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Suggest Treatment For Painful And Distressing Arrhythmias

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Posted on Wed, 14 Oct 2015
Question: I wore an event recorder for a month, and the painful lurching feeling I get in my chest correlated with sinus arrhythmia, sinus bradycardia, sinus tachycardia, premature atrial contractions, premature ventricular contractions, and ventricular couplets. My cardiologist told me these were normal arrythmias, and an anesthesiologist friend who views a lot of patient hearts beating real-time stated it can be good to have arrhythmias such as I have because it indicates favorable heart rate variability. If there are any cardiologists out there reading this, here is my question: Since these arrythmias only occur when I am exposed to high levels of toxic mold or electromagnetic fields, are painful and distressing and make it hard to function, and can occur as many as 15-20 times per hour, are there instances such as mine where these types of arrythmias are problematic?
Medical history: Lyme Disease, mycotoxicosis (toxic mold poisoning). Echocardiograms do not indicate carditis from Lyme Disease. CRP and sed rate labs very favorable. Mold mycotoxins can cause demyelination and arrhythmia.
I am not able to take beta blockers to stabilize heart rhythm because my blood pressure is naturally low.
doctor
Answered by Dr. Prasanna Heijebu (8 hours later)
Brief Answer:
Get an EP study.

Detailed Answer:
Hello, Sir.

I understand your concern.

I have gone through your query in detail.

The arrhythmias in your case need treatment since they are producing distressing symptoms.

Many a times, an excitable ectopic focus in heart conduction system is responsible for producing these arrhythmias.

These arrhythmias cannot be considered normal always.

I advise you to get an EP study(electrophysiological studies) of the heart to identify this focus.

Once identified, RFA (radiofrequency ablation) can be done with great success.

Beta blockers cannot be taken in the presence of low blood pressure.

Update me test results.

Post your further queries if any.
Thank you.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Prasanna Heijebu (6 hours later)
Thank you Dr. XXXXXXX

Would you surmise the arrythmias I experience only require treatment because of subjective distress they cause, or is it possible for them to produce other potentially dangerous arrythmias or cardiological problems?

I am fairly certain I cannot undergo RFA treatment, since RF radiation is one of
the things which causes these arrhythmias for me. If I cannot undergo RFA treatment, would there be benefit to getting an EP study done?

Again thank you so much.

doctor
Answered by Dr. Prasanna Heijebu (4 hours later)
Brief Answer:
EP study can gauge the outcome of benign arrhythmias.

Detailed Answer:
Hello, Sir.

I understand your concern.

EP study and 24 Holter ECG can accurately assess the future outcome or complications of the benign arrhythmias.

EP study can accurately determine the ectopic foci at various zones of heart.

RFA is actually curative in treating arrhythmias.

To conclude, EP study can assess the ectopic foci and their potential outcome.

Thank you.






Above answer was peer-reviewed by : Dr. Neel Kudchadkar
doctor
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Follow up: Dr. Prasanna Heijebu (23 hours later)
Thank you very kindly Dr. XXXXXXX I am impressed with your cardiology knowledge as a general and family physician. I will give you a good commendation on here.

When you are saying an EP study or 24 Holter ECG could accurately assess possible future outcomes of these arrythmias, would the ECGs that were captured every time I recorded an arrhythmia event during my month wearing an event recorder be able to be used to assess possible future outcomes? They did capture ECG readings during each arrhythmia I had.

I understand RFA is used curatively in treating arrythmias, but I have a concern such treatment could worsen my condition or cause new arrythmias, since RF exposure causes them in the first place in my case. If I get burned every time I stick my hand in a fire, it's hard for me to see the logic in putting my hand in the fire again to treat the burn, if that makes sense.
doctor
Answered by Dr. Prasanna Heijebu (1 hour later)
Brief Answer:
EP study can help to pick up the right kind of antiarrhythmic agent.

Detailed Answer:
Hello, Sir.

I understand your concern.

Yes, even an Event recorder can assess and capture the arrhythmias.But the results are less sensitive.

Whereas EP study(even more than Holter) can accurately assess the location as well the future outcome of these arrhythmias.These results are much ore reliable.

Coming to treatment, if you are apprehensive of using RFA, I advise you to go for antiarrhythmic agents. Now new drugs have emerged with good tolerance.


The exact antiarrhythmic agent can be chosen, once again based on the report of EP study only.


Post your further queries if any.
Thank you.


Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Prasanna Heijebu (2 days later)
Thank you Dr. XXXXXXX I just got an email from you checking up on me. I appreciate all your insights here. I have a call in to my cardiologist to discuss some of these things. In EP studies do they essentially put a catheter in you running to your heart, put radioactive XXXXXXX in it, and administer different types of beta blockers and other drugs to assess your response to them?
doctor
Answered by Dr. Prasanna Heijebu (12 hours later)
Brief Answer:
EP study involves cardiac catheterization.

Detailed Answer:
Hello, Sir.

I understand your concern.

I apologise for the delayed response.

Yes, EP study essentially involves insertion of one or more catheters and administration of various drugs, both proarrhythmic and antiarrhythmics to assess the response of heart rate.

This procedure does NOT involve administration of radioactive XXXXXXX

In an attempt to detect the abnormal focus, the procedure can last several hours in a XXXXXXX lab.

Post your further queries if any,
Thank you.






Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Prasanna Heijebu (38 hours later)
Thank you Dr. Prasanna! I will close out this conversation thread and give you a good rating and commendation. If I wanted to contact you specifically again on this website, how do I go about doing that? You have been very helpful.
doctor
Answered by Dr. Prasanna Heijebu (8 hours later)
Brief Answer:
You can contact me via DIRECT QUERY option.

Detailed Answer:
Hello, Sir.

I apologise for the delayed response.

Thanks for your feedback.

In case if you want to contact me again on this website, you can post your query directly to me either through the email sent to you by HCM on my behalf or through a quick search for my name in the search for doctors option on this website.

A direct query will be posted to me instantly.

Thank you.

Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Prasanna Heijebu

General & Family Physician

Practicing since :2010

Answered : 1422 Questions

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Suggest Treatment For Painful And Distressing Arrhythmias

Brief Answer: Get an EP study. Detailed Answer: Hello, Sir. I understand your concern. I have gone through your query in detail. The arrhythmias in your case need treatment since they are producing distressing symptoms. Many a times, an excitable ectopic focus in heart conduction system is responsible for producing these arrhythmias. These arrhythmias cannot be considered normal always. I advise you to get an EP study(electrophysiological studies) of the heart to identify this focus. Once identified, RFA (radiofrequency ablation) can be done with great success. Beta blockers cannot be taken in the presence of low blood pressure. Update me test results. Post your further queries if any. Thank you.