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catheter ablation
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catheter ablation

Hi I was wondering if anyone could give me some good advice. I am a 40 year old female with arrythmias, sinus tachycardia my heart rate at rest is 110 I am scheduled to see an electrophysiologist on the 8 of july I think after everything I read I would rather have a pacemaker than a catheter ablation what do you think? I can not take beta blockers because of my blood pressure being too low and I need to get my heart slowed down because I have a rare lung disease and for me to have the open lung bypass my heart must be fixed first. Can anyone help me make a decision on what to do.
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875426_tn?1325532016
Since you have low blood pressure and rapid heart rate, have they checked to see if you have an orthostatic intolerance problem, where the tachy increases with standing?  Have they checked your ferritin (iron stores) level to make sure iron deficiency is not causing tachycardia?  Are you sufficiently hydrated and are your electrolytes in balance?  Have they made sure you don't have a hyper-functioning thyroid?  

They should make sure you don't have postural orthostatic tachycardia syndrome, because if you have that, ablation is not recommended typically.  

Have they tried any medication that is supposed to slow heart rate?  I had one doctor tell me where a patient was given a blood pressure medication that actually slowed a man's heart rate down so it could work more effectively and the man's blood pressure went up!
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875426_tn?1325532016
Since you have low blood pressure and rapid heart rate, have they checked to see if you have an orthostatic intolerance problem, where the tachy increases with standing?  Have they checked your ferritin (iron stores) level to make sure iron deficiency is not causing tachycardia?  Are you sufficiently hydrated and are your electrolytes in balance?  Have they made sure you don't have a hyper-functioning thyroid?  

They should make sure you don't have postural orthostatic tachycardia syndrome, because if you have that, ablation is not recommended typically.  

Have they tried any medication that is supposed to slow heart rate?  I had one doctor tell me where a patient was given a blood pressure medication that actually slowed a man's heart rate down so it could work more effectively and the man's blood pressure went up!
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Avatar_f_tn
I have been through alot of test and tons of blood work and everything comes back normal that is why I am so stumped. They did try meds but they made me pass out because they lowered my blood pressure too low
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875426_tn?1325532016
Did they do the tilt table test then?  Are they saying what you have is inappropriate sinus tachycardia?  Please see PM with some info about pacemaker versus RF ablation.
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Avatar_f_tn
no they did not do the tilt table test I don't know what that is or even what it checks could you explain that to me?  Yes they said I have that inappropriate sinus tach but it is most of the time now along with something they call arrythmia because sometimes at certain activity my heart goes completely out of wack and I get dizzy and feel like I am going to pass out when that happens my heart goes out of rythm and is so fast I can't count the beats. what is PM that you want me to see for the info? I am not sure if pacemaker is what I should be looking for or an ICD?
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875426_tn?1325532016
A tilt table test is where an electrophysiologist or other cardiologist conducts a test on a table that the patient lays on that can tilt upward.  Your blood pressures and pulses are taken while lying down.  They then tilt you into an upright position and monitor your blood pressures and pulses for a number of minutes.  They then have you in a lying position again and give you something like nitroglycerine under the tongue (what I was given) & they tilt you up again and monitor your blood pressure and pulse.  It is helpful in diagnosing certain orthostatic intolerant conditions.  I originally was diagnosed with inappropriate sinus tachycardia or IST prior to be given a tilt table test, at which time I was told I had POTS (which stands for postural orthostatic tachycardia syndrome).

PM means private message and I'm glad you received it!  It looks like online from an american heart website the indication for an ICD is sustained  fibrillation or ventricular tachycardia, so if your test results are demonstrating you have this, I think you definitely should talk to your doctor about it!
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Avatar_f_tn
Thank you for explaining all that I will be sure to ask my doctor a ton of questions. I just hope I get a good doctor that will listen to me because I have been to so many in the last five years and nobody seems to care that I feel like I am sufficating and my heart is always going crazy. My lung doctor told me if someone does not fix my heart soon the muscle is going to tire out because I have been dealing with this for so many years and can't seem to find anybody to listen to me. I really thank you for all your help so now I know what types of things to ask this doctor, unless like all other doctors he will do the same thing and tell me to go to another doctor. Every time I go to a lung doctor they send me to a heart doctor and everytime I go to a heart doctor they send me back to a lung doctor and they have been doing this for so long that I am just about ready to give up on medical care. I will definately keep you posted after I go to this heart doctor Thursday. Again Thank you it is nice to be able to talk to other people for advice.
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875426_tn?1325532016
It's a joy to help.  Well, regarding your heart wearing out- know that it won't happen one moment before God plans it to, as He numbered all our days before there was yet one of them!  And please do keep me posted!
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1242509_tn?1279124464
Hi
SurgiMenopause brings up a good point that the Tilt table test is a non invasive type of test to rule out orthostatic hypotention. This is a abnormal response when a pt who has been standing for a period of time pass out. This is because instead of the blood vessels contracting the blood vessels dialate and thus the blood pressure drops and the patient passes out. These patients are told to keep well hydrated and eat some salt in their diet. There are a few rare cases where some patients have a very severe response to orthostatic hypotention and they receive a pacemaker.
Your symptoms appear to be from rapid SVT, there are many ways you can have a fast SVT causing your symptoms. U Penn from your state has one of the top electrophysiology programs in the country they will tell you if a tilt table is what you need or a EP study. I would reccomend you go there for your electrophysiolgy study(EP) to determine exactly why you are having such a fast SVT causing your symptoms. Having prolonged tachycardia can cause other problems also.
An EP study is when an electrophysiologist places catherters in certain spots in your heart(sound scarry but these Dr's do this several hundred times a year) and take electrical measuments to 'Map" exactly where in your heart this fast arrythmias is originating from. Once they find the exact spot they can zap it with electricle energy to stop that bad electrical circuit. If this is an  SVT causing your symptoms the good news this is a very easy arrythmia for theses specialist to treat.
I wish you all the best
Kevin
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Avatar_f_tn
Thank you very much. could you tell me something, what other problems does prolonged tachycardias cause?
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875426_tn?1325532016
Besides orthostatic hypotension and NCS (neurocardiogenic syncope)- orthostatic problems, tilt table test can be helpful toward diagnosing POTS, postural orthostatic tachycardia syndrome, what I was diagnosed with by tilt table after being diagnosed with IST (inappropriate sinus tachycardia).  Most people with POTS do not pass out from it.  My body actually overcompensates to keep from passing out and my blood pressure can spike when I'm standing!
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1242509_tn?1279124464
Tachycardia induced cardiomyopathy
Every form of supraventricular tachyarrhythmia, including ectopic atrial tachycardia, nonparoxysmal junctional tachycardia, and atrial fibrillation (AF), has been associated with reversible left ventricular dysfunction or "cardiomyopathy
This form of cardiomyopathy - dilated cardiomyopathy  when treated will result in improvement or resolution of the cardiomyopathy.
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Avatar_f_tn
ok that makes sense. well let me ask you this. They said my left ventricle is a little small but it is 3.2cm and they said it should be no less than 3.5cm and that was only reported in my last echo but not any of the previous ones, I also had a carotid doppler and they said there is less blood flow in my left carotid artery but they said it is because I am small(which is crap they blame my size on everything there is other small people that don't have this) but again all the doctors just blow me off. Should I question all this?
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Avatar_f_tn
Yes, you should question everything and not feel awkward about asking lots of questions. If your doctor doesn't take the time to answer your questions and address all your concerns, go elsewhere.
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