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What Does The ECHO Report Indicate?
Question: My mother is 62 Yrs. old and she is suffering from Heart problem. Renowned cardiologist has suggested to do EP Study for her. Could you please let me know in detail about EP study. if we do it then is there any after effects or risks?
Brief Answer:
please see details.
Detailed Answer:
Dear Madam
1. I have seen the reports. The ECHO report says that the patient has rheumatic heart disease but all the valvular lesions are mild. The holter study is reported to be normal.
2. I really could not get that why she has been advised EP study from these reports? Did she ever suffered from a heart rhythm disorder like atrial fibrillation, ventricular tachycardia or PSVT?
3. EP study means electrophysiological study. In this study the doctor insert catheters (kind of electrically sensitive wires) through the veins of legs (blood vessels of leg) into the right sides chambers of heart and look at the intracardiac ECG (electrical potentials). At times, give stimulation in form of current to induce various types of rhythm disorders. The primary aim of EP study is to establish the mechanism of heart rhythm disorder.The same procedure may be extended to give relief from various kind of rhythm disorder by burning or coagulating various electrical pathways in the heart.
4. Risks of procedure can be bleeding from the access site. There may be injury to heart chambers but it is uncommon. Procedure specific complications like complete heart block (which may require pacemaker) or induction of fatal or near fatal arrhythmia may occur but it is less than 1% in incidence.
Hope this helps.
sincerely
Sukhvinder
please see details.
Detailed Answer:
Dear Madam
1. I have seen the reports. The ECHO report says that the patient has rheumatic heart disease but all the valvular lesions are mild. The holter study is reported to be normal.
2. I really could not get that why she has been advised EP study from these reports? Did she ever suffered from a heart rhythm disorder like atrial fibrillation, ventricular tachycardia or PSVT?
3. EP study means electrophysiological study. In this study the doctor insert catheters (kind of electrically sensitive wires) through the veins of legs (blood vessels of leg) into the right sides chambers of heart and look at the intracardiac ECG (electrical potentials). At times, give stimulation in form of current to induce various types of rhythm disorders. The primary aim of EP study is to establish the mechanism of heart rhythm disorder.The same procedure may be extended to give relief from various kind of rhythm disorder by burning or coagulating various electrical pathways in the heart.
4. Risks of procedure can be bleeding from the access site. There may be injury to heart chambers but it is uncommon. Procedure specific complications like complete heart block (which may require pacemaker) or induction of fatal or near fatal arrhythmia may occur but it is less than 1% in incidence.
Hope this helps.
sincerely
Sukhvinder
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Thanks a Billion Doctor!!
Yes she went from Heart Rhythm disorder. I remember it is atrial fibrillation . In last 28 th October she has suffered first time from this and that time she was in USA. US doctors has given some shocks to make rhythm in order. After October , on 28th November she suffered the same again. She got much treatment in XXXXXXX Since January onwards she is fine in XXXXXXX and not experienced this. But she became very weak and her energy is down. She exercise daily like walking for 1 hr and cycling for 10 min. What you suggest for betterment of her ? Do you suggest replacement of Xarelto tablet - Blood thinner?
Yes she went from Heart Rhythm disorder. I remember it is atrial fibrillation . In last 28 th October she has suffered first time from this and that time she was in USA. US doctors has given some shocks to make rhythm in order. After October , on 28th November she suffered the same again. She got much treatment in XXXXXXX Since January onwards she is fine in XXXXXXX and not experienced this. But she became very weak and her energy is down. She exercise daily like walking for 1 hr and cycling for 10 min. What you suggest for betterment of her ? Do you suggest replacement of Xarelto tablet - Blood thinner?
Brief Answer:
please see details
Detailed Answer:
Dear Madam
1. As per the details mentioned by you, she may be suffering from paroxysmal Atrial fibrillation (AF).As per ECHO report, she has enlarged left atrium (56 mm)
2. As per literature, Ablation of AF (EP study followed by burning of certain areas of heart) can be attempted in patients with paroxysmal AF, however mostly such patients are young and free of structural heart disease. People have tried ablation of AF in presence of rheumatic heart disease with variable success. However in presence of enlarged left atrium, this may not work well.
3. I do not advise EP study to my patients with AF with underlying rheumatic heart disease with mitral valve disease with enlarged left atrium. My advice on this issue will be to take a second opinion preferably from a medical college.
4. Xarelto or rivaroxaban is a blood thinner which is approved for patients of AF who do not have valve disease. It is not approved for patients with rheumatic heart disease with mitral valve disease with AF. You can see more details at https://www.xarelto-us.com. But do not stop or change this medication on your own without consulting your cardiologist. Needless to say this requires a second opinion and modification of her drug therapy on priority.
Sincerely
Sukhvinder
please see details
Detailed Answer:
Dear Madam
1. As per the details mentioned by you, she may be suffering from paroxysmal Atrial fibrillation (AF).As per ECHO report, she has enlarged left atrium (56 mm)
2. As per literature, Ablation of AF (EP study followed by burning of certain areas of heart) can be attempted in patients with paroxysmal AF, however mostly such patients are young and free of structural heart disease. People have tried ablation of AF in presence of rheumatic heart disease with variable success. However in presence of enlarged left atrium, this may not work well.
3. I do not advise EP study to my patients with AF with underlying rheumatic heart disease with mitral valve disease with enlarged left atrium. My advice on this issue will be to take a second opinion preferably from a medical college.
4. Xarelto or rivaroxaban is a blood thinner which is approved for patients of AF who do not have valve disease. It is not approved for patients with rheumatic heart disease with mitral valve disease with AF. You can see more details at https://www.xarelto-us.com. But do not stop or change this medication on your own without consulting your cardiologist. Needless to say this requires a second opinion and modification of her drug therapy on priority.
Sincerely
Sukhvinder
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Above answer was peer-reviewed by :
Dr. Pradeep Vitta
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