Adventures in Electrophysiology

So, twenty or twenty-one years ago, I started to tell my parents that something was “wrong with my heart”.  I’d wake up in the morning, sit on the edge of the bed and rub my eyes, yawn and start to stand; if I didn’t gray- or black-out, it was a good day.  The day was even better if my heart didn’t race.  Mom took me to see “Dr. Quack”.  Dr. Quack’s reaction and determination of my complaints was: involved in too many extra-curricular activities, too much caffeine, nothing was wrong, etc.

For eleven years, these same symptoms continued, I told every doctor I saw about them, and yet, nothing.  There was no proof caught on paper for them to think I actually had a problem.; then, in the winter of 2001, while actually discussing the symptoms with a coworker, an episode came on.  A quick run to the doctor’s office, a demand to be hooked up to the ECG machine and an hour later, it was determined that there WAS in fact a problem.  I was diagnosed with AV Node Reentry, went through a cardiac ablation and was “cured”.

Fast forward 2 years, and I started to develop problems again.  My heart started to skip beats, especially at night as I lie in bed attempting to sleep.  After two solid weeks of this, and hardly a wink of sleep during that time, at 1130 PM one night, I broke down.  I was a mass of frustration, fear and tears and asked my husband to drive me to the ER because something had to be done.  The doctors there shot me full of medications to bring my heart rate back to normal, gave me a prescription for the anti-anxiety medication, Ativan, in the smallest dose possible with the instructions to take one every night for 10 nights to “relearn” how to sleep.  It worked great, but what exactly was wrong now?

I got together with my cardiologist, “Dr. Armenia” (cause that’s where he’s from), and was diagnosed with PVCs or Premature Ventricular Contractions.  Dr. Armenia told me it was “no big deal” and put me on medication, Metoprolol and Flecainide Acetate.  Dr. Armenia made me feel like a guinea pig.  He was always asking when I would have children, often discussing how he’d deal with that and my meds to keep these PVC’s that were “no big deal” under control.  His banter about meds and families didn’t bother me at first, because the answer was always “I don’t know if we’ll have children”… and after a while, husband and I decided to not have them.  I told Dr. Armenia this, that I’d decided to pull myself from the gene pool as I felt that it was irresponsible for me to reproduce when I “KNEW” my condition was hereditary.  My husband and I had discussed family numerous times, and ultimately decided that being without children was the best route for us.  Dr. Armenia either didn’t listen or didn’t care, and continued to ask about children and meds, but then he moved to a new hospital.

Enter my new Cardiologist (Electrophysiologist), “Dr. Awesome”.   My first visit with Dr. Awesome was great.  She told me I was too young to be in cardiology all the time, she didn’t like the fact that I was on meds, and she wanted “to fix [me]”.  Music to my ears.  She asked about kids, I said we weren’t having them, she listened!  She looked at all of the data in my HUGE file, and felt that she could fix the problems plaguing me.  We discussed options, and at the time, technology wasn’t advanced enough to handle my situation.  Dr. Awesome knew there were at least three focal points in my heart that were shorting.  She told me about a new 3-D Mapping program that they were starting to use, and would allow them to build a 3-D image of my heart, inside and out, but we might have to wait 5 years.  That was two years ago.

March 8th of this year, I was on week eight of training for a 5K, had started running on the treadmill, not even ten minutes, and felt my heart start to race.  It hadn’t raced like that for years, and after 15 minutes, when it hadn’t stopped, I headed out to the workshop to retrieve my husband.  I didn’t want to have him come into the house hours later to find me passed out or dead.  After a half hour of racing, we were on the phone with the after hours nurse line, then with the UW Hospital ER’s on-call cardiologist.  At the one hour mark of my heart speeding along at over 250 bpm, we were told to head to the ER.  We went in, and finally, after 2.5 hours after it began, I was hit with the paddles to shock my heart back into normal rhythm and was diagnosed with Ventricular Tachycardia (aka VT or VTach).

