Lexiscan Chemical Stress Test

[Debjimmay]

My EP wants me to have a chemical stress test before he puts me on Flecainide. I have so many problems with Afib and PACs that I’m terrified to have them inject me with something that’s going to make my heart take off. I contacted the doctors office to ask them if I can have the treadmill stress test instead. The answer was no. I’m a 72 y/o female and in good physical shape. I don’t see any reason why I couldn’t have just a regular stress test on the treadmill. I would rather have a CT Scan which I read is much more accurate than the stress test. I’m thinking about calling my doctor to ask me if I could have this done instead but I know he’ll be upset. Does anyone have any ideas of suggestions?

[mjames1]

Is it your age or do they have another reason why they won't do an exercise stress test? If they haven't told you, I would get an answer as the first step.

I had a nuclear exercise stress test at your age to qualify for Flecainide. That was my Ep's standard protocol at a top 10 cardiac hospital in the United States. I do not believe you will get the same kind of information from the cardiac CT scan.

Jim

[secondtry]

I agree with your concerns. I have grave doubts about all stress tests so I would keep pushing hard to find out more info and what is absolutely necessary.

I had a stress test on the treadmill at around 60yo. If memory serves I had already been on on-line Flecainide on a previous A & E visit. Anyway after I had stood on the treadmill, they came out with this page long disclaimer to sign so I did not push myself up to the required limit and eventually they accepted 'that will have to do'.

[Debjimmay in reply to secondtry]

Yes, my husband told me if you cant get to your limit on the treadmill it will cancel out the entire test. That doesn’t seem right to me.

[splashrollandplod in reply to Debjimmay]

When I got AFib it was paroxysmal ie occasional. They did a stress test, an Echo, a nuclear (stress) test and a 72 hour holter. At max stress my heart lost a bit of rhythm but not long enough to be classified AFib. Then it can back with regularity although it still self corrected. Thats when they put me on the list for ablation. I got that within 2 weeks in 2021. They gave me flecainide to reduce risk of AFib initially daily then as required (it wasn’t). I got some arrhythmia for a few weeks after the ablation then it settled down and disappeared! I only took Flecainide pills not an injection. 2.5 years I’m all good, I’ve done 4 triathlons since ablation. Good luck.

[Debjimmay in reply to splashrollandplod]

Thank you for your reply. I’m thinking the way things are going I may need to eventually have the ablation. It sounds like you had great results from yours. If I’m this anxious about having a stress test, I’m not sure how I would be getting the ablation but I suppose if it would help me and I keep getting worse like I have been, I would probably go through with it.

Four triathlons? Oh my gosh, that’s wonderful!

[Usta]

I certainly understand your concerns. As a layman, my understanding of the nuclear stress test is that it may provide additional clarity to the quality of your cardio/heart mechanism. I had the lexiscan injection two years ago and it was an interesting experience. I was first at rest with a 10 lead ecg/blood pressure cuff attached and then after the injection my cardio/heart felt like I had been exercising. I was monitored with the ecg and blood pressure cuff the entire time and the lexiscan wore off quickly. So, for me perhaps the most unsettling thing was that I didn't know what to expect and was still in the early afib evaluation protocols. I was afraid, but in retrospect it was a helpful diagnostic tool and nothing to fear. My hope is that you will soon have the quality of life you desire without the fears we all experience while getting there.

[Debjimmay in reply to Usta]

Your email was reassuring for me. Thank you for taking the time to share your experience. My heart is so out of rhythm right now with Afib, Etooics, and my PACs have been every other beat for almost the entire day for the last few month. I’m so worried that once they inject something to make my heart go faster it can cause a serious arrhythmia or even a heart attack. I realize there is someone there in case this happens but I’m still terrified to have in done. Due to the stress it’s causing me Ive considered cancelling the stress test but I know I need to go through with it.

[drdubb]

I was off Flecainide for awhile but went back on it because of ectopics. I had to have a stress test. When I asked why, I was told that a study showed a higher 10 year death rate for people taking flecainide, my guess is that they are looking for any risk factors. When my AFIB was detected in 2017, they also put me through a stress test.

