appt with the ep

I posted a couple weeks ago with trying to make the decision on getting a pm or not for 2nd degree heart block when I exercise. I went to the ep yesterday who said that this won't get better on its own and he would recommend the pm. Though its not a dangerous arrhythmia its more a quality of life issue. Then he wanted to do a stress test just to see it in action. Of course the block didn't happen even though it happens pretty much everytime I exercise...very frustrating...After seeing it he felt that maybe it wasn't as bad as he thought and thinks I should wait a couple months in case it improves. I don't understand how all my previous cardiologists/ep's said it will only get worse, yet I should now wait a couple months to see if it gets better? I start nursing school in september, so I was really leaning towards getting it this summer so I'm not dealing with recovery during nursing school...Anyways, though he would rather wait, he is willing to do it sooner and I'm supposed to call him next week after I've thought hard about it with my decision. I'm just really confused and keep going back and forth on what to do so I was hoping to get some of your opinions...My parents think I should wait, but I'm tired of not doing things (dropping out of volleyball tournaments, not playing soccer, etc). I prob won't have time to be really active during school so then it won't really bother me, but I still want to have the option of being active if I wanted to since I have been my whole life...
Thanks for your help,
Melanie

4 Comments

holter results

by wmelanie - 2010-07-08 11:07:54

yes they caught in on a holter but when I asked him how long I was in the block he said 4 seconds or 3 seconds...but when I'm exercising, it drops from 150 to 50 and stays down there long enough to take my pulse and know its down that low. I even made my dad go on a bike ride with me today so that when it happened he was right there and could feel my pulse. Of course it dropped and he felt it and it took a couple minutes to jump back up. I don't understand then why it only showed up on the holter for a few seconds. I know when I was wearing it it stayed down a lot longer than that...maybe I'm just misunderstanding what exactly the heart block is?

frustrated

by Tracey_E - 2010-07-08 11:07:55

How annoying that your heart behaved on the treadmill!!! Have they done a holter to see how much time you stay in block over a longer period?

Blocks come and go (that's why it's 2nd degree and not 3rd degree), but they do not go away, they almost always eventually progress. If it's keeping you from doing what you want to do, I would get it now while the timing is convenient. I knew from my teens that I would eventually need one but I stalled and procrastinated until it was an emergency. Not the easiest way to do it!

If you know you will need it eventually, what's another year one way or the other?? Dr's don't like to put them in young patients, but having been a young patient with drs who wanted to wait simply because of my age, I think that's really stupid logic. We're too young to feel old, why live with feeling bad when there's a cure? Once I got it and was able to be active, I really resented that no one pushed me to get it sooner. I was afraid of the unknown and my dr didn't want to do it when I was "too young" so I missed out on a lot of fun. That was 16 yrs ago. Looking back, it wouldn't have made a darned bit of difference if I got it at 23 or 24 instead of 27, except those years would have been spent feeling a lot better than I did.

Your parents understandably want to wait, they're parents so it's their job to worry about you. I think your dr has faulty logic (my nonprofessional opinion, of course, lol). Go with your gut. If there are things you want to do but your heart is holding you back, it's pointless to wait. If now is more convenient than after you start school, I agree with you that now's the time to do it. Recover at your leisure and start school in high gear and feeling your best.

If you have any questions about the surgery, recovery or living with a pm, please don't be shy.

Heart Block

by SMITTY - 2010-07-09 01:07:27

Hi Melanie,

What is heart block?

Let's start with basics. (If what I'm say here insults your intelligence, please accept my apology.) Our heart has an internal, or native pacemaker. This is a "spot" in the heart where an electrical impulse is generated. This impulse travels down a designated pathway to the atrial where it causes this chamber to contract which in turn pushes blood from the atrial into the ventricle. The impulse pauses for a few milliseconds while the blood transfer from the atrial to ventricle is completed. Then the impulse goes on to the ventricle where it makes it contract so the blood can then be pushed from the heart into the far reaches of the body. Sometimes the impulse from the antral to the ventricle is impaired or doesn't transmit. This is "heart block" or "AV block." This does not mean that the blood flow or blood vessels are blocked.

Heart block is classified according to the level of impairment — first-degree heart block, second-degree heart block or third-degree (complete) heart block.

You say you have second degree heart block and since there are two types I'll include a description of these which I got from an article on heart blocks.

Type I second-degree heart block. Electrical impulses are delayed more and more with each heartbeat until a beat is skipped. This condition is not too serious but sometimes causes dizziness and/or other symptoms.

Type II second-degree heart block. This is less common than Type I but generally more serious. Because electrical impulses can't reach the ventricles, an abnormally slow heartbeat may result. In some cases a pacemaker is needed.

Since Tracey has already given you lots of good information on this subject I'll stop here as I would just be trying to repeat some of what she has said.

I wish you the best.

Smitty

holter

by Tracey_E - 2010-07-09 10:07:47

The holter is telling them how many seconds you're in block, it sounds like it's taking longer than that for your hr to recover. The pm will help you two ways- when you go into block it'll make sure your ventricles don't miss any beats, and it can be programmed to prevent your hr from suddenly dropping off. I have that problem also, in addition to the block sometimes my rate would plummet briefly during exercise. We didn't even know about the plummets until I got the pm and the block was fixed, my block masked it. They simply adjusted my settings and now I'm good to go. And go and go and go Sitting still isn't my forte :o)

It is hard on your body when you are exercising and your rate drops off like that. I'm not a dr so take my advice with a grain of salt, but I would take it easy until you decide what to do about the pm, don't put yourself in situations that bring it on. I'm glad you were able to show your dad what's happening. Seeing it should help him get why you may not want to wait.

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