Debating EP Study

[Stay_Frosty]

Hello,

I have an EP study scheduled for Friday, but I've been thinking about cancelling quite simply because I'm feeling good.

The reason for the EP study is as follows. My two day holter picked up:

1) 185 bpm SVT while exercising. This happened when I was riding my bike at full speed (equivalent to a full on sprint), so I kind of expected the rate to be this high. I didn't have any symptoms as this was happening. I didn't even realize that anything was wrong because I just kept riding.

2) 7 beat NSVT while sleeping. Heart rate was 65, looked perfectly normal, then bam 7 beats of v-tach at 125 bpm. This was followed by a brief return to normal rhythm, then another 3 beats of v-tach. I was asleep during this so I didn't notice any symptoms.

Now obviously #2 concerns me. I've had low pottasium in the past (2.9) but I have since increased it to the 3.5-3.6 range. Still on the low side, but within range.

My heart is structurally normal according to an echo. My EP said that the v-tach could've been caused by a pottasium deficiency, even though bloodwork around the time said that I was within range (albeit borderline). He also said it was unlikely that he'd be able to reproduce it, but he would at least try.

As for #1, If I really did have SVT during exercise as the holter suggests, then I'm thinking that maybe I had it my whole life and just didn't realize it. Is this really a concern and is this really EP study worthy? I certainly don't want to be afraid to exercise.

I since continued to drink more OJ and eat more bananas, especially before falling asleep at night. I feel like I've been returning to normal, and haven't had any major racing heart episodes for over a month now. It's been a few months since the holter and I've had another one since, which didn't show any v-tach but it did show 120-130 bpm at one point when I was simply walking around a store.

Should I still go through with the EP study? My EP said that it was a "no brainer" and my primary care doctor tends to agree. But then again my EP also said that he would mainly be doing it for the SVT which again was asymptomatic. So should I really care about that? I'm more concerned about the v-tach returning.

What do you guys think? I appreciate any input. Thanks!

[tom_h]

While I'm a proponent of the ablation procedure, I don't believe a single event warrants it. If you're still not sure why your physicians are rushing you into this, consider what they stand to gain monetarily.  They'll be compensated whether or not your SVT can be provoked.  I'm actually surprised your insurance company has approved the procedure.

[MichelleP_3811]

I am with DeltaDawn, you need to be confident this is the right thing for you.  I would say the jolts and odd things you are feeling are pvcs.  The fact that they hurt means your heart is a bit irritated at this time for some reason maybe partly due to stressing about what is going on.  Or possiblyu because of some svt.  My heart was getting fairly irritated from my svt episodes before my ablation to the point I felt pain of some sort in my heart everyday.  Now that I am out of the svt for a year and a half the pvcs I do feel do not have the pain associated with them so it is possible some svt is irritating the heart causing your pain or since you state you could press the area and feel pain it is possible you strained something at some point and that is why the pvcs are hurting.  However as uncomfortable as they are they are not a threat.  I would say do your best to give your heart as much rest as possible to see if that helps the pvcs hurt less.  Are you sure they are even intending to do an ablation for the vt because a seven beat run that converts on its own that isn't causing you serious symptoms like passing out isn't necessarily a reason for an ablation so I might question what it is they plan to try and ablate.  As for doing the ablation follow your gut and you can't go wrong.  I wish you the best whatever you decide to do.

[littlegreenman1]

Here's the overall mantra for all things...

It's not a problem, until it's a problem.

If the SVT doesn't bother you... don't get it ablated. 7 beats of SVT == BFD.
If you find yourself having troubles with it... fix it.

[DeltaDawn23]

I just recalled when I had a stress test that showed a short, non-sustained run of VT, no one suggested an ablation to me.  This was after my first episode of Afib when they were running tests to see if there was an underlying problem.  I did, however, end up having a heart cath to rule blockages.  This was in 2003.  I was told they probably would not do that today. Hoping maybe some of this will be useful to you.  

[Stay_Frosty]

I cancelled for two reasons.

1) Still have that doubt and will definitely be seeking a second opinion ASAP.

2) I live with my nephew and he brought home a stomach virus from school. He was up all last night throwing up :( I'm not going to take the risk of having to throw up while I'm on the table or during recovery when I have to lay still.

My EP probably hates me at this point. But I need to get more opinions for peace of mind.

You guys are awesome, thanks so much for the input!

[littlegreenman1]

Who's opinion do you need beyond your own?