[downtherabbithole]

Any form of stress, overexercising and overeating or overtiredness, besides of course stressful situations can cause Afib. Perhaps that is the reason they want you to take Flecainide? It is a strange drug, meant to prevent atrial fibillation, but it also sometimes causes it. Read up on it, I have paroxysmal afib, I was scared to stop it. I became more serious about my diet and lifestyle and then quit the flecainide. That was years ago. I never took it again. I hardly ever have afib now. I do still take edoxaban a noac. A stressful event in august did cause a longer stretch 4-5 hours of afib. Since then everything has been normal.

Not worrying, being nice and calm, not overeating and going for a good walk is the best thing you can do for yourself.

[Debjimmay in reply to downtherabbithole]

Thank you for your reply. I am pretty much stressed and anxious all of the time. The strange thing is, I’ll go for months without Afib or any irregular heart rates. During those months there were times when I was extremely anxious and stressed but it never threw me into Afib or irregular heart rate. I might feel a small flutter now and then, but that is all there is. Another strange thing is, it seems to come back in October. This time it’s lasting much longer than usual and it’s much worse than usual. I can’t figure it out. I tried to relate it to medication or things that I’m eating but I’ve given up on that all altogether because it doesn’t seem to matter one way or the other. Now I know where you got your name. 😊

[downtherabbithole in reply to Debjimmay]

😄Oh yes... the strangest things happen down the rabbit hole! Sounds like you were basically pretty healthy if you didn't get afib while stressed! And wintertime wears us down, doesn't it. But now you are having a tough time. Of course it can be that your heart simply isn't working as well, but diet and lifestyle do help. Ive phased out sugar, eat lots of veggies and lots of fruit blue berries!, drink green tea, use only olive oil and eat fatty fish wild salmon and herring (omega 3) and meat only on occasion, avoid saturated fat. And what helped me lose weight too. I quit dairy, and use watered down almond milk and soya cream for sauces. I find any form of saturated fat does not suit me any more, especially also because of growing older. (just turned 76). And make sure you are physically tired enough.. Well, I do sin now and then and in wintertime it's harder. All of it helps though! Good luck to you.

[Debjimmay in reply to downtherabbithole]

it sounds like you’re doing everything to stay heart healthy, especially with your diet. That is great! I love all the foods that you mentioned, and I do eat them quite often, but find that I’m drawn to sweets, especially after I eat dinner or lunch. It may even be my hydration that’s causing a problem because I have a hard time drinking all the water I’m supposed to drink in a day.

I have a question for you. Have you ever taken or heard of taking magnesium taurate to help with your regular heart rate? I read a couple blogs on here where the people said it really helped them so I just ordered some from Amazon. Just wondered if you had any experience with it or knew anything about it.

[downtherabbithole in reply to Debjimmay]

No, I haven't. I know it's good, with the amino acid in there. You have to check if it's ok with the other medicines you might be taking. I might do so at some point. I do take magnesium citrate just now and then before sleeping only when I want to sleep well or didn't have many veggies or got some leg cramps. I already take a multivitamin which has some extra magnesium plus an extra vitamin D3 pill. (because of celiac disease.)

By the way, having some flecainide to stop a longer bout of afib, is a a good idea, as Wellperson just mentioned. I read about it. And if I ever get a bad session of Afib, I would certainly consider taking it. I take it with me on trips. I prefer to stave off the pills as long as I can by living well.. But at some point they can be very helpful I guess.

[Wellperson]

Hi Debjimmay

I have taken Flecainide for the past couple of years as a 'pill in the pocket' in other words just when I have had heart flutter or full AF .It works very well and brings things back to normal for me in a couple of hours. But now I am having more episodes of AF my consultants have put me on Diltiazem twice and day and one Flecainide in the evening each day. In addition I take a blood anti coagulant Dabigatran twice a day to prevent strokes. Things have been ok but as episodes of Af are more frequent and I get easily out of breath I have been refered for an ablation procedure for AF. But the waiting time for that here on the Health Service is about 9months or I could have it done privately which would cost several thousands so I will probably wait to have it done for free.

