Wednesday, February 6, 2013

Heart Update

The heart is a pretty wonderful chunk of tissue beating inside our chests; pumping blood throughout our bodies.  I know I have taken it pretty much for granted until recently; but no more.  Right now it is kind of like the proverbial squeaky wheel, demanding a little attention: attention that I am only too willing to provide.

There has been a certain amount of uncertainty since being told a couple of weeks ago that I had Atrial Fibrillation.  I had a visit with a cardiologist yesterday that provided some clarity, although the path forward is still far from clear.  The cardiologist yesterday seemed to think I had Atrial Flutter rather then Atrial Fibrillation, a less serious, although still troublesome, issue.  More test and visits with more specialists are in my future before any real treatment can be prescribed.

Until just a few weeks ago I had no real idea just how the heart worked.  It's a multi-chambered pump that circulates blood through the body.  It beats faster when you are more active, and slower when you are less active.  And I knew that it had some kind of electrical system to keep it beating at the proper rhythm.  But beyond that I was pretty clueless.

The SA node is the hearts internal pacemaker.  When it fires, it causes the hearts atria (upper chambers) to contract and force blood into the ventricles (lower chambers).  The signal from the SA also goes to the AV node when it is delayed briefly and then forwarded on to the ventricles, causing them to contract and forcing blood out into the body.

The EKG shown in the diagram has three peaks.  The first is the P wave, showing the stimulation of the atria.  The 2 dips with a large spike in the middle is the QRS complex, showing the stimulation of the ventricles.  The T wave at the end shows the ventricles relaxing and preparing for the next cycle.  This is a normal cycle that is repeated about 60 times a minute.  And some of mine look like that; but unfortunately many of them do not.

The EKG's of my heart taken over the past few weeks show that I have premature beats periodically, which is not uncommon or of much concern.  I also sometimes have multiple P waves in succession indicating Atrial Flutter, or a feedback loop in the atria that causes them to contract multiple times for each contraction of the ventricles. The EKG's also show a periodic rapid pulse, up to 210 bpm, indication the heart has gone into fibrillation, also likely caused by some form of feedback loop.

The cardiologist eliminated the more common causes for this since I don't drink or smoke, am not obese, not diabetic and have generally good cholesterol levels and generally good health.  I will be getting a blood test looking for thyroid issues along with an Echocardiogram to check for structural issues with my heart.  After that I will have a visit with an Electrophysiologist, a cardiologist who specializes in the hearts electrical system.

The two possible treatments discussed so far are to continue with medication to reduce my heart rate for the rest of my life, or a Catheter Ablation.  The Ablation involves threading a few catheters through veins and into the heart when it will be examined and the portion of the heart with the feedback loop will be destroyed. This option is kind of scary, but is pretty low risk, and will generally fix the problem.  The Electrophysiologist will provide more information about that alternative when the time comes.

Until then; keep taking the medication.  And I can try running again and see if the medication will keep my heart rate within reasonable limits.  Looks like this summer's backpacking season is not yet cancelled, although there likely are no marathons in the near future.
I know whom I have believed, and am convinced that he is able to guard what I have entrusted to him until that day. - 2 Timothy 1:12

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