ground rule double.

Had my follow up cardio appt today. Interesting and full of info, ideas, possibilities, etc. Nothing concrete, unfortunately. But. Plans at least?

The abnormal, irregular rhythms I've been having are "ok". They aren't anything that can be threatening or cause damage to the heart. Apparently it's normal to have anywhere from 1 to 10,000 of these "skipped beats" a day. Most people can have them and not even feel them.

When I was at my first doctor appointment today my pulse was 106. Hmmm. When at my cardiologist it was 110, and the EKG said it was sinus rhythm, at least to the naked eye. Luckily for me my doctor is an excellent EKG reader and can see things most would easily overlook.

Long story short, this is what he feels is going on:

I'm caught with dueling pacemakers. By that, he feels that either a couple cells from the irritable spot he froze stuck around, and have built up (apparently they can do that) or another spot developed a few days after the ablation. If that's the case, they're incredibly good at "playing dead" because of the levels of adrenaline and epinephrine I was given in the cath lab trying to locate any spots lingering around. While it's practically unheard of, my doctor said it was entirely possible for me. Thus far I've proved to be anything but a "normal patient".

He feels based on the EKG it's the latter situation: that another spot has developed and is fighting to take the role of 'pacemaker' for my heart. That's where the duel comes in. My natural pacemaker wants to pace the heart at a normal, healthy rhythm. The abnormal spot prefers tachycardia, which is why I'm sitting comfortably at 110 and not the 130 I was at pre-ablation.

Here's where we go:

He does not feel comfortable going in and doing a repeat ablation to locate the same spot as before and be even MORE positive that it is entirely, completely dead. He also wants to map out this new spot causing trouble. While he is not comfortable doing it now, he is positive it will need to be done. Timewise? We have no idea. Hopefully a little more healing will prove to be a good thing and see if things can't settle themselves (he doesn't hold out much hope, based on my heart. haha). The hard part is the location of the 1st spot - it lies almost right on my phrenic nerve. This nerve is what controls breathing so it's pretty important. Whatever damage would be done would be irreversible and I'd have breathing troubles the rest of my life.

So. For the time being I've still got my event monitor and will continue to wear it and record events and have them sent in. What we're watching for is how my heart responds to normal external conditions. Does my heart rate increase based on exercise, stress, emotions, etc? But does it remain steady when those aren't present and at night when I'm sleeping? If we see tachycardia when it shouldn't be (sleeping, resting, etc) then we will act more aggressively. Prolonged tachycardia can raise my chances of developing heart failure. 110 is not overly concerning right now. If I get back to hitting 120, 130 at rest over long periods of time we will act on it.

So. I guess I got some answers. Nothing real exciting. He's pretty stumped, so I guess that's kind of cool =)

We'll continue to go from here, I guess. Only time will tell.