In the past I have had a treadmill stress test.I have also recently had a Nuclear Cardiac myocardial perfusion scan ,where they inject you and then scan you. Different people react in different ways to these tests , for me it was OK it made me very short of breath but they monitor you all the time.

I hope that helps .

[Debjimmay in reply to Wellperson]

Yes, that surely helps and it sounds like we are basically on the same medication’s except I haven’t started the Flecainide yet. I heard that sometimes they make you go into the hospital the first time you try Flecainide. Did you have to do this or did you have any reaction from this medication? It does interact with my Lexapro, but my ET doesn’t seem concerned about it. Just wondering what your experience with Flecainide has been, both good and bad. Thanks

[Wellperson in reply to Debjimmay]

They don't in my experience make you go into hospital the first time you take flecainide in the UK. As I mentioned I just had it to start off with to take when I had AF. It dosn't seem to react with other medication I am taking but as I say everyones reaction is different so best to follow your consultants advice.

[Debjimmay in reply to Wellperson]

Thank you Wellperson.

[mikelocke]

Hi, I’d relax and go with what the specialists are telling you and accept what they are saying to you. I’ve been on flecainide for eighteen years !! now for AF and I’m now 80 and still enjoying life.

Yes, as the years went on I’ve had an ablation for flutter, yes I’ve had a pacemaker fitted so I can take bisolprolol and my heart rate doesn’t get too slow.

But good old flecainide is still doing its job and my heart is in NSR all the time.

Take the advice of the professional experts and don’t overthink it yourself.

[Debjimmay in reply to mikelocke]

Thank you for your kind words. I know you are right and I try so hard to relax and not overthink everything. In not sure why this is so hard for me to do. I did ask if I could take something before I come in to take the stress test to relax me and they said yes. That should help some and then when it’s all done and over I’ll be upset with myself for putting myself go through all this for nothing.

[Utahskier]

I had the same concerns when my nuclear stress test was ordered as I too was having chronic Afib & reacting badly to everything. But as I understand it, the extensive info provides is unparalleled. Day of test I was terrified, which I shared with my tech who was so reassuring, patient, and explained every detail…timing, in minutes, of each step, possible reactions, how they handle a bad reaction (they have a “reversal drug” that instantly nullifies the stress drug), etc. He stayed by me talking thru every step in a calming way. It was bearable and I got thru it ok…what a miracle! To this day with all my tests, ops, & other scary medical things it’s my biggest fear hurdle cleared. I hope this helps!

[Debjimmay in reply to Utahskier]

I appreciate you sharing your experience. Thank you. It’s so nice and also reassuring to know that I’m not the only one with these fears of anxiety. The test is scheduled for Friday and you have no idea how many times I thought about calling to cancel it. I even thought about going to another EP and getting a second opinion. I will go through with it though and I of course will be like you, and let them know how terrified I am. Hopefully I will have nurses and doctors that are as sympathetic, reassuring, and understanding as yours were.

[Utahskier in reply to Debjimmay]

You can do it! It’s really quite brief, with the stress drug effect lasting only about 3 minutes. The tech watches your vitals closely so knows your heart’s reaction and will offer the reversal drug throughout the procedure. I’d have taken it without hesitation had the sensation been intolerable! And the results were uniquely comprehensive, so alleviated a lot of my anxiety about what else could be going wrong in my body 😆 Best of luck…I know you’ll power thru it no problem!

[Debjimmay in reply to Utahskier]

Thank you. You are very kind. 😊

[DawnTX]

the test is not that bad. You will have an IV in you and the second you react they will stop the reaction for you. It’s all over in seconds. you will probably have a lot more testing to come so get used to it. I have had heart, MRI, CT, stress, etc. it becomes routine. Your doctor has reasons for doing these things sometimes we can question things, but we are not EPs if you want him to help you, you need to do what you’re told most of the time none of us are having fun with this. Trust me.

[Debjimmay in reply to DawnTX]

Hi Dawn. Thanks for your reply. The main reason my EP is having me go through the stress test is to see if I have CAD before he puts me on can Flecainide. I’m not thrilled about going on that medication either as I read, it can be quite dangerous. You are right, this is not fun at all and the frustrating part is no one understands what it’s like unless they’re actually going through this themselves.

