New tachy-brady diagnosis

Hi all,

I don't really know what to say, I feel a bit overwhelemed.  I was just diagnosed with tach-brady syndrome which was a shock.  I've had heart palpatations since my mid teens, I'm 37 now.  I just mentioned the palpitations to my pcp because I've lost a lot of weight and have been feeling anxious lately. The weight loss was intentional, I was 460 pounds now to 260. I wore an event monitor for a month but the cardiologists office called after a week telling me I needed to see an EP.  I did that yesterday.  On the whole it went well, he said it needed to be watched but for now no changes needed to be made and he said I need an echo to make sure he's not missing something.  I physically feel good but I'm really scared.  I've had major depression and GAD for all of my adult life but this is the first physical ailment.  I don't even have a pacemaker yet, I guess I'm just looking for shared expirence.  I've had an increase in panic attacks over the last five months and now I'm wondering if what I thought was panic is actually related to my arrhythmia. 



by AgentX86 - 2019-07-25 11:08:30

First, let me congratulate you on your progress. I know how hard it is, though my loss wasn't quite that extreme.. Keep up the good work. Now you know that you can do it.

Yes, the tachy part of tachy-Brady can easily be mistaken for a panic attack. Even an ER doctor could easily miss it. They only see a sliver of your life and tachy-Brady can't be diagnosed in one encounter. Given your history of weight and loss of same, I think you need both a cardiologist and an EP working together to make sure you're getting the proper care.

Don't worry yourself into more problems than you already have. This is going to be a pain in the ass but if you get competent care AND FOLLOW IT, this problem is unlikely to become worse than a PITA.

Keep up the good work!  And please find the best doctors that you can. This arrhythmia stuff isn't trivial to fix (and sometimes all that can be done is to manage it).


by theweeze - 2019-07-25 17:07:00

Thank you for your reply, I appreciate it.

This may sound like ignorance but I am new to this: How does one go about finding the best doctors?

Moreover, do you have any recommendations about the sort of questions I should be asking?  I feel like I know nothing.  My EP asked if I had any questions but it occured to me at home that I had no idea where to even begin.

Thank you for your time.

What to ask

by Gotrhythm - 2019-07-25 17:59:50

First of all, I would want the know the numbers. Tachy-brady means sometimes the heart is beating too fast, sometimes too slow. What was the highest rate? the lowest? For how long? How many episodes?

I would want to know what, exactly, was being "watched" and what would need to change for it to be time to do something. But then, the more data I can get, the better I understand, the less anxiety I feel.

I can't prove it, but I can tell you this. I think I had tachy-brady for years. It wasn't diagnosed because I was so obviously healthy and my heart was obviously healthy, and the episodes were widely spaced in time. But boy, did I run into doctors trying to tell me I had panic attacks!

In fact it wasn't diagnosed until the brady part became dominant and pretty much alll the time. Even then I sometimes had a "normal" heartrate.

I know you don't feel like tachy-bardy is good news, but I wish I had been diagnosed at your age. So many things would have been clearer, and, with a pacemaker, easier to deal with.

Good for you, dealing with your weight. Changing your life that much isn't easy.

Thank you

by theweeze - 2019-07-25 20:45:18

Seriously, thank you for the information.  It's amazing how many things are waved away by doctors as anxiety.

Basically the EP told me that nothing needed to be done right now.  I have pauses up to three seconds and short runs, 6-7, of tachycardia.  I go back in six months but I'll try to contact him before to get some more information.

Best doctors

by AgentX86 - 2019-07-25 23:14:31

That can be a problem.  I happened to find a really good PCP who was well connected.  He referred me to really good specialists.  He's since gone into concierge medicine to avoid Obamacare BS, so we lost him as our PCP but have retained the excellent specialists.  Another good way to find the best, locally anyway, is to ask nurses in the hospital something on the order of "Who would you bring your husband to if he were having _____?". I say a "hospital nurse" because they see them all and aren't usually financially connected to the doctors.  Also, if you're going to have a procedure, make sure the surgeon has done this procedure many, many times.  My heart surgeon did over 350 bypass surgeries each year.  Also be sure that the doctor is a member of the society that covers that specialty.  For EPs, that would be the Heart Rhythm Society, I believe.

Doctors seem to be reluctant to tell patients that they "don't know".  They're supposed to know everything, after all.  If they don't know, there seems to be a need to make something up.  They should be directing you to someone who can find out, though.

Three second pauses aren't scary.  I had that sort of pauses for a few years and it wasn't worrying my cardiologist at all and my EP never even mentioned it.  The "tachy" end of my tachy-brady wasn't much of a "tachy" either but it wasn't right - for me (90ish bpm).  The Brady part was pretty much a constant (38-50bpm) except then in flutter.  The eight second asystole is what bought me my pacemaker, though.

It sounds like your EP has things well in hand, at this point.  Relax and follow his instructions exactly.  If you're comfortable with him, I don't see any reason to change horses now.

Thank you

by theweeze - 2019-07-27 23:40:58

Thank you both for sharing your experience, I feel like I have a much better idea of what to expect.

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