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EP STUDY
Would an an EP study always show any dangerous arrymithia problems? I have been documented on two different holter monitors with short runs (5 beats) of v-tach and short runs (10 beats) of SVT and numerous (around 5- 8 per day) PVC's. I have a completely normal heart.
The studies took about one hour each and the doctor could not induce any v-tach or svt so they quit after one hour and said I was fine.
Would this mean that my heart cannot go into this rythum, or was it just being stubborn? Could something have been missed in an EP study? Should a person request a 3rd study? How often does anything serious get missed in an EP study?
Any light you can shed would be greatly appreciated.
Thank you for a great forum.
The studies took about one hour each and the doctor could not induce any v-tach or svt so they quit after one hour and said I was fine.
Would this mean that my heart cannot go into this rythum, or was it just being stubborn? Could something have been missed in an EP study? Should a person request a 3rd study? How often does anything serious get missed in an EP study?
Any light you can shed would be greatly appreciated.
Thank you for a great forum.
How many times can a person have an EP/Ablation? I've had three. I've heard that the radiation can be dangerous. How many have you all had?
If this helps any, in my case I went thru 9 EP studies over a 15 year period before "all" of my arrhythmias were documented. One EP study done at Duke University Medical Center lasted 6 hrs.
I was finally correctly identified as having a repolorization abnormality with a short PR interval and a short AH interval.
I was documented as having either idiopathic or sinus node re-entry tachycardia, atrial flutter, junctional tachycardia, AV node re-entry tachycardia, sick sinus syndrome and numerous PVC's and PAC's (over 5,000 per day). I know this sounds really bizzare but I had approximately 5-6 different pacemaker sites competing against each other to originate the impulse to make my heart beat. This was considered to be extremely rare and was published in an article in the Journal of Cardiac Surgery, June 1983. After open heart surgery and numerous ablation attemps, the arrhythmias always returned with a vengence. I had a total AV node ablation with permanent pacemaker placement almost two years ago. If you continue to be symptomatic from your arrhythmias and feel certain that what you are experiencing has not been fully documented, I would advise you to press your doctor to send you to a teaching facility such as Cleveland Clinic or Duke University. I volunteered to go as a teaching patient due to the rarity of my condition. The costs were waived and I got excellent care. Of course I had many (over 30) physicians exam me over a 15 day stay in the hospital, but we were finally able to document my arrhythmias. Hang in there!
This is to everyone out there, You know your own bodies. If you are convinced your rhythms have not been properly documented, don't give up. It may take years but it is surely worth the extra effort to be properly evaluated and treated. My persistance eventually paid off. I do not have a medical degree
but I certainly have "a degree in me". Good luck to all!
I was finally correctly identified as having a repolorization abnormality with a short PR interval and a short AH interval.
I was documented as having either idiopathic or sinus node re-entry tachycardia, atrial flutter, junctional tachycardia, AV node re-entry tachycardia, sick sinus syndrome and numerous PVC's and PAC's (over 5,000 per day). I know this sounds really bizzare but I had approximately 5-6 different pacemaker sites competing against each other to originate the impulse to make my heart beat. This was considered to be extremely rare and was published in an article in the Journal of Cardiac Surgery, June 1983. After open heart surgery and numerous ablation attemps, the arrhythmias always returned with a vengence. I had a total AV node ablation with permanent pacemaker placement almost two years ago. If you continue to be symptomatic from your arrhythmias and feel certain that what you are experiencing has not been fully documented, I would advise you to press your doctor to send you to a teaching facility such as Cleveland Clinic or Duke University. I volunteered to go as a teaching patient due to the rarity of my condition. The costs were waived and I got excellent care. Of course I had many (over 30) physicians exam me over a 15 day stay in the hospital, but we were finally able to document my arrhythmias. Hang in there!
This is to everyone out there, You know your own bodies. If you are convinced your rhythms have not been properly documented, don't give up. It may take years but it is surely worth the extra effort to be properly evaluated and treated. My persistance eventually paid off. I do not have a medical degree
but I certainly have "a degree in me". Good luck to all!
Hi again -- well, the 3,500 (it was actually 3828) PVCs in a 24-hour period was a few days after I stopped taking a beta blocker, so there was probably still some rebound effect (though my doctor thought not). My heart was "skipping" about every third beat but only about one every 15 minutes was one of the really hard beats. The rest were more like pauses and then a harder than normal beat, but not what I call a thumper (where I feel like I can actually see my chest move from the beat).
I was shocked at the total after the Holter results came back. I had had open heart surgery to repair my mitral valve and to patch a septal hole, and I truly expected all of wacky rhythms to go away after surgery. No such luck. My heart rate (when I'm off beta blockers) is in the 95-110 range at rest all of the time, and I have lots of PVCs. I take atenolol (low dosage, 25 mg per day) and that helps a lot. I still have periodic big tachys that go for about two or three minutes at a rate of around 160-180, but the PVCs are much milder than before, except for the periodic thumper (just a couple a day).
The really hard beats do make feel momentarily dizzy. I tried taking higher dosages of beta blockers, but my BP was low already at a normal of 105/70, so the atenolol, toprol, cardizem and everything else we tried made my pressure so low that I fainted a couple of times. Rather have the PVCs than worry about passing out while driving my kids!
Feel free to ask any other questions that I can answer from a patient's point of view. It's a hard thing to go through, but I've learned to live with it and still have joy in my life.
