Atrial tachycardia episodes, are they normal?

Just had my first visit with my new EP, although she kept saying she is technically an "engineer" not a tech (still not sure what that means).  Anyways she did a much more thorough interrogation then my prior tech, seemed to know her stuff. She said I have been having "quite a number" of atrial tachycardia episodes.  I told her I had some in the past and that my old tech said it was normal in people paced in both ventricle and atrium, she looked like she disagreed when I tried to get more information out of her she politely shut me down and said the doctor will go over it (in other words I'm not allowed to tell you what I see because the hospital doesn't want me to get them sued).  Any information on this would be helpful.  Additional info: familial history of AFIb, I have complete heart block as a result of an infection and surgical complications, 100 percent paced in ventricular, paced about 15 percent of the time in atrium.


3 Comments

EP? Doctor?

by AgentX86 - 2020-06-19 23:51:19

I'm a bit confused.  You said she was an EP, then the "doctor will go over...".   EPs are doctors, in fact cardiologists with two more years of residency in eletrophysiology.

AT is not normal, pacemaker or not.  If you've been having a lot of episodes, it needs to be taken care of. Long term, high heart rates are dangerous.  You probably should be on a beta blocker, at least, but I'm not a doctor either.

There really isn't enough information to go on here.  I can understand that if she is a PM tech, she's not allowed to tell you what she's found.  However, if she is an EP, I have no idea why she couldn't say anything. 

Yeah I was confused too...

by asully - 2020-06-20 00:02:23

I have never actually had an EP.  When I scheduled the appointment it said it was with an EP.  When she introduced herself I asked her if she was the EP or a pacer tech, she said neither, that she was an "engineer" (I had never heard that before). I asked her what that meant and she said it means she has a PHD.  She seemed annoyed so I didn't ask more.  I do not think she is an EP,  I think maybe she is a tech but with more education?

Normally I ask for full print outs of my interrogations, but as it was my first appointment I didn't want to come across as a pushy patient.  So not sure how many episodes I am having.  She did say most were for less than a minute.  I have had these show up on past interrogations about two years ago, about 5 in a one month period, cardiologist in Seattle told me it was normal with a pacemaker.  More concerned now that it's happening again.

Problems start when we deviate from best-practice

by crustyg - 2020-06-20 09:52:09

I can understand your desire not to be the awkward patient, but the only person who loses here is you.  For very good reasons you usually take away your interrogation reports, now you're in the dark.

I can understand that the session got off to a difficult start with the response to your perfectly valid question EP (doc)? or pacing tech? - the touchy response probably wasn't your fault.  If she's insecure about her intermediate position (a Doctor but not a Medical doc, more than a pacing tech) that's not your fault, and her inexperience comes across loud and clear.  We PM patients have a lot invested in our devices, and the experienced staff understand and respect that (where we've shown an interest - not everyone does).

In your situation I would be pushing to get back to your EP doc - let his team know that you'll be expecting to pick up the reports from your last interrogation - because, as AgentX86 says, this is not normal.  If I understand correctly, your acquired CHB actually protects you from the biggest risk of prolonged ATachy (SCD due to overdriving the ventricles), but the longer you can keep some form of A=>V synchrony the better for your cardiac output.  Once you're in sustained AFib, life becomes more complicated.

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