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Suggest Treatment For Arrythmia
Question: Hi LLir Sharka! Hopefully you are doing good!
Can you give me you advice on this matter- another doctor answered, but I dont know if he knows as much as you do about me.
Hello again.
I know ilira doctor have alot of information on me. So maybe all of you can access it too
My question today is heart rythm during exersise
I was walking today and it was a rather long Walk, maybe an hour or so. I am å little ligheaded and i get Even more when walking. Should say that i do have rather low bloodpressure. Anyway. After about 20 minutes walking i get a bit higher heart rate as is normal, but i also then get disturbances in rythm
I get normal rythm and Every now and then i get thumps i will describe as such:
Normal : babam babam babam
But when walking and straining myself å little i get babam babamBAM! babam babam babamBAM!
And those BAM! Actually are hurting a bit.
This is a concern.
They dont feel like the regular ectopics
Also i get tight in the middle of chest and feel weak in the muscles.
I know that ectopics during exercise is bad
So what can this be. . . Made me a little scared and sad that my heart felt almost on the border to fail or go into arrythmia
Asked by Me , 13 hours ago
Doctor's reply to your question above...
Brief Answer:
Palpitations need further evaluation
Detailed Answer:
Hello Sir
After going through the medical details provided by you I can very well understand your concern and I would like to tell you that your symptoms are suggestive of some cardiac rhythm abnormality that can be ongoing transiently.
I went through your old records and came to know that you are dealing with this issue from a long time and need not say that this can be really bothering.
I know that by this time you have had undergone a lot of tests including Ecg's, Echo, Stress testing, Holter monitoring etc with have just shown some ectopics or some short runs of SVT as per your symptom explanations.
Here I would like to bring in picture the role of EPS ( Electrophysiological Study). Probably your doctor might have discussed this diagnostic modality with you as your symptoms are long standing.
This is basically a invasive test procedure in which your heart electrical system is provoked to generate abnormal rhythm so that the culprit pathway can be mapped and then ablated with the help of RFA.
This can be a solution to your problem.
Kind Regards
Dr XXXXXXX partap
Can you give me you advice on this matter- another doctor answered, but I dont know if he knows as much as you do about me.
Hello again.
I know ilira doctor have alot of information on me. So maybe all of you can access it too
My question today is heart rythm during exersise
I was walking today and it was a rather long Walk, maybe an hour or so. I am å little ligheaded and i get Even more when walking. Should say that i do have rather low bloodpressure. Anyway. After about 20 minutes walking i get a bit higher heart rate as is normal, but i also then get disturbances in rythm
I get normal rythm and Every now and then i get thumps i will describe as such:
Normal : babam babam babam
But when walking and straining myself å little i get babam babamBAM! babam babam babamBAM!
And those BAM! Actually are hurting a bit.
This is a concern.
They dont feel like the regular ectopics
Also i get tight in the middle of chest and feel weak in the muscles.
I know that ectopics during exercise is bad
So what can this be. . . Made me a little scared and sad that my heart felt almost on the border to fail or go into arrythmia
Asked by Me , 13 hours ago
Doctor's reply to your question above...
Brief Answer:
Palpitations need further evaluation
Detailed Answer:
Hello Sir
After going through the medical details provided by you I can very well understand your concern and I would like to tell you that your symptoms are suggestive of some cardiac rhythm abnormality that can be ongoing transiently.
I went through your old records and came to know that you are dealing with this issue from a long time and need not say that this can be really bothering.
I know that by this time you have had undergone a lot of tests including Ecg's, Echo, Stress testing, Holter monitoring etc with have just shown some ectopics or some short runs of SVT as per your symptom explanations.
Here I would like to bring in picture the role of EPS ( Electrophysiological Study). Probably your doctor might have discussed this diagnostic modality with you as your symptoms are long standing.
This is basically a invasive test procedure in which your heart electrical system is provoked to generate abnormal rhythm so that the culprit pathway can be mapped and then ablated with the help of RFA.
This can be a solution to your problem.
Kind Regards
Dr XXXXXXX partap
Brief Answer:
I would explain as follows:
Detailed Answer:
Dear Kaj!
I am glad to hear from you again on HCM!
I passed carefully through your question and would explain that it is true that all these palpitations that you have been feeling during physical activity seem to be ectopic heart beats.
But this is not a new issue for you! You have had similar complaints in the past and have performed a lot of cardiac tests to investigate on this clinical situation.
Fortunately your performed cardiac tests have not revealed any serious heart disorder. Besides some isolated extra-systoles (ectopic heart beats and isolated bigemini) no complex cardiac arrhythmia has been noticed.
Coming to this point, it could not be concluded about any dangerous cardiac arrhythmia.
It is true that an electrophysiological study could give more information on the possibility of any additional complex arrhythmia, that has not been possible to be revealed by traditional non invasive tests.
But, from the other side, a provoked cardiac arrhythmia during EPS could not always happen in the real life and vice versa.
So, the more rational approach to address your recent symptomatology would be to prolong the period of continuous cardiac rhythm monitoring by implanting a loop recorder.
In that way, it would be possible to know precisely your heart rhythm behavior in every possible clinical situation during your daily activity (running, sleeping, physical exertion, etc..) for many days to several months.
This test could definitely give the responses to any heart rhythm issues.
Hope you will find this answer helpful!
If you have any other questions, please don't hesitate to ask me again!
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Dear Kaj!
I am glad to hear from you again on HCM!
I passed carefully through your question and would explain that it is true that all these palpitations that you have been feeling during physical activity seem to be ectopic heart beats.
