Invasive electrophysiological study

Hi everyone :)
I first posted in December as I waa told I needed a pacemaker, your advice and stories were very reasuring.
Ive since had a 7day monitor and again my heart is dropping beats, ive not fainted again but feel faint frequently.
Im going in hospital on 5th march for an invasive electrophysiological study and possibly pacemaker. Im absolutely frightened to death.
He has said im showing signs of AV block type 2 but its very unusual for someonebof my age, im 35? When I have googled it it says you can be born with it?
Im seeing my consultant on the 3rd have so many questions for him. Can anyone tell me what its like? during/after an invasive electrophysiological study? Will I be staying in? Coming home? I have a 2and a 4 year old who keep me very busy but am I going toneed lots of help? Thanks sasha

10 Comments

Reason for EP study

by WillieG - 2015-02-12 07:02:02

I had an EP study to determine which type of 2nd degree heart bock I had. If the block is 2:1, it is not possible to tell from the EKG strip if it is Mobitz I (which usually do not require a PM) vs. Mobitz II, which can advance to 3rd degree heart block. With Type I, the EKG shows the PR interval getting longer and then you skip the QRS wave. For Type II, you don't see the progression, it is just skipped. During the EP study, they determine the exact location of your block. If it is in the AV node, it would be Mobitz I and you might not need a PM. If it is below the node in the Bundle of His (where my block is located) they put in a PM as they say the disease is unpredictable and can advance without warning.

I am not a doctor and this is my understanding after months of reading. Hope this might help understand why they want you to have the study. The EP study was not unpleasant. I was drugged and felt nothing! Was surprised to wake up with a PM, but they seemed to think was necessary. Am not convinced I need it with zero pacing, but time will tell.

~ Wilma

why the study

by Tracey_E - 2015-02-12 09:02:45

If you already know why you feel faint and have a diagnosis, why bother with the ep study? They aren't that big a deal and they can be very useful when you have arrhythmias, but confirming av block, imo, isn't useful.

Most of us have no idea why we have av block. I was born with mine,it was found by accident when I was 5 and I have been paced since I was 27. It's possible to be born with it but go undiagnosed for years because you'd only find it if you were on an EKG when you were in block, or if you had symptoms bad enough to warrant tests. Most young people never have reason for a cardiac work up and it's possible to be asymptomatic for years. Some infections can cause it, some medications can cause it, but the vast majority never know. Nothing we did caused it, nothing we could have done differently would have prevented it, and other than the electrical short circuit most of us (young with av block) have otherwise perfectly healthy hearts.

I would clarify with the dr what he hopes to gain from the study. Some drs are hesitant to do a pm on someone young so they do extra tests and wait and ponder. It's rare enough many drs don't have any similar patients, but if you read the other posts here you'll see there are a lot of us. The reality is you probably will not find out what caused it and there is only one fix. Just my not-a-dr-opinion, but I'd skip the invasive study unless there's a compelling reason. If you were 80 would he do the same tests or just give you the pm?

The study is a catheter, they go in through the artery the the groin. They apply pressure for several hours after then you can go home but have to take it easy. If you end up getting the pm, they usually keep us overnight. Here's an animation that explains the surgery.
http://health.sjm.com/arrhythmia-answers/videos-and-animations

If you get the pm, you may need some help with the kids for a week or so. We aren't to lift for 6 weeks. You learn to work around it! I changed diapers sitting on the floor, had them grab around my neck so could pick them up one handed with my right arm.

Don't be frightened!! I know it seems overwhelming and scary at first but look at it as a cure so you won't pass out. Passing out is dangerous, this is a little high tech emergency back up system. You may also find you have a lot more energy. My own experience was I gradually got a lot more tired over the months (years!) before. It happened so gradually I had no idea how bad it was until I felt better. Once my heart was beating in sync again, I had a lot more stamina, was a lot less tired. I've always been grateful that if I have to have a heart condition, at least I have one with a fix. It doesn't hold me back at all. I'm 48 now, healthy and active. Most of us get it, heal, then move on with our lives. If you have questions, please don't be shy!

Ep study

by Sasha - 2015-02-12 10:02:17

My comment just dissapeared!! Ill try again..
thanks seabreeze, im glad your well and enjoying life, I posted before I read your comment.

