Member Comments are provided by individuals and reflect their personal opinions only. Under NO circumstances should you act on any advice or opinion posted in this forum. ALWAYS check with your personal physician before taking any action regarding your health! MedHelp International and our partners, sponsors and affiliates have no obligation to monitor any comments posted on this site, or the content and/or accuracy of such exchanges. MedHelp International does not endorse the views of any user.
Heart Disease (Expert Forum)
Electrophysiology (EP) Study
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve, Pacemaker, PAD, Stenosis, Stress Tests
Electrophysiology (EP) Study
by Carol, Nov 03, 2000 12:00AM
Hello, I am a 57 Y/O, non smoking, non drinking female diagnosed with CM and CHF. I had open heart surgery last year to repair an aneurysm of the left descending coronary artery. While the surgeon, "was in there" he also did a double bypass around the aneurysm, taking one vein from the mammary gland and one from the leg. After surgery, while in recovery, I developed an arrhythmia problem and was given Amiodarone. I remained in ICU for 4 days following surgery because they said my chest x-rays indicated "a complete white out", whatever that means, and no one could figure out why. (Murphy's Law)
I was released from the hospital by mistake on the fifth day following surgery with a Pulse Ox of 74. (Murphy's Law)
Seven days later I was rushed to a nearby ER in acute respiratory distress. My BP ws 57/40, Pulse 130, respiration 30 and labored, temperature 102.7, pulse ox 37 on room air and 72 on 100% oxygen. I was intubated and placed on a mechanical ventilator. I remained on Amiodarone another 2 days until it was determined that the Amiodarone was causing pulmonary toxicity. The medication was discontinued, put on steriods and my condition began to improve, however the arrhythmia problems returned. I remained in CCU for another 20 days on dopamine and doputamine in an effort to raise the BP and lower the heart rate. I was hospitalized 5 more times in 3 months in respiratory distress, rapid heart rate and low BP, each time given oxygen, put on dopamine and doputamine and told that the effects of the Amiodarone could remain in my system for 4 to 6 months. Six months went by and was told it could be 6 to 12 months. Twelve months went by and was told it could be 12 to 18 months. It has now been 15 months. When will this end or will it ever? I am sick and tired of being sick and tired.
In the ensuing months I have had several EKGs, weeks apart, and each one comes out differently. One will show, "Sinus Tach, Wide QRS Tach, Left Axis Deviation, Left Bundle Branch Block". The next will show, "Sinus Tach, V-Tach, Minimal Voltage Criteria for LVH, Nonspecific ST and T Wave abnormality, Prolonged QT Interval". I have no idea what this means.
The next EKG will show, "Sinus Tach, V-Tach, with notes, "Ventricular rate has increased by 53 BPM, Left Bundle Branch Block is no longer persent". Does a LBBB come and go? Still the next EKG will show, "Left axis deviation, left bundle branch block". I am thoroughly confused.
I also had an echo which found, "Enlarged left ventricle with also hypertrophy, enlarged left atrium, aortic root mildly dilated at upper limits of normal, paradoxical septal motion, tricuspid regurgitation and overall left ventricular hypokinesa with hypokinesia of the anterior wall as well, reduced ejection fraction approximately 36%. The conclusion was, "The patient has global hypokinesia with paradoxical septal motion with mitral regurgitation as well as tricuspid and aortic regurgitation". Again, I'm thoroughly confused. What does this mean?
My local cardiologist, which is about 60 miles from where the surgery was performed and who referred me to the surgeon at the other hospital, now wants me to have an Electrophysiology Study. After reading the patient's guide to this study I find the prospects terrifying. (1). I would have to go back to the hospital where the surgery was performed. (2). I understand that the study is done through veins and not arteries as in a heart cath. I have very poor veins. Each time I go into a hospital I have to have a central line. No one is ever able to find a vein to simply draw blood. Even the heart cath showed that I have very small cardiac arteries and veins. (3). I have a back problem that does not allow me to lay on my back for prolonged periods without severe pain. The heart cath was bad enough and it seems that the EP study would be unbearable. (4). I am the clasic example of Murphy's Law, "If anything can go wrong it probably will", and does. I think I am the reason Murphy wrote the law in the first place.
What should I do about this EP study. How important is it? Is it absolutely necessary? Do I have other choices? I have heard the up sides to it, what are the down sides? Is treating me without it a hit and miss situation? Could my arrhythmia problems be the lingering results of the bypass or the Amiodarone and will therefore eventually go away, as in "ignore it and it will go away"? My husband is pushing me to have it, I don't think he realizes how scared I am. Lastly, I don't know an Electrophysiologist and I'm leary of seeing another doctor that I do not know and/or trust. What should I do?
