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Debating EP Study
Hello,
I have an EP study scheduled for Friday, but I've been thinking about cancelling quite simply because I'm feeling good.
The reason for the EP study is as follows. My two day holter picked up:
1) 185 bpm SVT while exercising. This happened when I was riding my bike at full speed (equivalent to a full on sprint), so I kind of expected the rate to be this high. I didn't have any symptoms as this was happening. I didn't even realize that anything was wrong because I just kept riding.
2) 7 beat NSVT while sleeping. Heart rate was 65, looked perfectly normal, then bam 7 beats of v-tach at 125 bpm. This was followed by a brief return to normal rhythm, then another 3 beats of v-tach. I was asleep during this so I didn't notice any symptoms.
Now obviously #2 concerns me. I've had low pottasium in the past (2.9) but I have since increased it to the 3.5-3.6 range. Still on the low side, but within range.
My heart is structurally normal according to an echo. My EP said that the v-tach could've been caused by a pottasium deficiency, even though bloodwork around the time said that I was within range (albeit borderline). He also said it was unlikely that he'd be able to reproduce it, but he would at least try.
As for #1, If I really did have SVT during exercise as the holter suggests, then I'm thinking that maybe I had it my whole life and just didn't realize it. Is this really a concern and is this really EP study worthy? I certainly don't want to be afraid to exercise.
I since continued to drink more OJ and eat more bananas, especially before falling asleep at night. I feel like I've been returning to normal, and haven't had any major racing heart episodes for over a month now. It's been a few months since the holter and I've had another one since, which didn't show any v-tach but it did show 120-130 bpm at one point when I was simply walking around a store.
Should I still go through with the EP study? My EP said that it was a "no brainer" and my primary care doctor tends to agree. But then again my EP also said that he would mainly be doing it for the SVT which again was asymptomatic. So should I really care about that? I'm more concerned about the v-tach returning.
What do you guys think? I appreciate any input. Thanks!
I have an EP study scheduled for Friday, but I've been thinking about cancelling quite simply because I'm feeling good.
The reason for the EP study is as follows. My two day holter picked up:
1) 185 bpm SVT while exercising. This happened when I was riding my bike at full speed (equivalent to a full on sprint), so I kind of expected the rate to be this high. I didn't have any symptoms as this was happening. I didn't even realize that anything was wrong because I just kept riding.
2) 7 beat NSVT while sleeping. Heart rate was 65, looked perfectly normal, then bam 7 beats of v-tach at 125 bpm. This was followed by a brief return to normal rhythm, then another 3 beats of v-tach. I was asleep during this so I didn't notice any symptoms.
Now obviously #2 concerns me. I've had low pottasium in the past (2.9) but I have since increased it to the 3.5-3.6 range. Still on the low side, but within range.
My heart is structurally normal according to an echo. My EP said that the v-tach could've been caused by a pottasium deficiency, even though bloodwork around the time said that I was within range (albeit borderline). He also said it was unlikely that he'd be able to reproduce it, but he would at least try.
As for #1, If I really did have SVT during exercise as the holter suggests, then I'm thinking that maybe I had it my whole life and just didn't realize it. Is this really a concern and is this really EP study worthy? I certainly don't want to be afraid to exercise.
I since continued to drink more OJ and eat more bananas, especially before falling asleep at night. I feel like I've been returning to normal, and haven't had any major racing heart episodes for over a month now. It's been a few months since the holter and I've had another one since, which didn't show any v-tach but it did show 120-130 bpm at one point when I was simply walking around a store.
Should I still go through with the EP study? My EP said that it was a "no brainer" and my primary care doctor tends to agree. But then again my EP also said that he would mainly be doing it for the SVT which again was asymptomatic. So should I really care about that? I'm more concerned about the v-tach returning.
What do you guys think? I appreciate any input. Thanks!
Does $1,234 sound right for EP study pre-testing? All they did was an EKG and take some blood. Just got the bill today. My jaw dropped.
"you don't want all that radiation" just wow :(
2nd doc is on the ball. Like I mentioned above, SVT us a very broad term, it can mean all sorts of stuff including exercise, which is a completely normal response.