AngrySparrow1, im so sorry that is absolutely awful and scares me all the more! I keep saying what if... and being yold dont be silly! The whole thing is taking so long its stressing me out and making me worse! Want it all sorted now. I feel exhausted all the time and starting to get a luttke breathless if I say run up the stairs. I get hubby to make sure im alive every morning, hes really worried too. Most of what I know is off Google.
Just being fit and healthy then suddenly I have a heart pribkem is a huge shock

consult?

by Tracey_E - 2015-02-12 10:02:26

Can you have a consultation rather than procedure? Then if he has a compelling reason you can schedule it, or just schedule the surgery and be done with it. Not sure how much flexibility you have with NHS but you need more information.

I would specifically ask the question "If I was 80 instead of 30, would we be having this discussion or would I already have a pacemaker?" My dr was the same way, he wanted to put it off. In hindsight I really resent that attitude. Electrical problems can happen at any age, why put us through waiting and testing to confirm what they already know simply because they don't normally do pacemakers on the young. (end rant, that's a sore spot for me!)

Ep study

by Sasha - 2015-02-12 10:02:32

Thank you :)
I havent a clue why im having it the whole thing has stressed me out. Ive not seen him since I found out I just got a letter explaining that he is going to do this procedure on me and to make an appointment in clinic to discuss things further. I got the appointment for the 3rd march and was told the study would probably be a while off as there is a waiting list, but got a letter on friday asking me to ring the appointments line and she gave me 26th feb for pre op and 5th march for the procedure. Im only seeing him 2days before! I feel hes not give me enough info on anything! I agree about going through something I dont need to and know ill end up with a pm. He just says hes not entirely sure and needs to investigate further. its holong its taking its ridiculous!
Thank you for replying , sasha

EP Study

by bluebowtye - 2015-02-12 10:02:44

Hi,

My doc ordered one for me, but my insurance denied it. I wore a Holter monitor for 24 hours and that showed 2nd degree AV block so I was scheduled for PM surgery 5 days later. As Tracey says, if you are already showing signs of block the study is probably not necessary. You never know when the block can occur so without getting a PM you could pass out anytime. I was just thankful mine happened while sitting on my couch and not driving. I had no other symptoms prior.

While very scary, getting a PM is not the end of the world. In most cases it will allow you to live a healthy, active life without fear of fainting so you can enjoy raising your kids and be able to do fun things with them!

Good luck to you!
~Sheila

Ep study

by Sasha - 2015-02-12 10:02:53

Totaly understand Tracey E, Ive got loads of questions written down ready!
Sorry for all the typos by the way!

Relief

by Seabreeze - 2015-02-12 10:02:57

Hi! I didnt have time or a choice to think about a pacemaker....I was feeling faint for months and one night I stood up to get a pen to call the cardiologist because I was feeling so faint, passed out cold. Off to the hospital with EMS. I had a temporary PM until later the next day my permanent one was put in. I was a little anxious but felt so horrible I just wanted relief ( a lot of flat lining going on). It's still scary but the great news is no fainting feeling. I have days I feel like I can conquer any thing, then I have days the couch and I are best buds. Overall.....you will be relieved. I turned 55 this past Dec and my second chance at life has changed a lot of things for me. Enjoy your life-get the PM.

Ep study

by Sasha - 2015-02-12 11:02:22

Sorry, have an appointment with him 3rd March then the EP study on 5th so will take me note book and millions of questions :)

Update

by Sasha - 2015-03-08 01:03:01

Thank you to everyone that commented, my ep study was on thursday. Soooo I didnt need a pm and they couldnt do ablation so have implanted a loop recorder! My dropped beats are safe its mobitz type1, but have put loop recorder in as a precaution incase I faint again . Felt absolutely worn out after it, still do, think it was the stress and worry leading up to it. Plus its really sore!! Can't lift my hand to reach my head , hubby washed my hair for me this morning what a laugh!!The bruising is quite bad my 4year old keeps asking me to cover it up bless her. Wanted to update you and say thanks sasha x

You know you're wired when...

Jerry & The Pacemakers is your favorite band.

Member Quotes

A pacemaker suddenly quitting is no more likely to happen than you are to be struck by lightening.