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Medical Forum / General / Cardiology / July 2006

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Heart Block

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George - 09 Jul 2006 18:16 GMT
I don't know if I should be worried about this, but I recently had a
cardioversion to try and correct attrial flutter. It was not causing
any symptoms, as far as I could see, - and it was only a routine ECG
that brought it up. This failed to achieve the desired result and I was
left, - so I was told with an unsynchronised atrial beat of some 50
bps.

For years (and years) I have been a long distance runner and have a
resting beat of about 32 - 34 which goes up to 80 or so max. on a long
run. It goes down to 29 when I really relax. This has always caused
concern to Doctors, and they always ask about dizziness and fainting
spells etc, which I never have. In fact I have never had any problems
that I can ascribe to my heart even though I had an angioplasty and
stent in 1999 for a blocked LAD. Again after a routine ECG. I can swim
about 50 metres underwater with little effort. Or I could a few weeks
ago. I am 6'4" and about 86 kgs.

The post cardioversion report says "arrythmia (Complete Heart Block)"
and says I should go back in September for follow-up.  They gave me a
24 hour monitor to wear but I did not get any freedback.  Since the
procedure, however I get out of breath a bit sometimes and often seem
to be breathing more heavily. On the two runs I have had of 6 and 5
Kms. I am about 20% slower than three weeks ago.  At 65 I am not really
expecting to set any records but I can't see why I should be worse off.
If I had a flutter of 300 bpm previously; surely an unsynchonised beat
at the top (atrial) of about 50 bpm is an improvement.  My resting
ventricular beat seems a bit slower, if anything and on the ECG It says
- and I quote, as I don't understand it and was told to ignore it
anyway,  - 3rd degree AV block Ventricular rate 32. QRSD   140
Leftwards axis. QT 499  LVH by voltage.   QTc 364 Poor R-wave
Progression, possibly due to LVH Anterolateral T wave abnormalities,
--AXIS--  Possible ischemia
P   Ind.    QRS   -17.   T   172.    Abnormal ECG.

Can anyone translate any of this?   Any comments, please?  I should
like stop eating rat poison and an angiotensin-II receptor antagonist,
Micardis, that I am reluctantly taking every day. Should I consider
leaving my heart to medical science? Not yet, as I am a bit fond of it.

Thanks George.
Andrew B. Chung, MD/PhD - 10 Jul 2006 04:43 GMT
> I don't know if I should be worried about this, but I recently had a
> cardioversion to try and correct attrial flutter. It was not causing
[quoted text clipped - 12 lines]
> about 50 metres underwater with little effort. Or I could a few weeks
> ago. I am 6'4" and about 86 kgs.

You might be about 10 lbs heavier than optimal.  This might represent a
significant amount of visceral adiposity.

> The post cardioversion report says "arrythmia (Complete Heart Block)"
> and says I should go back in September for follow-up.  They gave me a
[quoted text clipped - 14 lines]
>
> Can anyone translate any of this?

Yes.

>  Any comments, please?

Would be concerned that your decrement in athletic performance may be
due to a return of inducible anterior wall ischemia because of the
occlusive lesion you have in your LAD.

> I should
> like stop eating rat poison and an angiotensin-II receptor antagonist,
> Micardis, that I am reluctantly taking every day. Should I consider
> leaving my heart to medical science? Not yet, as I am a bit fond of it.

Understandably.  You may benefit from biventricular pacing and becoming
as lean&trim as possible once the possibility of inducible anterior
wall ischemia has been addressed.

> Thanks George.

You are welcome.  All thanks and praises belong to the LORD, Whom I
love with all my heart, soul, mind, and strength.

Prayerfully in Christ's amazing love,

Andrew B. Chung
Cardiologist, Atlanta, Georgia, USA
http://tinyurl.com/frep8
 
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