I have a few questions to ask relating to chronic arrythmia problems. I am 32 and have had acouple of ablations, and now have a pacemaker. I now have more frequent and more serious arrythmias than before the ablations. They are coming from several focal points. One of the rhythms they have said is wide-complex tachycardia at rates up to 300bpm. I'm a little confused as I have had seen cardiologists in the hospital that have said I need an EP studies to determine if the rhythm is atrial or ventricular. My EP doc says he doesn't want to do an EP studies right now and thinks it's probobly atrial.
My question is
1)Can you know for sure whether wide complex tachycardia is coming from the atria without doing an EP studies. During these rhythms, my blood pressure drops dramatically.
Because I also have a-fib, I am taking coumadin. My doctors have said that because I have a P.F.O., I have a higher risk of a clot going through the shunt.
Question
2)Is this a reason to have the P.F.O surgically repaired. No one has mentioned this to me but I am curious.
My next question is
3)If you had a patient with these types of arrythmias would you prescribe tikyson or amiodarone. I have tried all others to no avail. Now I am on amiodarone, but I'm wondering which of the two has the most potential for serious side-effects?
I still don't understand why I have these rhythms. When I got my pacemaker, they told me I had sick sinus syndrome, rates down in the single digits. From my own understanding that means that you can have a problem with fast and slow rates. This to me would explain the cause of my arrythmias. But my doctors keep saying they don't understand why I'm having these rhythms and think there is another underlying cause.
Question
4)Could you explain why they are not blaming the rhythms on sick sinus syndrome if that is what the diagnosis was that led to the pacemaker?
I know there is so many questions. I don't know if your able to answer them with the information I have provided. I am hoping for a little more insight, if at all possible.
Thank you so much.