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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!
I am with DeltaDawn, you need to be confident this is the right thing for you. I would say the jolts and odd things you are feeling are pvcs. The fact that they hurt means your heart is a bit irritated at this time for some reason maybe partly due to stressing about what is going on. Or possiblyu because of some svt. My heart was getting fairly irritated from my svt episodes before my ablation to the point I felt pain of some sort in my heart everyday. Now that I am out of the svt for a year and a half the pvcs I do feel do not have the pain associated with them so it is possible some svt is irritating the heart causing your pain or since you state you could press the area and feel pain it is possible you strained something at some point and that is why the pvcs are hurting. However as uncomfortable as they are they are not a threat. I would say do your best to give your heart as much rest as possible to see if that helps the pvcs hurt less. Are you sure they are even intending to do an ablation for the vt because a seven beat run that converts on its own that isn't causing you serious symptoms like passing out isn't necessarily a reason for an ablation so I might question what it is they plan to try and ablate. As for doing the ablation follow your gut and you can't go wrong. I wish you the best whatever you decide to do.
While I'm a proponent of the ablation procedure, I don't believe a single event warrants it. If you're still not sure why your physicians are rushing you into this, consider what they stand to gain monetarily. They'll be compensated whether or not your SVT can be provoked. I'm actually surprised your insurance company has approved the procedure.
You need to be at peace about this. Find a doctor you trust and turn it over to him or her. Sounds like 2 doctors have said you need the study. Third opinion? Good luck whatever you decide.
Well, my procedure is scheduled for Monday but I'm having second thoughts after reading various posts on this board. It seems like a lot of people with NSVT in structurally normal hearts have doctors that tell them not to worry unless it becomes frequent. In my case, I only have one documented case of it.
Now I know that I was feeling PVCs the last time that I made a post here, and that's very unusual for me. There have also been some times where I have woken up in the middle of the night in an absolute panic, as if my heart had stopped. And during these panics I could sometimes feel PVCs (which makes me think that maybe it's NSVT that wakes me up). All I know is that once I wake up I seem to return to normal fairly quickly.
I'm not so sure why my doctors are so quick to rush me to an EP study based on a single recording while other recordings have shown no such thing.
My main problem over the past few months has been chest pain. I get some really nasty jolts in the sternum area. Sometimes it's obvious that it's non-cardiac. Like I can push on my sternum during the pain and make it worse. Other times I feel I get deeper pain, like heart spasms. And other times I get lightning bolt through the chest sensations. Some pains have been so severe that they force me to stand up and panic, because I think my aorta is about to erupt or something. But the pains are always over within a few seconds. Other days I have a lingering "funniness" underneath my sternum. It's like a light clamp around my heart or esophagus or something. It feels like something is in there that doesn't belong. This is especially prevalent when I get up from my chair and start walking around. One idea I had was hiatal hernia. So that might be my next investigation.
That's been my life for the past 6 months or so. It's been terrible, and I still get some nasty sensations and funniness in my chest at times. I haven't been able to correlate any of the pains with physical activity, and none of my doctors even want to consider a blockage because of my age and lack of risk factors.
All of this hit me at the same time so I feel it's all related. For example, I never had (or at least never felt) PVCs or NSVT or any kind of arrhythmia at all in the past. I never had nasty chest holts and pains on a daily basis. 27 years of my life my heart was perfect then all of a sudden I turn 28 and I have all of these chest symptoms? It's just so bizarre and none of my doctors seem to be able to help.
But going back to my original debate, I'm not so sure if I should continue with the EP study because in terms of rhythm, I feel I've been pretty normal for the past couple of months. And from reading this board, it seems that everyone who goes to an EP for NSVT is unable to have it induced during the study. So what's the point? Especially in my case since NSVT seems to be a rarity.
Appreciate any thoughts. My EP is going to kill me if I cancel again. :(
Now I know that I was feeling PVCs the last time that I made a post here, and that's very unusual for me. There have also been some times where I have woken up in the middle of the night in an absolute panic, as if my heart had stopped. And during these panics I could sometimes feel PVCs (which makes me think that maybe it's NSVT that wakes me up). All I know is that once I wake up I seem to return to normal fairly quickly.
