Dear Doctor. Below is my Medical Summary:Age 31 Y Sex: MaleProgress Notes:HTN (-) DM (-)H/o left cervical caseating Lymphadenitis + PT - -> S/P ATT 3 yrs ago, took ATT for 1 year Very brief palpitations of 2-3 minutes on and off 4 yrs with dizzy feeling.Palpitation goes away with deep breathingNo h/o prolonged palpitation needing medicationsTMT Oct 10: Bruce 8 min 9 mets 91% THR, -ve for ischemia/arrhythmiaRPT Holter(27.12.2010): Seven short run of narrow QRS tachycardia-- > regular at 220/min, max for 3 min or so Euthyroid status.Came for routine review:Brief palpitations 2-3 minutesHad palpitation on (17.05.2011)Holter Min 34/min at 2:30 AM, Max 200/minRegular narrow QRS tachycardia initiated by 3 VPCs (triplet) at 200/min, no definite P waves, fixed rate + Abrupt termination? AVNRT,? Orthodromic AVRT (concealed pathway) Rx:T.Seloken XL 50 mg 1-0-0 ( to be stopped 5 days prior to EP study)Plan:EPS + RFA1% risk of CHB explained. Should i proceed with EP in 2d or 3d. My previous Doctor ask me to implant a Pacemaker without an EP study . makes me confused. if so which pacemaker is good for my condition . waiting for your advice.
DEAR FRIEND the EP study will clearly establish the cause of your palpitation and in case there is an aberrant path which can be ablated. The need for a permanent pacemaker then will not be there, it is a good idea to undergo EP studies before taking the decision of pacemaker implant