But this is not a new issue for you! You have had similar complaints in the past and have performed a lot of cardiac tests to investigate on this clinical situation.
Fortunately your performed cardiac tests have not revealed any serious heart disorder. Besides some isolated extra-systoles (ectopic heart beats and isolated bigemini) no complex cardiac arrhythmia has been noticed.
Coming to this point, it could not be concluded about any dangerous cardiac arrhythmia.
It is true that an electrophysiological study could give more information on the possibility of any additional complex arrhythmia, that has not been possible to be revealed by traditional non invasive tests.
But, from the other side, a provoked cardiac arrhythmia during EPS could not always happen in the real life and vice versa.
So, the more rational approach to address your recent symptomatology would be to prolong the period of continuous cardiac rhythm monitoring by implanting a loop recorder.
In that way, it would be possible to know precisely your heart rhythm behavior in every possible clinical situation during your daily activity (running, sleeping, physical exertion, etc..) for many days to several months.
This test could definitely give the responses to any heart rhythm issues.
Hope you will find this answer helpful!
If you have any other questions, please don't hesitate to ask me again!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
As always, you are fantastic Sir.
I will talk to my doctor about a loop recorder, even though I am worried about any form of operation!
I know, you are right - i have felt alot of this before, it was just kind of new to me that the heart actually felt irritated when I am active now, and the thumps! or BAM! feel actually painfull.
I would prefer to have these registered and looked at.
But I guess they are probably the same type as you have seen? They just feel diffrent.
Btw. The cardiologist called to say he was sorry to not have listened to me about the last recording that I said to him could be "off" timewise, and the recorder could show wrong time.
You Sir, found it immediately. He did not. And I payed 500 euro for that. So I was dissapointed.
He even said: If you dont feel them, we wont treat them. I answered: Do you really think I would go to cardiologists for YEARS if I did not feel them??
I will talk to my doctor about a loop recorder, even though I am worried about any form of operation!
I know, you are right - i have felt alot of this before, it was just kind of new to me that the heart actually felt irritated when I am active now, and the thumps! or BAM! feel actually painfull.
I would prefer to have these registered and looked at.
But I guess they are probably the same type as you have seen? They just feel diffrent.
Btw. The cardiologist called to say he was sorry to not have listened to me about the last recording that I said to him could be "off" timewise, and the recorder could show wrong time.
You Sir, found it immediately. He did not. And I payed 500 euro for that. So I was dissapointed.
He even said: If you dont feel them, we wont treat them. I answered: Do you really think I would go to cardiologists for YEARS if I did not feel them??
Brief Answer:
My opinion as follows:
Detailed Answer:
Dear Kaj,
I think that exploring the real nature of heart rhythm correspondent to the time you are experiencing palpitations (those BAM thumps) is necessary to give the right answer whether further investigation is advised.
Whether a loop recorder or a prolonged Holter monitoring (a whole week ECG monitoring) it will depend on the frequency of your palpitations.
If they appear after every physical exertion, then sufficient heart rhythm investigation may be provided by just a prolonged ECG monitoring.
Nevertheless, I believe that no complex cardiac arrhythmia are present and your isolated ectopic beats do not deserve any invasive therapy.
You need to discuss with your attending cardiologist on the above mentioned issues.
Kind regards,
Dr. Iliri
My opinion as follows:
Detailed Answer:
Dear Kaj,
I think that exploring the real nature of heart rhythm correspondent to the time you are experiencing palpitations (those BAM thumps) is necessary to give the right answer whether further investigation is advised.
Whether a loop recorder or a prolonged Holter monitoring (a whole week ECG monitoring) it will depend on the frequency of your palpitations.
If they appear after every physical exertion, then sufficient heart rhythm investigation may be provided by just a prolonged ECG monitoring.
Nevertheless, I believe that no complex cardiac arrhythmia are present and your isolated ectopic beats do not deserve any invasive therapy.
You need to discuss with your attending cardiologist on the above mentioned issues.
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I agree.
I will discuss it with my doctor first, and then she will probably send me to a cardiologist.
No its not after physical exercion, its during.
And no, its not every time. It is like I have periods where the heart is more sensitive - and then after that period I can be fine for weeks, with just the ordinary ectopics which doesnt bother me really.
But these "THUMPS" and when the bigeminy and/or the sudden onset of elevated heartrate really bothers me.
I will discuss it with my doctor first, and then she will probably send me to a cardiologist.
No its not after physical exercion, its during.
And no, its not every time. It is like I have periods where the heart is more sensitive - and then after that period I can be fine for weeks, with just the ordinary ectopics which doesnt bother me really.
But these "THUMPS" and when the bigeminy and/or the sudden onset of elevated heartrate really bothers me.
Brief Answer:
I would explain:
Detailed Answer:
Dear Kaj,
I think that a reasonable approach would be to plan a frequent daily physical activity program during one week Holter monitoring.
In this way, it will be possible to have a full information how your heart is going to react and what do those disturbing thumps really signify.
I remain of the opinion that we have to do with just the common episodes of extrasystolic beats.
Regards,
Dr. Iliri
I would explain:
Detailed Answer:
Dear Kaj,
I think that a reasonable approach would be to plan a frequent daily physical activity program during one week Holter monitoring.
In this way, it will be possible to have a full information how your heart is going to react and what do those disturbing thumps really signify.
I remain of the opinion that we have to do with just the common episodes of extrasystolic beats.
Regards,
Dr. Iliri
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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