2nd doc is on the ball. Like I mentioned above, SVT us a very broad term, it can mean all sorts of stuff including exercise, which is a completely normal response.
Just as an update, I went to a new cardiologist, because my current one thinks that MRI's have radiation. After I requested a cardiac MRI, he said "you don't want all that radiation". I wish I was joking.
New cardiologist seems a lot smarter. He immediately ordered me a cardiac MRI and an echo stress test.
I also showed him my holter results and he looked at the 185 bpm that I had during the bike ride. I told him that my other cardiologist (and the EP) said that it was SVT. He looked at me wide eyed and said "you were riding a bike!" as if the holter recording was completely normal. He also mentioned that it was too quick to even tell if it was SVT. And I tend to agree with him because 1) the holter software said no SVT detected 2) I had no symptoms at all and 3) The holter shows my heart slowing down once I slowed down with the pedaling. So that made me very happy.
My second holter did detect some SVT, in which the software clearly labeled it SVT. A very minimal 7 or so seconds of SVT out of 48 hours. And it all occurred as I was sleeping.
I'm glad that I'm getting more tests. I still think that something serious is going on in terms of chest pain at times, like maybe a brief coronary spasm or something. I just hope it's not clogged arteries at age 28. That would suck.
Thanks again for the support. You guys are the best!
New cardiologist seems a lot smarter. He immediately ordered me a cardiac MRI and an echo stress test.
I also showed him my holter results and he looked at the 185 bpm that I had during the bike ride. I told him that my other cardiologist (and the EP) said that it was SVT. He looked at me wide eyed and said "you were riding a bike!" as if the holter recording was completely normal. He also mentioned that it was too quick to even tell if it was SVT. And I tend to agree with him because 1) the holter software said no SVT detected 2) I had no symptoms at all and 3) The holter shows my heart slowing down once I slowed down with the pedaling. So that made me very happy.
My second holter did detect some SVT, in which the software clearly labeled it SVT. A very minimal 7 or so seconds of SVT out of 48 hours. And it all occurred as I was sleeping.
I'm glad that I'm getting more tests. I still think that something serious is going on in terms of chest pain at times, like maybe a brief coronary spasm or something. I just hope it's not clogged arteries at age 28. That would suck.
Thanks again for the support. You guys are the best!
I agree. The rates you note are quite normal for the activities you mention. On a treadmill test just before my ablation, I started throwing salvos of SVT that were almost the same rate as my sinus pulse at the time, 195 bpm.
SVT is a bucket term, what is causing the SVT is what should be discussed. Your 185 was being caused by exercise, so that's normal. The 108-126 while walking around is normal and healthy!
I never actually found out what kind of SVT it was. I'll ask my cardiologist next time I see him.
The interesting thing is that the holter software reported "No SVT detected" and yet my doc says that the 185 bpm while riding my bike was SVT. Could he or the holter be mistaken? I feel that when I go full sprint I can always get myself up to that rate, so does that mean I'm having SVT every time and just don't realize it? I certainly don't become sustained @ 185. Once I stop my heart rate starts slowing as it should.
My second holter report did actually report some SVT, but only 7.2 seconds out of two days, and when I was sleeping no less! There was also a time when I was out shopping and it showed my heart rate between 108 and 126 for the hour - just walking around the store. It didn't say that it was SVT though, just tachy. I wonder again - Can that be SVT and the holter software just isn't catching it? Or do I just have IST at times?
The interesting thing is that the holter software reported "No SVT detected" and yet my doc says that the 185 bpm while riding my bike was SVT. Could he or the holter be mistaken? I feel that when I go full sprint I can always get myself up to that rate, so does that mean I'm having SVT every time and just don't realize it? I certainly don't become sustained @ 185. Once I stop my heart rate starts slowing as it should.
My second holter report did actually report some SVT, but only 7.2 seconds out of two days, and when I was sleeping no less! There was also a time when I was out shopping and it showed my heart rate between 108 and 126 for the hour - just walking around the store. It didn't say that it was SVT though, just tachy. I wonder again - Can that be SVT and the holter software just isn't catching it? Or do I just have IST at times?
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