Electrophysiologist Appt

[Jules209]

Hello, I have posted here before about possible sinus tachycardia diagnosis but today I went to my dr appt with the electrophysiologist after gathering all my medical records from prior cardiologists, he said none of my holters proved that I had anything but a fast heart. He said my most current cardiologist suspects svt, he said he will first do an EP study and if the problem is coming from outside of the heart he will ablate it. If it is coming from the sinus node itself he said he will stop there and prescribe something for the symptoms (tachycardia) he said something like a stress reducer or anxiety medication. He said from all my stress tests and echocardiograms that there is no structural issues going on. I agreed to have the EP study/Ablation on Sept. 14th, I just want to get answers and possibly be cured. I am feeling confident after talking with the electrophysiologist that and stressing to him, I am not interested in a sinus node ablation, he stressed that is far out of pocket as far as what is going on with me. Well thank you all for listening, pray for me as my appt draws near.

[madamebrianne]

Hello,

Please look into Postural Orthostatic Tachycardia Syndrome (POTS). It is a very unheard of nervous system disorder that prevents the body from being able to properly adjust to the pull of gravity. Therefore, symptoms arise, such as: rapid heart rate upon standing, low or high blood pressure, dizziness, fainting, fatigue, sweating, anxiety-like symptoms, headaches, shortness of breath, inability to exercise, digestion problems, etc. The symptoms are endless and vary person to person day to day. Very few doctors are familiar with this illness and often misdiagnose patients.

Please feel free to contact me if you have any questions.

Best wishes,
Brandi

[Jules209]

Thank you all for your knowledge and nice hopes for me. Tom_h  I guess what I meant is that the electrophysiologist said, if it something he can fix, he will. He said he will not at all mess this the SA Node. he said according to my cardio he believes it svt. My symptoms start suddenly and end suddently, my rate rate climbs to 180 or so beats a minutes. I have never had to have it stopped at the ER I usually just do my own maneuvers at home. Sometimes I'll feel a thump, a flip flop and sometimes it dosen't speed up to an svt episode after the flip flops and thumps. but honestly, it sounds like they don't even know, I mean ususally when people have an EP study done it's because they have already been diagnosed in my case I just keep getting the symptoms but nothing caught on the holter except fast heart rate. and about the cost of this procedure yes it is very expensive but I have double coverage with my insurance and my husbands.

[tom_h]

".....he said he will first do an EP study and if the problem is coming from outside of the heart he will ablate it........"

I hope this is a typo or a misunderstanding on your part.  The pathway which supports SVT is most definitely WITHIN the heart.

[tom_h]

"Also, notice that sinus tachycardia is not a diagnosis. It's a normal response from your heart towards something. "Real" SVT, on the other hand, is caused by an abnormal electrical pathway or focus in the upper heart chambers, which can be fixed with ablation."

Yes.. i_s_w nails it.  Unless you have something really rare like Inappropriate Sinus Tachycardia (IST), sinus tachycardia is a normal response from something "outside" the heart.

I've mentioned the symptoms of SVT in prior posts, but I don't think you've ever commented on whether or not you experience them.  It may help to restate the symtoms of SVT again.  They are the same for everyone.

SVT initiates suddenly; within one beat.  There can be a fluttery feeling as the accessory pathway fights with the primary pathway for dominance, but it starts immediately.  You can literally go from 70bpm to 200+bpm in one beat.  Now this is important to understand: SVT doesn't ramp up. IOW, it doesn't gradually speed up.  Likewise, SVT drops back to normal sinus rhythm within one beat. You feel a little blip, and the beating pressure in your chest is suddenly gone; not gradually but immediately.  The duration of these events can last seconds or hours, They can even be self sustaining like mine were and run on indefinitely.  These symptoms are the same for everybody with SVT.  If you don't experience these symptoms, you don't have SVT.

So if you follow my description of SVT.  Have you experienced this before?  The eledctrophysiology procedure is a very expensive one.  You or your insurance company will be billed based on what they do, but it could be anywhere from $50,000 to over $100,000 (US).  Each step in the procedure is broken out and billed separate.  If they pace your heart, that's billed.  If they ablate an area, it's billed.  Keep in mind that you electrophysiologist most likely doesn't consider what your out-of-pocket expenses are.  He's getting paid, and that's all he cares about.  When I asked about the charges during my consultation, my chosen electrophysiologist stated that he got a flat rate from his employer, the hospital, and had no idea what the charges would even be!

So.... based on what you've told us here and in a few previous posts, do not be surprised if they are unable to provke SVT.  If you don't have an accessory (or alternate) pathway, they will not be able to get your heart to "jump to hyperspace".  I'm just suggesting to prepare yourself.  I mean, if you're getting to procedure to rule out SVT, I guess that's a valid reason.  But then again, in my opinion you don't need to spend upwards of a hundred grand to determine that. You either feel the symptoms......or you don't.

As always, we're pulling ya.

[MichelleP_3811]

Best of luck with your study.  I will send good thoughts your way.

[is_something_wrong]

Hello,

What your EP is planning sounds very reasonable.

Also, notice that sinus tachycardia is not a diagnosis. It's a normal response from your heart towards something. "Real" SVT, on the other hand, is caused by an abnormal electrical pathway or focus in the upper heart chambers, which can be fixed with ablation. Unless you have alternating tachycardia and bradycardia, so-called sinus node dysfunction, it's no point in modifying the sinus node. If someone has unbearable symptoms which do not respond to medication, the sinus node itself can be ablated/destroyed and replaced with a pacemaker, but your EP will not do that, which sounds very reasonable.

If you truly just suffer from sinus tachycardia, it's important to find a cause. The list is long, but with a healthy heart, the cause must be something not cardiac related. Stress and anxiety are very common reasons. Hormone imbalances can happen. Electrolyte disturbances? Dehydration? Variable blood sugar? ANS disorders?

Many of us "suffering" from sinus tachycardia are taking beta blockers to slow the heart rate some. But again, the best treatment is to treat the cause.