[DawnTX in reply to Debjimmay]

No matter what medication you read about it will make you unhappy for everything. It does good for us. It has side effects. The worst one I had been on was amiodarone. I was going to be Tikisan sp? Talk about dangerous I was going to have to stay in the ICU for five days monitored constantly because of things that it could do. what choice did I have continue the way I was that wasn’t going to work either. The entire thing was called off because my cardioversion failed, and I had bad effects. It was not gonna be tried again. If you had read any of my story, you would know I’ve been on pretty much everything and from day one I have had tachycardia. And ablation quiet my heart for six months then I had another ablation and for a year and a half I was doing pretty good, for the most part, I forget what I was on for medication at the time, and I have been on an anticoagulant from day one of being diagnosed my EP has referred to me as unique, and I have a special pacemaker now. There’s gonna be a lot of trials with medications and more , unless you are very lucky. You are at the beginning all I can tell you is every day they are working on new things. I am proof of that because my first anniversary of my new working heart is coming up on the 13th and I feel normal for the most part. I am now on Metropol sucrate twice a day because my cardiologist wants my heart rate down. It’s normally around 82 now. compared to the 180+ I was living with from day one and the heart failure 82 sounds good to me but now I can go out with the dog etc. and usually keep it in the 70s. I have dropped about 40 pounds but I think a lot of it is getting out of my own head about all of this, and not scaring myself. Stress can be as harmful as a fib and a fib act up. Sometimes even eating ice cream will trigger it also a meal that’s too heavy is another one. Recently, I am happy to say I was able to have a glass of sangria for the first time in two years. The last time I had it by the time we got to the car, I was in serious a fib. I could barely breathe. Remember, we are also all different.

I should’ve kept a journal of my journey. I don’t even know if I can go back and try to do it now because I have had so many changes. In such a short period of time. I have a typical flutter, and I had a typical a fib the a fib appears to no longer show up but the flutter does. My doctor told me I will always have the flutter and will fill it when I do. the difference now is I had my AV node ablated which means my pacemaker is in charge and no harm is being done to my heart. Tachycardia is very damaging. I will tell you my end has actually reversed a bit to being better and my ejection rate once in the 50s is now in the 70s because my heart was able to get rest. I was unable to walk from May until the following February Because of my heart and circulation or lack of it. The only time that changed was 3 1/2 weeks following a cardioversion the best 3 1/2 weeks I had had in a very long time even after my pacemaker I went in a wheelchair wheel and I left getting into the car and being able to walk. My stamina is no longer what it was but I can walk.

I hope you read what I told you so that you can have a different perception of what you are dealing with.

As far as people not understanding what it is like you are very right you and I didn’t understand either. A fib was a word I heard that meant absolutely nothing and I could’ve cared less about because I didn’t have it. check out the numbers of people with it. Here in the states after I already had it the American heart institution started. A campaign on TV and elsewhere called no time to wait. It’s true there is no time to wait the longer you have it untreated the more damage you are doing to your heart. It probably won’t make you die as far as I know it does not kill you, but it can sure make you miserable.

I was very blessed by moving to Texas, which, especially Houston has one of the greatest medical centers consisting of many hospitals. I wonder if I would still be alive if I had not come here. Not all doctors are the same if you feel unhappy, talk to him or change doctors, it could save your life

Buckle and it’s gonna be a long ride with a fib or a flutter or both. I was told with the pacemaker it could be a year for healing, and it pretty much was and I don’t fool myself. There may be other things, and there will be such as battery change eventually. I feel so much better that’s all I can tell you is I believe I am a success story. Regardless of the Past year’s ups and downs. Sometimes you may think you just can’t take it anymore but you will. It’s like a salmon going upstream you will get there and when you do I hope you feel like I do.

[Debjimmay in reply to DawnTX]

Wow! What an amazing story. Thank you for sharing. You are a very brave and courageous person. It sounds like you are doing ok now, but you are right, I may have a long road ahead of me. Hopefully I will be strong like you and make it through it all. Again, thanks writing. Take care and be well. 😊