Aa
wpw or Brugada variant
Thank you for taking my questions.
1. Could the person with wpw also have Brugada variant?
2. What does this mean : ST = J + 70 Could you break this code for me, please? It was printed on my treadmill stress test report?
3. Reason for Ending test: Interpretation limiting ECG changes (Change in Bundle Branch Block Conformation) Why he didn't state is RBBB or LBBB? Is BBB represents for both RBBB & LBBB? Is that when BBB occur, not encourage to continue exercise?
4. Also in the Conclusions: Rhythmic instability at peak exercise and subsequent Cardiology Referral (Note T wave inversion in V5) Could you use simple English to explain this to me? T wave indicates what? Everyone has T wave?
5. Could myocardial infarction right on the spot of the accessory pathway? If that is the case, better not to reverse or reverse?
6. On my little pacemaker book said that next day after my His bundle ablation, EP studies showed still can induce SVT. Doctor ask me "Why?" Can you tell me the answer so next time I can said because.........
1. Could the person with wpw also have Brugada variant?
2. What does this mean : ST = J + 70 Could you break this code for me, please? It was printed on my treadmill stress test report?
3. Reason for Ending test: Interpretation limiting ECG changes (Change in Bundle Branch Block Conformation) Why he didn't state is RBBB or LBBB? Is BBB represents for both RBBB & LBBB? Is that when BBB occur, not encourage to continue exercise?
4. Also in the Conclusions: Rhythmic instability at peak exercise and subsequent Cardiology Referral (Note T wave inversion in V5) Could you use simple English to explain this to me? T wave indicates what? Everyone has T wave?
5. Could myocardial infarction right on the spot of the accessory pathway? If that is the case, better not to reverse or reverse?
6. On my little pacemaker book said that next day after my His bundle ablation, EP studies showed still can induce SVT. Doctor ask me "Why?" Can you tell me the answer so next time I can said because.........
MEDICAL PROFESSIONAL
I think I would need to see the study to render my thoughts. I am not exactly what happened -- there are many possibilities.
Dr, thank you for your explaination. I know it is very hard for you to answer without my history. You answered my first post in 2005 and this is my second post.
http://www.medhelp.org/forums/cardio/messages/35316.html
I've wpw. In 1985 had my His bundle ablation. I still have a very active anterograted accessory pathway. Dr told me I got AF and AT. Now I've a lot of chest pain. It always wake me up during my sleep around 3:00am - 4:00am with heavy sweat. I'm unable to have a 45 minutes walks daily (to correct my diabetes). I've a lot of dizzyness and blur vision. I went for a treadmill stress test and the dr there diagnosed me with Bundle Branch Block + ST elevation V1 ? Brugada variant. You haven't answered me this:
"Is that when BBB occur, not encourage to continue exercise?" I know this occur. My chest very tight like an elephant sit on it and short of breath! When I was 15, during SVT I still can play basketball (half a round).
I'm very confused. Thanks for you help.
http://www.medhelp.org/forums/cardio/messages/35316.html
I've wpw. In 1985 had my His bundle ablation. I still have a very active anterograted accessory pathway. Dr told me I got AF and AT. Now I've a lot of chest pain. It always wake me up during my sleep around 3:00am - 4:00am with heavy sweat. I'm unable to have a 45 minutes walks daily (to correct my diabetes). I've a lot of dizzyness and blur vision. I went for a treadmill stress test and the dr there diagnosed me with Bundle Branch Block + ST elevation V1 ? Brugada variant. You haven't answered me this:
"Is that when BBB occur, not encourage to continue exercise?" I know this occur. My chest very tight like an elephant sit on it and short of breath! When I was 15, during SVT I still can play basketball (half a round).
I'm very confused. Thanks for you help.
MEDICAL PROFESSIONAL
Hello,
1. Could the person with wpw also have Brugada variant?
It is possible that someone could have Brugada and WPW, but this is a very unlikely combination.
2. What does this mean : ST = J + 70 Could you break this code for me, please? It was printed on my treadmill stress test report?
I am not sure what this is referring to. There is probably some automated software package that determines EKG changes during a stress test. We have always done our stress test by measuring changes on the actual EKG. This is not a detail I would worry about –I would focus more on the conclusions of the stress test.
3. Reason for Ending test: Interpretation limiting ECG changes (Change in Bundle Branch Block Conformation) Why he didn't state is RBBB or LBBB? Is BBB represents for both RBBB & LBBB? Is that when BBB occur, not encourage to continue exercise?
