks away.  She said it is to find out what's wrong with my electrical system in my heart and a possible ablation.  I am also being evaluated for a pacemaker.  I have no "diagnosis".  

At this time I am told something is wrong with the electrical system and the EP study will tell her what it is.  I was sent to the EP for slow heart beat, irregular heart beat, and to be evaluated for a pacemaker.  I was sent by my cardio after a monitor.  I have had a Holter monitor, but don't know the results yet.  I am on a Heartrac e-cat monitor now.  No alerts to my EP as of yet.

[chuparosa]

I'm confused a bit. What is your diagnosis? I don't think a pacemaker will help with all rhythm problems. You may need an ablation and a pacemaker. Personally, I have atrial flutter and bradycardia. I need an ablation for the flutter and my ep doc said its possible that down the road I may need a pacemaker due to the bradycardia. So perhaps you need an ablation for the rhythm problem and a pacemaker to deal with the pauses.

[chicky2001]

Thanks.  I guess it is just the next step in treatment.  I  hope the EP can finally give me a life I can live with a little quality.  Feeling so bad all the time is really not a way to live.

[Jerry_NJ]

I believe the EP study is to determine where and if an ablation should be done.  

I think giving an ablation a chance of providing a "cure" is better than going directly to a pacemaker.