Getting referred to a electro cardiologist

An EP electrophysiocardiologist can help you

by Gotrhythm - 2022-07-13 14:01:06

I know you are in shock to have all this thrown at you when you thought you just needed an adjustment in your meds. You didn't know your heart had developed a new problem. Lots of us have been where you are now. It takes a while to wrap your head around all you've been told.

The good news is that you have been referred to an electrophysiocardiologist. Most of us call it an EP for short. That's the kind of doctor who can help you now.

See if you can figure out what your questions are and ask them here one at a time. Someone will try to help with the answers.

What’s going on?

by Gemita - 2022-07-13 16:19:26

Cadaverock, Just more of the same is going on.  Instead of second degree block and a slow heart rate, your electrical disturbances seem to have progressed to include ?atrial flutter and ventricular tachycardia?  Unfortunately that is the nature of electrical disturbances.  They tend to progress, particularly in the presence of other health conditions, one of which could be any uncontrolled hypertension. High blood pressure can lead to an arrhythmia even in the absence of heart disease.  I have arrhythmias without a cause although there are plenty of triggers (another subject).

High blood pressure and a sense of fluttering in the chest can occur due to electrolyte imbalances or heart rhythm disorders (arrhythmias). These symptoms can also occur due to temporary conditions like stress reactions, anxiety, panic attack, or excessive caffeine consumption..

From your comments it appears you are only getting palpitations once in a while which would still be good news and that your Atrial Flutter (flutter sensation) although scary, lasts for only a few seconds.  If my understanding is correct, you are also getting VT (ventricular tachycardia) which would be more concerning, although it depends on whether it is sustained (lasting more than 30 seconds) or non sustained (lasting less than 30 seconds and in most cases lasting for only a few seconds).  This would appear to be the main reason for your referral to an EP (electrophysiologist) who will decide how to treat this and your atrial flutter.  He might suggest an anti arrhythmic as well as a rate control medication, like the beta blocker you are on, or an ablation.  They usually try medication first, although an ablation is more effective.

I am assuming they have checked your thyroid and have ruled out other conditions like sarcoidosis as a cause for your ventricular tachycardia?  I would definitely ask during your forthcoming appointment.  I hope for the very best for you

A vts?

by AgentX86 - 2022-07-13 17:59:09

Are you sure that it doesn't say "SVTs"? Ventricular tachycardia is really serious stuff so I'm sure he'd be a lot more concerned. SVTs, or SupraVentricular Tachycardia, is something to be somewhat concerned about but it's rarely all that serious. It's rather like Afib or Aflutter. It can often be controlled by meds. The key is to lower the heart rate  (under 100bpm) and anticoagulation (blood thinners) in many cases.

The big hint for me is that he's suggesting that you're a candidate for an ablation. This is a pretty standard procedure for SVTs but would be unheard of for Ventricular tachycardia.

Seeing an EP us exactly the right thing to be doing right now. I know it's hard but try to relax. You're going to be fine.

My wife was all upset about being referred to a  cardiologist (mine ;-) for a 1st degree block. I told her to forget it. After what I've been through she was scared. She saw the cardiologist and her didn't even mention it. When specifically asked about it, he just waved his hand and said, "so what?".

EP

by Lavender - 2022-07-13 18:44:38

I had a complete heart block as I was being brought out of general anesthesia following gallbladder removal.  No one referred me to an electrophysiology cardiologist because they thought it was Mobitz (Wenckebach). The cardiologist said it was ok. 
 

Meanwhile my fainting episodes started within the year and it took another six months for me to finally be referred to the EP who installed my CRT-P device. I did confront the cardiologist for not referring me sooner. It would have saved me from developing fear of leaving my house and anxiety about sudden drop attacks. 
 

The EP fixed me up. Wish I had met him sooner. Nothing to lose to let them check you. 

AgentX86

by Gemita - 2022-07-14 04:29:47

I believe you are correct.  SVT (supraventricular tachycardia) sounds more likely.  If the statement "patient has a vts hard to control" was referring to VTs (ventricular tachycardias), Cadaverock would certainly know about this and his doctor would be acting faster to treat with meds and an ICD I would think.  

Why do you say a VT ablation is unheard of?  I see they do them in some cases to help control the arrhythmia and where they find extra electrical pathways 

VT ablation

by AgentX86 - 2022-07-14 11:08:00

My EP told me that ventricular ablations were quite dangerous.  It's hard(er) to get to the LV.  Insead of using the femoral vein, the femoral artery is used. The catheter has to be threaded up the femoral artery, through the aorta and backwards through the aortic valve. This the higher pressure of the femoral artery can cause more probelms with hematoma but going through the aortic valve, uphill, may be a problem and much harder to fix.  The atria and even RV are dog simple comparitively.  I don't know if they can use the radial artery to access the LV, as they do with a heart cath, which would be somewhat simpler but the aortic valve is still in the way. A ventricular ablation is essentially cutting away pieces of your hearts main pump, which may well come back to bite you in the future. Some damage to the atria isn't a big deal. They don't pump anything and at a low pressure.

Ventricular ablations aren't unknown, just very unusual. The normal treatment for VT/VF is drugs and/or an ICD.

Absolutely baffled

by ROBO Pop - 2022-07-16 17:00:03

I just don't get it. You've had a pacemaker since 2007 (15 years) and in reviewing your posts I see you've been a member of this group for a number of years, yet in reading your most recent posts you don't seem to have even a basic understanding of your drvice and your heart condition. More importantly, by your own words it's obvious you are alienating the very medical team trying to help you... what gives?