Tuesday, July 21, 2015

Heart Cath- Rhythm Study, 7:00 arrival/9:00 procedure Children's Hospital

Tomorrow's Heart Cath (EP Study) and potential ablation is slated to start at 9:00am with 7:00am arrival. Typically at Children's patients would have to arrive till 1.5hrs before but b/c they need a urine sample, have to access the Port (yay to my Anesthesiologist, Dr.Taylor for talking to the pre-op Nurses on my behalf about this!!) and the stress dose steroid is to be given an hour before any sort of sedation is given, no matter big or small.
In tomorrow's case we're using conscious sedation but apparently i'll be awake during the study if I understood the Nurse and my EP dr. both correctly whereas w some forms of conscious sedation I've atleast drifted off in to another land of sleep of sorts.
The reason for being awake/very midly sedated is the arrhythmia the Cardiac Team is looking for "tends to go to sleep when pts. go to sleep". Dr.Kovach, my EP dr. felt based off my recent Holter monitor this was definitely likely the case as my HR went from the abnormally high rates to down in to the low 60s very suddenly and must have stayed there as I slept.
The Stress dose steroid is ordered, which is always a relief to know I don't have to battle w the Anesthesia drs. about this and timing (some don't want to give it at all, some think it can be given after they've given some sedation but before they given fully put a patient under). Another bonus I suppose of having the same Anesthesia dr. on my case for this who did both OHS 2yrs ago and 2yrs ago in Sept. + the sedated TEE (Echo where a probe is put down a patients throat to see internal views of their heart).
Per Jane, my Cardiologists Nurse she would call regarding f/up, whether it would be Dr.Earing and Dr.Kovach together or whether it would be something else such as I would imagine (but not certain) just f/up with Dr.Kovach if they do find an arrhythmia and feel reasonably good they where able to ablate and get rid of it and thus this overly fast heart rate would settle down and slow down on it's own.
If that is the case chances are we won't have to go on the new Heart failure med, Ivabradine and we may (but no one knows for certain) have more time to needing to replace the Mitral valve if symptoms improved w this study tomorrow.
If the Team does not find an arrhythmia they can ablate or if they find an arrhythmia but it is not amenable to ablation then likely f/up will be meeting w both Dr.Kovach and Dr.Earing together to discuss our next steps (likely the med) and what next.
I am a little curious how tomorrow plays out..I think out of anything related to tomorrow I am a little nervous about laying flat during the study but as I think I wrote about in my last blog update (or maybe it was on fb, can't remember) hopefully Dr.Taylor, my Anesthesiologist can help come up w something to manage any nausea if this became an issue during tomorrow.
It is an out-pt procedure, it can take according to Dr.Kovach anywhere from 2 (or maybe it was 3) hours up to 6hrs depending on any difficulties they run in to getting the catheters in place, mapping the electrical activity of the heart and if they find any arrhythmia/abnormal areas and if they do how well it responds to being hit w the RFA which is the energy source used to ablate abnormal areas.
I'll update on fb and update here either tomorrow night or later in the week how everything went.
Prayers always appreciated =)
What is RF Ablation:
Just an article on what radiofrequency ablation is, ironically i've had RFA used in my spine before to help nerve issues.
In Radiofrequency Ablation abnormal nerve signals are destroyed with high frequency energy. This often cures the individual of the problem permanently. - See more at: http://pediatricheartspecialists.com/articles/detail/atrial_tachycardia#sthash.XJ4gyZFj.dpuf a radiofrequency ablation. In this procedure, the abnormal focus of tissue is ablated or destroyed

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