Shannon
I was shocked at the total after the Holter results came back. I had had open heart surgery to repair my mitral valve and to patch a septal hole, and I truly expected all of wacky rhythms to go away after surgery. No such luck. My heart rate (when I'm off beta blockers) is in the 95-110 range at rest all of the time, and I have lots of PVCs. I take atenolol (low dosage, 25 mg per day) and that helps a lot. I still have periodic big tachys that go for about two or three minutes at a rate of around 160-180, but the PVCs are much milder than before, except for the periodic thumper (just a couple a day).
The really hard beats do make feel momentarily dizzy. I tried taking higher dosages of beta blockers, but my BP was low already at a normal of 105/70, so the atenolol, toprol, cardizem and everything else we tried made my pressure so low that I fainted a couple of times. Rather have the PVCs than worry about passing out while driving my kids!
Feel free to ask any other questions that I can answer from a patient's point of view. It's a hard thing to go through, but I've learned to live with it and still have joy in my life.
Shannon
hi,
I have had several arrythmias and two ep studys the first was unsuccesful they abalted the av node re-entry tachy this last time(may23rd,2000). I continue to have pvc's and pac's and atrial tachy but it is not inducible for long periods of time in an ep study therefore it makes it very hard to map out. my cardiologist has informed me that there is techknowlogy already out that can map out an arrythmia with just 4 or 5 beats rather than having it happen for several minutes as before. this i am very excited about and is possibly something i will consider having done again because it would make life just a little more enjoyable. i strongly suggest that you seek out the best cardiologist or electrophysiologist in your area as i did and have been lucky so far,but i will tell you that at first i was very frustrated and angry at the docs because they just didn't understand. my doc now says he just wants to make me right. hope this helps. i can give more info if you like.
good luck!
melody
I have had several arrythmias and two ep studys the first was unsuccesful they abalted the av node re-entry tachy this last time(may23rd,2000). I continue to have pvc's and pac's and atrial tachy but it is not inducible for long periods of time in an ep study therefore it makes it very hard to map out. my cardiologist has informed me that there is techknowlogy already out that can map out an arrythmia with just 4 or 5 beats rather than having it happen for several minutes as before. this i am very excited about and is possibly something i will consider having done again because it would make life just a little more enjoyable. i strongly suggest that you seek out the best cardiologist or electrophysiologist in your area as i did and have been lucky so far,but i will tell you that at first i was very frustrated and angry at the docs because they just didn't understand. my doc now says he just wants to make me right. hope this helps. i can give more info if you like.
good luck!
melody
Shannon!!!!! How can you possibly stand having 3500 PVC's a day!!!! I hate having any at all. What do yours feel like? Do they feel like little skips or hard thumps. I also get tingly hands when I get mine so that really scares me. Do you get that? Thanks.
Hi, Conni --
Just as a benchmark, I have in the neighborhood of 3,500 PVCs per day when not taking beta blockers. So you see why the CCF doc wouldn't be too concerned about your number. I'm sure you know already that, in the absence of any heart abnormalities, PVCs are quite benign (just annoying as hell!).
I had the same experience with an EP study -- a couple of short runs (4 beats) of vtach and several straightforward tachycardias of around 120 beats lasting for a few minutes at a time. The doc was unable to reproduce any of the wacky or fast rhythms, too. He told me it wasn't an uncommon occurrence.
for what it's worth -- at least you know you have company!
Shannon
Just as a benchmark, I have in the neighborhood of 3,500 PVCs per day when not taking beta blockers. So you see why the CCF doc wouldn't be too concerned about your number. I'm sure you know already that, in the absence of any heart abnormalities, PVCs are quite benign (just annoying as hell!).
I had the same experience with an EP study -- a couple of short runs (4 beats) of vtach and several straightforward tachycardias of around 120 beats lasting for a few minutes at a time. The doc was unable to reproduce any of the wacky or fast rhythms, too. He told me it wasn't an uncommon occurrence.
for what it's worth -- at least you know you have company!
Shannon
Very good question conni. I also had v tach (5 beats) caught on tape. I also had several other v tach episodes (4 or 5 beats each) that were not caught on tape. During the ep study they found my PSVT problem and ablated it, but the v tach was not found and I was told not to worry about it. My EP study lasted several hours. I have not had any short v tach in a couple months so maybe it was just a fluke thing.
Conni-
It is unlikely that the EP study missed any underlying Arrhythmias. The fact that you had 5 beats of V-Tach and 10 beats of SVT is of no clinical significance in an otherwise healthy heart. The fact that the EP study was negative means there is no abnormalty in the electrical conduction system in the heart. Also, 5-8 PVC's a day is a very small number. PVC's are also benign in the absence of heart disease. In fact, most people have PVC's but are unaware of them. If they are bothersome, a beta blocker can help supress the beats.
It is unlikely that the EP study missed any underlying Arrhythmias. The fact that you had 5 beats of V-Tach and 10 beats of SVT is of no clinical significance in an otherwise healthy heart. The fact that the EP study was negative means there is no abnormalty in the electrical conduction system in the heart. Also, 5-8 PVC's a day is a very small number. PVC's are also benign in the absence of heart disease. In fact, most people have PVC's but are unaware of them. If they are bothersome, a beta blocker can help supress the beats.
An EP study is sometimes unable to trigger a particular arrhythmia. However, with two negative EP studies, I am not sure that a third would be helpful. A negative EP study makes life-threatening arrhythmias much less likely as a risk.
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