Opinion regarding electrophysiology

[martyalaska]

I am a 64 year old man.  Brief cardiac history: Left Bundle Branch Block, PSVT, 90% blockage in right coronary artery that has been stented.  Three other arteries with 40 % blockage left alone.  

I have had two episodes of what I can only call blackouts.  I was physically in the process of performing an action and lost 10 to 20 minutes of time.  The neurologist has done brain MRIs and EEGs and can find no evidence of a seizure.  They now think it may be due to either tachycardia or bradycardia and I have a consultation scheduled with a cardiologist who does Electrophysiology Studies.  Can anyone there offer an opinion as to whether or not this is something that should be done?

[Mom2four85]

I understand about the misdiagnoses or cop out's - I've had doctors tell me nothing was wrong, or I was stressed and I even had a doctor prescribe Phentermine AFTER seeing bigeminy & trigeminal pvc's (tons) on an EKG in 2007 telling me all I needed to do was lose weight.

I had bouts of fainting once or twice a year and dizziness was part of my normal days and no doctor I complained to thought it was anything until my EP did the HuTT; which showed my heart stops when I faint and my BP tanked to 0.  

There are times I've known I was going to pass out, I get symptoms and feel it and grab onto something --  then there's others that I'm out cold and have no clue I even fainted. Driving when you faint is scary as all get out - I did that but luckily I was almost to my home and driving very slow and only drove onto the side of the road.  It's been rough not being able to drive at my age; but I think about the consequences of hurting someone verses my wanting to go somewhere.

I'm right there with you, I'd get the EPS and find out what's going on instead of waiting for that long and being stressed over your health.  Can you find another primary doctor?

[martyalaska]

No one has mentioned the tilt table yet.  I've read about though.  I have had to wear a 30 day monitor but it didn't show anything.  Of course it was the quietest 30 days I've had in quite a while.  My regular cardiologist has mentioned an implantable monitor that would be in place for 2 or 3 years.  I think I would rather have the EP study done and get the whole thing over with one way or the other.  I know it carries risk but that really doesn't bother me.  

At this point these episodes are very few and very far between.  I may have had more than the two episodes that I've noted.  The problem is with the other times I can't say if I fell asleep for a short interval or blacked out (I suspect the latter).  With the two I mentioned I was actively doing something when I blacked out and I was able to note the time that was lost.  It's very disconcerting.  My main worry is that if it is heart related it may hit me while I’m driving.  

I’m reaching a point with my primary care doctor where he thinks that some of my symptoms are due to anxiety.  That’s an infuriating point of view to me.  It’s a cop-out diagnosis when a doctor doesn’t know what he’s looking at.

[Mom2four85]

If they haven't mentioned it to you; ask about a (HuTT) head up tilt table test or tilt test for fainting/blacking out - if you're having the blackouts like that it can be dangerous; but some doctors don't take them seriously enough.  It took me from the age of 9 to 42 to get a doctor to finally say OH something is wrong with you and order this test.

In my situation my fainting (neurocardiogenic syncope and orthostatic intolerance) are connected to my heart problems or so they think :P during the test, my bp tanked and my heart stopped.

It could be as simple as your LBBB being the cause of the problem or something else not related - they may not know for sure until they go in and test your heart's electrical system out (thats basically what the EP study does) only your doctor can determine the cause.

If it's bradycardia; then you may benefit from a PM - Pacemaker; has your doctor talked to you about this option? I had a PM/ICD combo implanted, which has helped me with bradycardia & fainting, but I still suffer daily pre-syncope symtpoms.

[Jerry_NJ]

I am not sure what your EP has planned for the EP studies, but I assume it would start with a wearable monitor to watch you heart for 24 hours or longer.  The catch here is, as I understand it, the monitor will be of great value if you have an episode while wearing, and not of any value if your heart behaves the whole time.  Some people wear these monitors for weeks, day and night... I've worn one and took it off to take a shower/bath, but wore it otherwise.  In my case it confirmed I have Atrial Fibrillation full time/permanent day and night.  The good news?  No other heart signal problems were seen.