[Lisa33167]

I am getting rid of all of my posts here.

[Jeff]

I should go get copies of my EKGs from the event monitor in February. I saw them as the Dr and I went through them, but having a hard copy would be nice. And interesting to post here, too.

Interesting that your doctor would not have thought to mention anything about bigeminy in the 4/27/07 EKG. Though it does look like for the most part, the morphology of the PVCs has stayed pretty consistent over all the EKGs (which from my limited knowledge indicates that most of the problems are coming from a single focus of renegade heart cells).

Lisa - do you mind if I post these in a different manner in this thread, allowing someone to click on a thumbnail of each image and have it pop open in a new window?

[Jeff]

They are your records, for tests performed on your body. If anyone has a right to them, it's you. They may charge you a copying fee or something, but I can't imagine why you would be denied your records.

I'm off to work right now - I'll take care of the EKG images later today.

[Jeff]

I thought that "jiggle" or toothed pattern was indicative of atrial flutter or afib, not an "almost" PVC. The depolarization of the atria is a much smaller reaction in terms of voltage, and the ventricles much larger, so from what I understood, all the "big" waves on an EKG are usually from the ventricles.

Then again, I'm no cardiologist.

As someone for whom this is not an occupation, I'm fascinated by your EKGs. I've always wondered if my PVCs are unifocal - and from the looks of most all of your EKGs, yours are. Which hopefully will make the ablation that much easier, since it appears there is mainly one trouble-making area.

[Jeff]

Again, not a doctor, but I think most cardios, when they speak of flutter, they're talking about atrial flutter. If it were your ventricles fluttering you'd be having a much different conversation. And, you wouldn't see the normal QRS complex that you see on your EKG (Here's a breakout of QRS and the other waves in an EKG: http://www.skippinghearts.com/articl...nus_rhythm.gif )

And yes, it's possible to have atrial problems and ventricular problems that are independent of each other. Though the atrial flutter may not have been something that was recurring and only happened because a unique set of circumstances came together at the time of that EKG. So it may be nothing.

Just a week or two ago I read something about the double-spiked PVC, but for the life of me I can't remember what it meant. Or maybe it was a double-peaked QRS. Rrrr. I'll have to search for that again.

[Jeff]

Oh, and one thing I want to make sure I don't do here, because I see it elsewhere, and I certainly hear about it a lot with patients visiting their doctors, is that if the doctor sees one or two symptoms of a common ailment, they'll stop the diagnosis process right there - that's what it sounded like they did with you.

It's almost as though you need a medical degree yourself to know what questions to ask, what tests to request, and when to fight your doctor. For tests, that is.

[Jeff]

Which one was that? Each of the ones you posted seemed to have the rhythm tracing.

[Jeff]

Lisa, I've been looking at that very first EKG - the one with the "wiggly" or toothed lines, and I'm almost thinking that the appearance of the teeth has something to do with the copy of the EKG itself - it's more pixelated than the rest of the EKGs, and the tracing has the same line weight as the dot graph behind it, making it appear that the dots from the graph and the line are merging a bit, making the line look more wavy than it is.

It's possible that the resolution of the scan is not as high and that's why it looks like that to me, and you having the hard copy it might be more clear.

[Jeff]

Thanks for posting these.

I'm not sure what I'm looking at, either. But I'll figure it out. Hopefully your heartbeat is one of the lower tracings, not that top one.

But if I had to guess, I would guess that the top tracing is measuring pressure in the ventricles, or possibly blood pressure, as the ECG tracing shows the electrical activity and the actual muscle contraction is always a bit behind the spikes in voltage, and so pressure in the heart, arteries and veins goes up some time after the big QRS wave on the ECG.

Do you know when these readings were taken? Were they during the ablation, or during the ICD implantation? Or some other time?

[Jeff]

Ok, I'm figuring it out - oh - I see you posted more info. I'm still not sure on the top tracing, but the second tracing is the electrical impulses taken from your atria. The third is the tracings taken from your ventricles (which explains why I couldn't find a P wave there). These tracings are called EGMs (aka cardiac electrograms) because of where they were measured from (the inside instead of the outside). I'm not sure if the fourth tracing is the ICD pacing your heart. Have to dig a bit more.

The science is amazing, isn't it?