Exercise stress test count on the ability to follow changes in later portion of the QRS complex – specifically the ST segment. An exercise related bundle branch block makes interpretation more difficult with right bundle branch block and impossible with left bundle branch block. It was probably a left bundle branch block if they prematurely terminated the study. The only way to know for sure is to ask them.
4. Also in the Conclusions: Rhythmic instability at peak exercise and subsequent Cardiology Referral (Note T wave inversion in V5) Could you use simple English to explain this to me? T wave indicates what? Everyone has T wave?
The wave is the last portion of the the P-QRS-T complex. Take a look at the picture on this site:
http://en.wikipedia.org/wiki/Electrocardiogram
It labels the T wave. From the end of the QRS complex to the end of the T wave represents repolarization of heart muscle, it’s recovery from the last beat making it ready to beat again.
5. Could myocardial infarction right on the spot of the accessory pathway? If that is the case, better not to reverse or reverse?
If a myocardial infarction hits the area of WPW, the WPW is cured – the pathway can no longer conduct. This can be tricky because WPW can look like a myocardial infarction on 12 lead EKG and actually just represent polarization changes of the extra pathway. If you have an accessory pathway or WPW, it is probably best to see someone that specializes in these disorders – a cardiac electrophysiologist. Trust me when I say this a very complicated condition and is difficult even for some specialists to understand. It is rarely a life threatening problem but should be addressed if it causes symptoms.
6. On my little pacemaker book said that next day after my His bundle ablation, EP studies showed still can induce SVT. Doctor ask me "Why?" Can you tell me the answer so next time I can said because.........
There are several types of SVT that are still able to occur after His ablation like atrial tachycardia, atrial flutter, and atrial fibrillation. Tachycardia caused by WPW should not be induced after His ablation except in very rare circumstances. I would need to know more information about the mechanism of the SVT.
These are very complicated issues. I hope this clarifies some of them. Good luck and thanks for posting.
1. Could the person with wpw also have Brugada variant?
It is possible that someone could have Brugada and WPW, but this is a very unlikely combination.
2. What does this mean : ST = J + 70 Could you break this code for me, please? It was printed on my treadmill stress test report?
I am not sure what this is referring to. There is probably some automated software package that determines EKG changes during a stress test. We have always done our stress test by measuring changes on the actual EKG. This is not a detail I would worry about –I would focus more on the conclusions of the stress test.
3. Reason for Ending test: Interpretation limiting ECG changes (Change in Bundle Branch Block Conformation) Why he didn't state is RBBB or LBBB? Is BBB represents for both RBBB & LBBB? Is that when BBB occur, not encourage to continue exercise?
Exercise stress test count on the ability to follow changes in later portion of the QRS complex – specifically the ST segment. An exercise related bundle branch block makes interpretation more difficult with right bundle branch block and impossible with left bundle branch block. It was probably a left bundle branch block if they prematurely terminated the study. The only way to know for sure is to ask them.
4. Also in the Conclusions: Rhythmic instability at peak exercise and subsequent Cardiology Referral (Note T wave inversion in V5) Could you use simple English to explain this to me? T wave indicates what? Everyone has T wave?
The wave is the last portion of the the P-QRS-T complex. Take a look at the picture on this site:
http://en.wikipedia.org/wiki/Electrocardiogram
It labels the T wave. From the end of the QRS complex to the end of the T wave represents repolarization of heart muscle, it’s recovery from the last beat making it ready to beat again.
5. Could myocardial infarction right on the spot of the accessory pathway? If that is the case, better not to reverse or reverse?
If a myocardial infarction hits the area of WPW, the WPW is cured – the pathway can no longer conduct. This can be tricky because WPW can look like a myocardial infarction on 12 lead EKG and actually just represent polarization changes of the extra pathway. If you have an accessory pathway or WPW, it is probably best to see someone that specializes in these disorders – a cardiac electrophysiologist. Trust me when I say this a very complicated condition and is difficult even for some specialists to understand. It is rarely a life threatening problem but should be addressed if it causes symptoms.
6. On my little pacemaker book said that next day after my His bundle ablation, EP studies showed still can induce SVT. Doctor ask me "Why?" Can you tell me the answer so next time I can said because.........
There are several types of SVT that are still able to occur after His ablation like atrial tachycardia, atrial flutter, and atrial fibrillation. Tachycardia caused by WPW should not be induced after His ablation except in very rare circumstances. I would need to know more information about the mechanism of the SVT.
These are very complicated issues. I hope this clarifies some of them. Good luck and thanks for posting.
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