I'm not so sure why my doctors are so quick to rush me to an EP study based on a single recording while other recordings have shown no such thing.
My main problem over the past few months has been chest pain. I get some really nasty jolts in the sternum area. Sometimes it's obvious that it's non-cardiac. Like I can push on my sternum during the pain and make it worse. Other times I feel I get deeper pain, like heart spasms. And other times I get lightning bolt through the chest sensations. Some pains have been so severe that they force me to stand up and panic, because I think my aorta is about to erupt or something. But the pains are always over within a few seconds. Other days I have a lingering "funniness" underneath my sternum. It's like a light clamp around my heart or esophagus or something. It feels like something is in there that doesn't belong. This is especially prevalent when I get up from my chair and start walking around. One idea I had was hiatal hernia. So that might be my next investigation.
That's been my life for the past 6 months or so. It's been terrible, and I still get some nasty sensations and funniness in my chest at times. I haven't been able to correlate any of the pains with physical activity, and none of my doctors even want to consider a blockage because of my age and lack of risk factors.
All of this hit me at the same time so I feel it's all related. For example, I never had (or at least never felt) PVCs or NSVT or any kind of arrhythmia at all in the past. I never had nasty chest holts and pains on a daily basis. 27 years of my life my heart was perfect then all of a sudden I turn 28 and I have all of these chest symptoms? It's just so bizarre and none of my doctors seem to be able to help.
But going back to my original debate, I'm not so sure if I should continue with the EP study because in terms of rhythm, I feel I've been pretty normal for the past couple of months. And from reading this board, it seems that everyone who goes to an EP for NSVT is unable to have it induced during the study. So what's the point? Especially in my case since NSVT seems to be a rarity.
Appreciate any thoughts. My EP is going to kill me if I cancel again. :(
I'm only 16 years old, I had an ep study done which at the time I felt was unnecessary as id only collapsed and thought it was a once off. I was so wrong, turned out the abolition saved my life as I had a severe case of WPW, my advice would be to go ahead with the ep study it could be worth the two or three days of discomfort.
COMMUNITY LEADER
As your EP said, he may not be able to stimulate during the EP study. I have never had one, but I'll comment anyway.
First I do not argue with anything Michelle told you, in fact I didn't read it carefully as I wanted to comment just on the 185 HR during exercise. I can say I used to run up to 165 when running and that was when I was in my late 50s, so if you are in physical condition I'd say 185 isn't too high if you are able to handle... I always considered my ability to breath hard enough more important that my HR. One test was can I still say a simple sentence without gasping for air.
I'm now on Medicare, so my biggest concern is finding a great doctor who will work for those low wages. As for my private coverage it has something like a $2K out of pocket before it starts to pay 80%, and a $5K before it pays in full - again assuming in-network. For us old folks that is Medicare rates, which are way down even compared with the large private insurance in-network rates. Sorry for the distraction, I also felt a need to add comments on the cost subject too. Where this all goes in the future is anyone's guess... I doubt that it will be better. I had no idea a EP study was $4K, that may be the "list price" or "rack rate" : )
First I do not argue with anything Michelle told you, in fact I didn't read it carefully as I wanted to comment just on the 185 HR during exercise. I can say I used to run up to 165 when running and that was when I was in my late 50s, so if you are in physical condition I'd say 185 isn't too high if you are able to handle... I always considered my ability to breath hard enough more important that my HR. One test was can I still say a simple sentence without gasping for air.
I'm now on Medicare, so my biggest concern is finding a great doctor who will work for those low wages. As for my private coverage it has something like a $2K out of pocket before it starts to pay 80%, and a $5K before it pays in full - again assuming in-network. For us old folks that is Medicare rates, which are way down even compared with the large private insurance in-network rates. Sorry for the distraction, I also felt a need to add comments on the cost subject too. Where this all goes in the future is anyone's guess... I doubt that it will be better. I had no idea a EP study was $4K, that may be the "list price" or "rack rate" : )
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