I was pulled off of the Flecainide Acetate, told to stop running and suppress adrenaline until further notice.  I was told that I would be going through an ablation to destroy the problem area.  And that brings us to today.

Today I had my second ablation.  The ablation was in conjunction with an EP Study.  Dr. Awesome wanted to find out exactly what was going on and where it was going on in my heart.  She explained that there were multiple theories that could explain why and how I went into VT, which was why she wanted to do the EP Study.  My nurses and PAs were great.  I went in with a great attitude, and after a lot of drugs, and 4 hours of Cath Lab time, came out.

I learned, here and there, through my husband, the nurses and PAs and Dr. Awesome, that two focal points were found and ablated (destroyed).  Dr. Awesome was thrilled that she’d be able to come out of the lab and announce that I was fixed.  Done deal or so she hoped.

Dr. Awesome’s team likes to “pressure test” the patients before leaving the lab, and injected a high dose of synthetic adrenaline.  What I have been told is that she stopped counting at 6 focal points that reacted (there are more).  I went into VT, but my blood pressure was normal, high normal, but normal.  I was coherent, the nurse asked me how I was feeling, and I told her I was “gooooood” (with a grin).  I knew my heart was racing, but hey, I was in the perfect place to go into VT.

What else I have learned is that the technician running the 3-D mapping software had NEVER seen a VT episode like what I had: extremely fast heart rate, no irregular heartbeat, a normal blood pressure AND the patient being cognizant of what was going on.  So what does that mean?

So far, Dr. Awesome needs more data to be able to determine what, why and how.  I have to meet with Dr. Awesome to go over all the results  of the EP Study and Ablations.  They are also scheduling another cardiac MRI and I will also have a stress-test.  She firmly believes I will be back to running soon, but she wants to ease me into it in conjunction with a change in medication, a beta-blocker called Nedolol, which she has Tri-atheletes using.  So, more data, more testing, and then a work out regime will be “worked out”.

I have to say that comparing this ablation with my last one, this was 100% better.  I FEEL FANTASTIC!  Yes, I didn’t get “fixed” completely, but, two more spots were zapped.  Yes, six-plus more locations were discovered, but they were discovered by way of a dose of adrenaline that would be highly UNLIKELY for me to produce on my own.  Dr. Awesome told me I was special… but her curiosity it piqued and she wants to FIX ME!  Ultimately, she would like me to be able to stop meds altogether.

Till then, I am still on hold with working out to the extent I had been.  I start my new meds tomorrow, and wait for a call back with my appointment dates.  I also get to go back to work on Thursday!

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About The Amusing Muse

Deep thinker whose mind operates at warped speed. Philosopher pondering the big (and little) things in life. Storyteller. Office Ninja. Model. Teller of bad jokes. User of big words.
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3 Responses to Adventures in Electrophysiology

  1. Pingback: Sunday Morning: Stress is my Nemesis. | musingsoftheamusingmuse

  2. Lila says:

    Hi! What did you feel during the ablation?

    • Howdy! Hmm, it’s been a while since my last one. Because the catheters they use are snaked up through your groin, after getting local anesthetic, you really just feel pressure where the doctors and technicians are cutting, etc. Once everything is placed, including leads, and you’re on all the good drugs, you don’t really feel a whole lot. You’re awake but really mellow. I don’t recall feeling any of the internal goings on, though during my first ablation the monitor for the catheters was in my field of vision so I got to watch them bouncing around as my heart beat and could see my lungs filling and emptying in part of the screen (which got me into trouble because I kept taking really big breaths and interrupting the doctor’s work – they gave me more drugs).

      Afterwards, you have to stay fairly mellow for a few days and just pay close attention to what your body tells you. I was told with my first ablation that I had to lay flat on my back for 10 days, only getting up to eat/drink/use the restroom. I was bored out of skull! After my second ablation, I had to rest well for the first 24 hours and then could slowly ramp back up to my normal activity level over the course of a few days. And well, with a groin that is bruised and sore – it’s easy to take it slow.

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