I was released from the hospital by mistake on the fifth day following surgery with a Pulse Ox of 74. (Murphy's Law)
Seven days later I was rushed to a nearby ER in acute respiratory distress. My BP ws 57/40, Pulse 130, respiration 30 and labored, temperature 102.7, pulse ox 37 on room air and 72 on 100% oxygen. I was intubated and placed on a mechanical ventilator. I remained on Amiodarone another 2 days until it was determined that the Amiodarone was causing pulmonary toxicity. The medication was discontinued, put on steriods and my condition began to improve, however the arrhythmia problems returned. I remained in CCU for another 20 days on dopamine and doputamine in an effort to raise the BP and lower the heart rate. I was hospitalized 5 more times in 3 months in respiratory distress, rapid heart rate and low BP, each time given oxygen, put on dopamine and doputamine and told that the effects of the Amiodarone could remain in my system for 4 to 6 months. Six months went by and was told it could be 6 to 12 months. Twelve months went by and was told it could be 12 to 18 months. It has now been 15 months. When will this end or will it ever? I am sick and tired of being sick and tired.
In the ensuing months I have had several EKGs, weeks apart, and each one comes out differently. One will show, "Sinus Tach, Wide QRS Tach, Left Axis Deviation, Left Bundle Branch Block". The next will show, "Sinus Tach, V-Tach, Minimal Voltage Criteria for LVH, Nonspecific ST and T Wave abnormality, Prolonged QT Interval". I have no idea what this means.
The next EKG will show, "Sinus Tach, V-Tach, with notes, "Ventricular rate has increased by 53 BPM, Left Bundle Branch Block is no longer persent". Does a LBBB come and go? Still the next EKG will show, "Left axis deviation, left bundle branch block". I am thoroughly confused.
I also had an echo which found, "Enlarged left ventricle with also hypertrophy, enlarged left atrium, aortic root mildly dilated at upper limits of normal, paradoxical septal motion, tricuspid regurgitation and overall left ventricular hypokinesa with hypokinesia of the anterior wall as well, reduced ejection fraction approximately 36%. The conclusion was, "The patient has global hypokinesia with paradoxical septal motion with mitral regurgitation as well as tricuspid and aortic regurgitation". Again, I'm thoroughly confused. What does this mean?
My local cardiologist, which is about 60 miles from where the surgery was performed and who referred me to the surgeon at the other hospital, now wants me to have an Electrophysiology Study. After reading the patient's guide to this study I find the prospects terrifying. (1). I would have to go back to the hospital where the surgery was performed. (2). I understand that the study is done through veins and not arteries as in a heart cath. I have very poor veins. Each time I go into a hospital I have to have a central line. No one is ever able to find a vein to simply draw blood. Even the heart cath showed that I have very small cardiac arteries and veins. (3). I have a back problem that does not allow me to lay on my back for prolonged periods without severe pain. The heart cath was bad enough and it seems that the EP study would be unbearable. (4). I am the clasic example of Murphy's Law, "If anything can go wrong it probably will", and does. I think I am the reason Murphy wrote the law in the first place.
What should I do about this EP study. How important is it? Is it absolutely necessary? Do I have other choices? I have heard the up sides to it, what are the down sides? Is treating me without it a hit and miss situation? Could my arrhythmia problems be the lingering results of the bypass or the Amiodarone and will therefore eventually go away, as in "ignore it and it will go away"? My husband is pushing me to have it, I don't think he realizes how scared I am. Lastly, I don't know an Electrophysiologist and I'm leary of seeing another doctor that I do not know and/or trust. What should I do?
Doctor's Answer
by CCF CARDIO MD - CRC, Nov 03, 2000 12:00AM
Dear Carol,
I think you're past due for a change of Laws. From now on you need to follow Morphy's Law - Anything that can go right will go right!
Your medical situation is quite complex and the interpretation of the tests is somewhat beyond the scope of the fourm. Suffice it to say that you have had some damage to the heart and the electrial system of the heart may also be damaged. For this reason I think it probably is a good idea for you to get an EP study. Perhaps it is something that does not need to be done right away but you could discuss this with your local doctor. In addition you may want to make an appointment with him to sit down and go through your medical condition and what everything means. This may help you to get a better feel for thing and to remove some of the anxiety. When you make the appointment tell them you don't need a medical exam but just 20 or 30 minutes to discuss everything that is going on with you. I think this will help you alot. Best wishes.
I think you're past due for a change of Laws. From now on you need to follow Morphy's Law - Anything that can go right will go right!
Your medical situation is quite complex and the interpretation of the tests is somewhat beyond the scope of the fourm. Suffice it to say that you have had some damage to the heart and the electrial system of the heart may also be damaged. For this reason I think it probably is a good idea for you to get an EP study. Perhaps it is something that does not need to be done right away but you could discuss this with your local doctor. In addition you may want to make an appointment with him to sit down and go through your medical condition and what everything means. This may help you to get a better feel for thing and to remove some of the anxiety. When you make the appointment tell them you don't need a medical exam but just 20 or 30 minutes to discuss everything that is going on with you. I think this will help you alot. Best wishes.
