Pericarditis after EP study

[martyalaska]

On 9/1/2010 I had an EP study done.  I was under general anesthetic for 4 hours.  Doctor ablated four separate areas and placed a dual chamber pacemaker.  For the first week I felt like I was in my twenties again.  Then I started to slow down.  I started having chest pain along with spasms.  Then I was feeling a constant pressure under my sternum.  They did an Echocardiogram and found what they say was a small amount of blood in the pericardium.  They said they aren’t sure where the blood came from but that they didn’t think it was still bleeding.  They said they think it may be from the placement of the pacemaker.  They put me on a prednisone taper for the inflammation.  That constant pressure seems to have subsided for the most part.  I still get occasional spasms and chest pains.  I am a little short of breath but it isn’t real bad.  Anyone else have this?   Can anyone offer any comments?  I don’t know what to do next.  I feel like all of the cardiologists and nurses involved do this stuff everyday but don’t look at things from the patient’s perspective.  To me it’s pretty concerning.  Though they don’t say it the feeling I get is that I should just go along with them and not worry about it.

[martyalaska]

UPDATE: Well it turns out that the nurse practitioner who said I had paricarditis wasn’t quite correct.  Let me give a more detailed explanation of what was done and what precipitated this whole long process.

Earlier in the year around February/ March I had a couple of scary episodes where I lost time – blacked out.  The first one was about 20 minutes and the second around 12 minutes.  Because I was actively involved in doing something I was able to determine how long each was.  It was as if I had simply shut off during these “blackouts”.  When they were over I was fully awake and aware of my surroundings as if nothing had happened.  I think I had more of these blackouts but I can’t specifically pin them down.  Thankfully these happened at home and not on the road or at work.  I went to my primary care doctor who was quite concerned.  He first checked with my cardiologist to see if it could be related to me heart.  She said no so he then had me see a neurologist.  The neurologist had previously done MRIs of my brain and he was satisfied that was all clear.  He had me undergo an electroencephalogram which came out completely normal.  So a neurological cause was ruled out.  I then went back to my primary care doctor who said if it wasn’t neurological it had to be cardiac.  He wanted me to have an electrophysiology study done.  He had to press his point with my cardiologist but she agreed and referred me to an electrophysiology specialist.  When I first met with him and went over my history he said he believed the odds of this being a problem with my heart were 50 to 1.  On September 1st I had the EP Study done.  He found a number of things wrong.  He ablated four separate areas inside my heart to take care of Atrial Fibrillation/Flutter and Supra Ventricular Tachycardia.  One of the tests he did confirmed what his main suspicion was – I was going into intermittent complete heart block that was slowing my heart so much I could maintain consciousness.  So he implanted a dual chamber pacemaker.  The procedure took four hours to complete during which I was under general anesthetic.  I was sent home feeling like I was in my twenties again.  About a week and a half after that things started to go downhill for me a little.  I went back for a couple more echocardiograms and pacemaker checks.  They found I had developed an epicardial hematoma near where one of the pacemaker leads was implanted into my right ventricle.  It was rubbing against the pericardium and causing an inflammatory response.  They put me on Colchicine and Advil for the inflammation.  On my last echo the hematoma was pretty much all gone and I’ve been taken off the Colchicine. I am feeling quite a bit better now.  

Now that this is pretty much behind me I can’t tell you how pleased I am with the outcome.  I was somewhat apprehensive about the EP study but it turned out to be an easy thing to go through.  All in all I wish someone would have had me do this years ago.  It has completely eliminated almost all of my symptoms and is really changing my life.  I do find if I want to dwell on all that has happened I can see that I am still emotionally fragile but I expect that will pass with time.  

[Pamz]

That's interesting - the lead they moved was in the right ventricle on her also.  Maye that is more of a touchy area.  Her pericarditis was cause by the irritation of the lead.  She had her 1 week check up today and she's doing well.  She'll be taking the anti-immflammatory for 3 more weeks.  They told her that if she has any sharp pain, instead of just pressure, to get in to see them.

Be careful and take care!

[martyalaska]

Failed to mention:  Cardiologist said this was caused by the placement of the pacemaker lead into the right ventricle.

[martyalaska]

Had another echo done.  My cardiologist finally got involved.  What she says I have is an epicardial hematoma.  Siad it will take some weeks to clear.  Put me colchisine for inflammation.  I am to take 3 advil 3x a day.

[Pamz]

My daughter just got an icd implanted last Wednesday.  In the middle of the night, still in the hospital, she felt like an elephant was standing on her chest, major pain down her right side and couldn't breathe.  They thought a lead on the right might have moved, did a bunch of tests, had her on morphine until morning and performed a 2nd surgery.  They moved the lead and said that she had some swelling, or pericarditis, that the pin head on the lead must've been rubbing the heart a little or her heart just didn't like it there.  She pretty much felt instant pain relief when they moved the lead but still had a lot of pressure.  They put her on an anti-imflammatory and an antibiotic but not sure of what kind of an antibiotic as she's allergic to pencillin.  She only has the worse pressure trying to lay down.  She was sent home on Friday and told that it will take 2-4 weeks for the swellng to go away completely.  She hasn't said anything about spasms, just pressure and a little hard to breathe.  The meds aren't agreeing with her, upsetting her stomach.  They pretty much said the same thing as you've been told, that it's not too much to be concerned about.  She does go in for a follow-up on Thursday.  It's concerning to me as well, but all we can do is take their word for it and pray it'll get better.  I see the same doctor as her on Wednesday for my 3 month follow-up and hopefully he'll tell me some more about this since we didn't get much of a chance to talk to him when they were doing surgeries, etc...  The place was very busy.

Do you see the doctor again soon?  If not, I'd set up an appt so they can do an xray to see if the swelling has gone down and tell them about the spasms.  I don't know how they test for bleeding but I'd want to know for sure that that still wasn't bleeding.

Hope you start feeling better soon!