Have an EP evaluate you

[canyonsister]

I live in the US (I get the sense that many on this forum are in the UK). I had a 21 day event monitor report that said I had all kinds of weird and scary things, like AF, A flutter, PVCs, and even ventricular tachycardia (which can become the fatal ventricular fibrillation!) My regular cardiologist just repeated to me what was on the event monitor report and it scared the heck out of us both! Turns out it was WRONG. Two EPs looked at the EKGs and agreed that I had "aberrant conduction" from ectopics and atrial tachycardia that looked like PVCs and V tach. I don't even have AF...there are P waves buried in there that must be absent for a diagnosis of AF. (I am also a veterinarian so know a bit about cardiology.)

The lesson I learned is to have an EP look at things and don't trust the monitor report. Your regular cardiologist will likely not be skilled enough to sort out very complex EKG readings either.

I am scheduled for ablation in 6 days to zap the very angry little foci causing the problem. Yes, it is very early in the course of things but affecting my quality of life and also what I have is a strong predictor for developing AF later. Recommendations for early ablation over drugs have changed in the last couple of years, so now insurance companies will pay for it without any argument. The biggest worry my EP has is finding the misbehaving spots, so i have to be off drugs, supplements, magnesium, etc. and he plans to do it without any anesthesia (YIKES) in order to have it as irritated and apparent as possible when it is mapped.

I'll be sure to post my experiences post ablation!

[Whatamug1]

All the best - dont you just love EPs.

[RichardE]

Interesting. I've just had quite a similar experience with a regular cardiologist getting quite interested in some 7 day monitor results. Like yours, he found all sorts including : SVT, atrial flutter, VT, and broad complex tachycardia ! However he did say that a 2 lead monitor is a very one dimensional view and referred me to an EP for an opinion.

To be honest I've not been too concerned since I have little in the way of symptoms except when the SVTs kick in, and that's not too often anyway. Indeed the EP wasn't at all concerned with anything other than the SVTs, for which he suggested ablation. I've already considered this but since I can stop them with vagus techniques they don't really affect my quality of life. So I'm avoiding the procedure for now.

But anyway, all the best for the ablation. I'll be interested to hear how you get on as I'm sure this is something that'll eventually come up for me in future

[Zemer in reply to RichardE]

Hi Richard, just see you mention you are able to stop the flutters etc with vagus techniques and wondering if you could say a bit more about that and anything recommended to read or look up?

[RichardE in reply to Zemer]

Hi Zemer.

I’d first off just suggest that you have a chat with your GP and/or cardiologist about this. I believe that the vagus techniques are specifically aimed at helping to control SVTs. So you might need to check with your clinicians that it is appropriate for you to use.

Personally, I use the valsalva method with pretty good success to manage my SVTs. Although after discussions with my cardiologist we also changed the dose of beta blocker I was taking in order to minimise the occurrence of the palpitations.

Arrhythmia Alliance and The British Heart Foundation have some good info on arrhythmias in general and the two booklets below also have some info on vagus techniques too.

Hope this helps,

Richard.

heartrhythmalliance.org/res...

bhf.org.uk/-/media/files/pu...

[Zemer in reply to RichardE]

Thank you Richard, I will have a look at those links. Am checking what I eat, meds etc at the moment to see what triggers it. 🙂

[Kam73]

Canyonsister, I was a wreck thinking about being awake for the ablation but I was in and out. It really was not bad. The only pain I had was the EP trying to get the catheter into my femoral vein...not his fault just my anatomy. A little chest tightness when they ablated and a very warm rear end from the grounding pad. I would do it again without hesitation. I was extremely sick with the PVCs.

[Loversghost]

All the best and let us know how you are

[PattiJay]

Hi Canyonsister!

Good Luck with the ablation! You are right on! I am in the USA too...University of Chicago! the ONLY way to find the culprit is with sedation (but see if you can get something afterward for your 4 hr rest to help you relax--talk about it ahead of time, you MIGHT need it! I had one 2 wks ago and they couldn't find the little SVT pacman and laying there for 3 hrs with attempted ablation, Rt Heart Cath, EP Study...I don't know where my head was after! Had a really FAB wonderful nurse named KIM tho...<3!!!...Anyway back to your ablation....You are SO spot on..having the EP go in there and try to figure out what conduction issues you have is priceless! If he has to do an EP study while he's in there go for it!  I'm going to follow you Canyonsister and pray all goes well! As I tell everyone I have a Medtronic CRT-D (you can actually see it in pic) because I have EXTENSIVE conduction issues-almost complete AV Block-100% pacing. You are very well read about these issues and I am glad you are doing this now instead of waiting for things to get worse. Your advice to others to have an EP eval is WELL ADVISED! GODSPEED HEARTFRIEND!