Progressive Bradycardia

That's kinda the punch line for this one, with a month-long lead-up.

Most of that has been posted, so just a quick review. Heart monitor for cardiac study, technology issues, restart study, more issues, and finally, today, the visit with my cardiologist to get the results.

You know it couldn't go that smoothly, didn't you, by now? Nothing to do with the cardiologist, of course. She's been top notch. But at the office visit, only part of the results had been sent on to her from the monitor company. Whoever sent them in didn't allow for the restart, so data cut off early. What it showed wasn't particularly useful. So we had a long chat (imagine a long chat! with a cardiologist!), made plans to change a couple meds, adding one to deal with symptoms from the last new med, and dropping the dosage on another. Just a bit complicated, but doable.

Around suppertime, she called me back. The rest of the study results were in, along with some assessment of the results. During the study, a couple episodes of flutter didn't even register, even though I had a button to hit to mark the spot electronically that they were to evaluate. I had been hoping for some kind of feedback about what was happening during those times, leading ultimately to weighing in on one side or another of surgery and/or pacemaker. Can't evaluate what you don't see.

The study also showed no episodes of A-fib. The heart beat never sped up to where there might have been an issue. Heck, I could have told them that! I've always known when I had an A-fib attack.

The completed results did show something definitive. Not only was the heart not kicking up into high gear, it was slowing down! It started with an increasing percentage of a 24-hour day with a heart rate below 60 bpm. Then nearer 50 bpm. Most recently it's been spending way too much of its time in the 40s. We had a technical term now: progressive bradycardia. It means what she'd just described to me, an increasingly slowing heartbeat.

We made more definitive plans to adjust those meds that might be contributing to it, keeping careful to avoid kicking me back up into A-fib again, along with a plan for communication of any progress. I also had an appointment already scheduled with a cardiac surgeon for next week. The original idea was that the study might show whether ablation surgery - zapping those heart cells that were sending the wrong timing signals to the different heart chambers - would be appropriate to deal with A-fib now that amiodarone - the only med that prevented A-fib for me - had been discontinued due to its toxicity for me. It's now looking like the conversation might swing more to the advisability of a pacemaker. Possibly even both.

Both my parents wound up with a pacemaker. I recall the golden oldies of technology when a monthly phone call would prompt connecting a bracelet to an intermediary machine so that the signal could be sent over the landline and read without an actual doctor's visit. I wondered how that might work in the age of smart phones, and whether a pacemaker would finally require me to break down and buy one. Hey, I still love my little flip phone.

I also recall that phone call from Mom the day Daddy had his pacemaker implanted. The whole thing was news to me. Some version of "don't scare the kiddies"? I never had known he was even going to the hospital, much less for surgery and what kind. When I asked why he needed one, the only answer I ever got was because his heart was beating "a little slow". She never did explain hers.

I also recall them worrying about how close to the microwave they could get and still live, and needing to avoid the airport x-ray machines, with a card to prove the need was real. These days I might be in a position to do them one better at an airport. The latest version of a pacemaker looks like a small caliber bullet in the heart!

It's an entertaining thought.