Wednesday, October 22, 2008

EP Study in a Nutshell

I know you all have been waiting with baited breath. What does "baited breath" mean any way?

Whatever, I survived a month without so much as a murmur. Much to the chagrin of my insurance company. I shouldn't say that the Dr's were just following protocol.
My brother's definition or protocol.
Protocol:

  • Patient
  • Roulette
  • Organized
  • Through
  • Official
  • Channels
  • Obstructing
  • Logic
  • P.R.O.T.O.C.O.L

Watch this video if you would rather not read this post.

On August 14 I met with Dr. Anonni my Electrophysisist, or maybe he's an electrophysiologist.

Probably the latter. Hold on a sec while I check. Isn't the Internet wonderful it is the latter.

Dr. Anonni my Electrophysiologist, saw that my EF or ejection fraction had not improved so he suggested a two lead ICD, or implantable carioverter defibrillator.

This will shock my heart when and if my heart goes into arrhythmia or stops.

I recieved the dual chamber ICD. Leads are attached in the right atrium and the right ventricle. Energy is delivered first to the right atrium and then to the right ventricle, helping your heart to beat in a normal sequence.
Before the ICD is implanted Anonni wants to do an EP study. No one has explained what the EP study consists of. All I've gotten so far is that the ICD is a simple in and out procedure. I guess my in and out is different from doctors in and out. Because after the ICD placement I was in the hospital four days. With a return to work in 2 weeks. Does this sound like a simple in and out procedure? And even with doctors release for work I had restrictions, no lifting, pushing, pulling five lbs or more for 6 weeks.

Of course by now my employer is fed up with having to temporarily fill my position. I had told them I would be back to work on the Monday after my ICD. My employer would not accept the restrictions for returning to work. Thus I was fired.

I veered off course sorry about that. Back to the EP Study. I had not clue what this entailed. I searched the Internet and could find nothing simple that I could understand. But now after the fact I have found a website.
http://www.stronghealth.com/services/cardiology/cathep/eplab/havinganepstudy.cfm

Let me see if I can explain what I under stand it to be:

An EP study is a minimally invasive diagnostic test. The study is performed after the patient is given a local anesthesia and conscious sedation with medicine through an IV. BUZZZZZ!! I was put totally asleep. I was told on the table that I would be put to sleep. But there was no anesthesiologist that I know of in the lab. Remember in and out and on my way.

Back to the study. The procedure involves inserting one or more catheters—narrow, flexible tubes attached to electricity-monitoring electrodes—into a blood vessel, often through a site in the groin or neck, and passing the catheter wire up into the heart. Seems every time I go into the hospital something is passed through my groin. What's up with that?

The journey from entry point to heart muscle is navigated by images created by a fluoroscope, that provides continuous, live images of the catheter and heart muscle.

Once the catheter reaches the heart, electrodes at its tip gather data and a variety of electrical measurements are made. This data pinpoints the location of the faulty electrical site. While this is going on an electrophysiologist, may instigate the use of tiny electrical impulses, to induce the arrhythmia that are causing the problem. These induced events are safe, given the range of experts and resources close at hand. The inducement is necessary to ensure the precise location of the problem. DING !!!! I had the best experts in central Florida at Pepin Heart Hospital and Kuran C. Patel Vascular Institute. And Dr. Anonni is said to be the best EP guy around.

Once the damaged site or sites are found, the specialist may administer different medications or electrical impulses to determine their ability to halt the arrhythmia and restore normal heart rhythm. The specialist will choose to place an ICD or a pacemaker or will perform radiofrequency ablation. (Not sure what this is). I got the former as you know.

The procedure usually takes about 2 hours. The patient remains still for 4 to 6 hours afterward to ensure that the entry point incision begins to heal properly. The 2 hour part I was told. Ding!

The rest I was not. Buzz!

Now wasn't that easy? I don't know why it's so difficult for doctors or their PA's to go through this procedure with the patient. Is it because the Internet is so readily available for information to be found? I gotta tell ya that the Internet is not always spot on.

My cardiologist had no problem telling me the basic facts of cutting a pocket in the left pectoral muscle and implanting the ICD. I'm not sure that he knew there would be an EP study first,
Or he would have given me more information. I'm sure Dr. Pascual, my cardiologist, assumed that Dr. Annoni would give me the facts.

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