EPS needed prior to PM implant ?

Yes!

by AgentX86 - 2018-09-11 12:22:56

An EPS will tell you nothing that you don't already know. Your heart is stopping. Every day you fart around hoping for some fool to give you the answer you want to hear is another day you're asking to die. Get the pacemaker or die. Your choice.

more tests

by Tracey_E - 2018-09-11 13:22:07

I'm on my 5th pacer and have never had an ep study. I've never even had a nuclear stress test, though I've done a treadmill stress test lots of times. It provides information, yes, but nothing that we need in my case to treat what's wrong with my heart. In your case, the event monitor told them all they need to know, that your heart goes too slowly sometimes, and sometimes it stops. Nuff said. You could have every test out there and it's not going to shed anymore light on what's going on and the fix is still going to be a pacer. 

The echo and stress test both show the heart structure and how well it functions. Our problems aren't structural, they are electrical, so it's not surprising they came back normal. Normal hearts with wonky electrical systems, that's us! It's good to have those two so they know if there's anything else going on.

You want an ep not a cardiologist doing your implant. Ep's are cardiologists that only deal with electrical systems.  Think of a general cardiologist as more of a plumber. If the ep thinks the study is needed for further diagnosis or to decide on a pacer, they will do it before the implant, but the event monitor should tell them plenty.

Some of us it's structural...

by BOBTHOM - 2018-09-12 00:11:19

For some of us it is structural.  My entire left ventricle is basically scar tissue so it doesn't bend/flex to properly pump blood.  Along with that scar tissue also doesn't conduct electric current the same way.  But in your case, since the tests came back normal, it does appear to be purely electric and the PM should be of great help to you.

Structural

by AgentX86 - 2018-09-13 09:01:41

Yes, the problems are all structural, at some level, whether a section of the heart isn't working (e.g. SSS or AV block), parts of the heart don't conduct electricity well  (your scar tissue), or too well (my Maze scar tissue). That's why EPs are cardiologists first. However,  in most cases these structural defects wouldn't be a problem in themselves,  without the electrical problems they cause. It's a good idea to have both a cardiologist and an EP on your team because the problems go together.

Pauses and EPs

by Gotrhythm - 2018-09-15 13:04:39

It sounds like you're not really sure you need a pacamaker. Even though your heartrate is 60 which is considered normal, that many pauses indicates a rhythm problem. Based on my experience I would say if you think you even might have a rhythm problem and need a pacemaker, there is no reason not to go to an EP.

EPs are cardiologists who specialize in heart rhythm (the heart's electrical system.) An EP can do everything and order every test a cardiologist can. Although all cardiologists theorectically can implant pacemakers, EPs have much more experience. They also are more aware of the fine points of the different makes and models of pacemaker which will help them choose the best one for you.