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EP consultation Scheduled for Tachardia w/ Syncope

I've been fainting for two years now, but only recently has it happened while under a doctor's care (I never could even manage to do it with an event moniter). The doctor noticed that my heart rate (already high) of 110 skyrocketed it 137 right after I collapsed. He's scheduled for me to have an EP consultation, to see if there's anything wrong with my heart, given that I have normal EKGs and normally my heart rate is under 110 (though I've noticed it's higher when I've had a cluster of fainting spells).

However, this EP study thing sounds kind of scary to me, so I went out and bought one of those real-time sport heart rate moniters, just to see if I could get data to the doctor I go to for consultation that helps him decide not to do it. What I've found kind of confuses me, and I wanted to see if it made sense to anybody (or if they outright recommend I stop self-monitering and leave it up the proffesionals)

On average, my heart rate is in the 70's to 80's while laying down for awhile, 80s to 90s when sitting, and as soon as I stand up it's at 120-130, but quickly drops back down to 100-110.  When I'm walking it tends to be in the low 100s (lower than just standing, at least).  However, all of this is without any symptoms at all, much less full on collapse.

When I DO have presyncope symptoms (I feel cold, chest pain, heart palpitations, and sometimes I'll grey out, feel tired or full on pass out), my heart rate is much LOWER than it normally is.  I've had symptoms while sitting with a heart rate of 59, I've stood up and felt symptoms with a heart rate of 86 (both rates much lower than anything I'd seen before in those positions.)

Even more confusing, on days when I have symptoms, hours before I have the symptoms my heart rate is extremely high. It's hit 157 just standing (after picking something up off the ground) before, and then a few hours later it was at the 59.  A few days later it was 135 standing (I was standing for a few minutes before it hit that, and it never went down), and in the afternoon it was at the 86 standing, with me on the verge of collapse (the only reason I didn't was that I sat down very quickly and put my head down).

Is this normal? Is my high regular heart rate meaning that a 'normal' (for most people) heart rate is low enough that I pass out?  

If so...would an EP study be useful for this afterall? What exactly would it be able to tell me that an EKG keeps missing?
3 Responses
Avatar universal
Sounds like inappropriate sinus tachycardia or orthostatic tachycardia..that is, nothing really wrong but your heart is a bit more sensative to standing. I get the same thing. Taking beta blockers helps dramatically.
You should have the EP study. It is a bit painful and kind of scary (at least for me). But in the hands of a good doc, you'll be fine. The odds of dying are 1:5000 but when you strip out the people who are very old and those who would die anyway, the risk is practically nill. If you were to go into arrest, it would be a blessing that you had the EP study because if you go into arrest during the study, you would have probably gone into arrest in the outside world soon after anyway. And they could jump start you back up without much problem at all and give you the treatment you need (implantible defibrilator, etc). EP study can rule out some scary things and give you assurances.
267401 tn?1251852496
I agree that the odds are remote that you'd have a problem - however, @stutterheart, there was a study done comparing ablation outcomes with people 70+ and those under that age, and the mortality rate was just about the same (albeit a small sample size).

I don't mean to instill fear - just want to shed light on a study I read awhile ago.
Avatar universal
Well, if it sounds like inappropriate sinus tachardia, etc. how would my doctor go about diagnosising it? If EKG is fine, if everything seems to be fine, how would anything get diagnosed? Would an EP test diagnos something like that? I've heard tilt table tests are good for getting readings during a sycope episdoe, but aren't all that great for actual diagnosis. Is this correct? (The doctor I'm currently under doesn't seem to be in any sort of rush to do a tilt table, despite everything I read online saying that it's the test to do for syncope).

And in any case, if it's some sort of tachardia, then why do I only feel symptoms when it's normal/low for me? I understand the high rates are a matter of concern, but if they're asymptomatic, what does that mean?
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