reality ain't what it used to be

Cardiology wanted their monitor back this morning and I was surprised when I was asked to sit so they could get the preliminary results from the 48-hr ECG. They were looking for significant events and they immediately found them. In general, they found a number of instances where my heart stops beating for a couple seconds, but one reading was as high as 5 sec. These were ostensibly during sleep, but could also have been when I was trying to get back to sleep (eg., 2:30 am). This was enough to have a cardiologist read the printouts, which do a mighty fine summary of their own. There were multiple instances of SVT anomalies, to wit: speeded up areas (in the heart above the ventricles) and a number of instances where the heart slowed down in the ventricles. This condition is called tachycardia/brachycardia and is difficult to treat because one wants to slow down one area of the heart while speeding up another. And most medications are too general for that. For example, the attenolol, a beta blocker, that I have taken for 28 years has the effect of slowing the heart, so that while that is good for the supra-ventricular regions, it's contrary to the speeding up needed in the ventricles. Can you say Pacemaker? But wait.

First we are going to see whether simply dc'ing the attenolol allows the ventricles to speed up some, without the SVT going beserk, This would be the best outcome, and we will explore that first. So, no more attenolol. It will take 4-5 days to clear the system and I will go back on the Holter monitor to see what the undrugged heart looks like. I am to watch for palpitations, flutters and the like. Normal activity; no working out (doh!). Trumpet okay, nothing above a high C the doc said and smiled.

It appears as though the ventricular slowing is happening primarily at night, so I am at low risk of passing out during the day. Therefore we take this first step and if successful outcomes, then no pacemaker. If not, and the SVT area speeds up and has its own anomalies, then it may be an ablation study where they check for the electrical path causing the SVT anomaly and burn it out. Good outcome, still no pacemaker,  Otherwise, pacemaker.

Ya learn something new everyday...