I apologize for my tardiness in posting updates to this site. I am well acquainted with George through Facebook, and he has my permissions to share anything that he wants. I feel bad that I haven't posted in detail before, but I generally work 80 hours per week, and have limited time to post in any social platform. But, I will try to add a few helpful details here.
The QuardioCore is an excellent device, but does not provide any interpretation of the ECG. The App that comes with it can be buggy at times, but I generally like the device and strap. However, if you use the ECG feature, you have to be able to interpret single lead ECG patterns. I originally bought the device, as I plan to return to long distance bicycle touring and wanted to be aware of rhythm disturbances. While I'm not an expert on interpreting ECG's, I can generally identify noise artifacts, etc. To save time, I'm posting part of a post from my Facebook wall, which will be to simplistic for many of you that are familiar with rhythm disturbances.
I was wearing this strap while sitting at my desk on Wednesday morning (9-18-2018), and felt instantly bad at about 8:58 AM. I had the app open at the time on my phone, and glanced over. Unlike most people that have heart rhythm problems, I rarely experience pain or other symptoms. In this case, I was sitting and felt bad. The best way to describe it is that it felt like I had a bunch of gerbils running on a wheel really fast in the area of my lower heart. I knew something was wrong, but having had heart rhythm problems before, wasn’t alarmed. From a casual glance at the screen, I figured I was having an episode of Atrial Flutter which isn’t uncommon for someone that has rhythm disturbances. My heart went back to normal rhythm in 18 seconds, so I made note of the time (first time I’ve been out of rhythm in 7 months), and continued working.
Later on, after I went home, I pulled up the App for the device, scrolled back to that point in time, and realized that I had made a significant error in judgment. While I’m no expert medical professional, or certified in any way, I spent 14 months investigating heart rhythm disturbances, and quickly identified the heart event as some form of Ventricular Tachycardia. I actually had another 4 second event about 15 minutes later, that was identical in nature. At that point, I contacted my wife and asked her to come home from Chicago. While most forms of heart rhythm disturbances are not dangerous, I knew that any disturbances in the Ventricles (bottom chambers of the heart), and not in the Atrium (top chambers of the heart), are far more dangerous as they can more easily lead to things like cardiac arrest, or what is commonly known as a heart attack.
I contacted my cardiologist via phone and he kindly returned my call. I had made him aware that I had received this ECG device three weeks ago during an email exchange, so he was aware that I had the monitor. I quickly sent him pictures of both events via text message and he agreed that it was probably Ventricular Tachycardia of some form, and agreed that this could be far more serious than what I had before. While he advised me to go to the hospital in Springfield, Illinois which is geographically closer than his hospital in St. Lukes, he agreed to admit me to his hospital if I wanted to go there instead. After discussing it with my wife, we felt it would be better to travel back to the hospital where he was, as he has the details for my past history. While this may seem risky (Martha drove), we felt it was the right thing to do. The reality is that we never know when our last heart beat will happen, so it is a risk we live with every day.
Upon admission to the hospital, they put on their more sophisticated heart monitor (12 lead ECG), put in an IV port, drew a bunch of tubes of blood for lab work, and told me to sleep. Since Ventricular Tachycardia carries a risk of cardiac arrest, they wanted to test me 3 times for Troponin levels. For non-medical people, Troponin is a protein molecule that gets released in great quantities during a heart attack. In my case, they only did the blood test twice as it become evident that the heart muscle seemed to be undamaged. In any case, sleep was hard to come by during the night, but the nursing staff was excellent, and we both slept as we could.
My cardiologist arrived Thursday morning and woke me up, and asked me if it was okay with me to discuss my case with his four residents and have them attend with me. After assembling them, I showed them my ECG strap, the resulting ECG strips, and began answering their questions. After discussing the various options with the residents, along with the cardiologist, we decided that the first step would be to have a Transthoracic Echocardiogram (TTE), as I wanted to be sure that my heart failure was still absent after 7 months. With heart failure, the chambers of the heart can change shape, that can cause both Atrial and Ventricle heart rhythm disturbances. While I was fairly sure that my heart failure had not returned, based on blood lab work I had run two weeks ago, the TTE is a nice, non-invasive procedure that allows the cardiologist to determine the ability of the heart to function. The typical human heart functions at about 55 to 75 percent meaning that the 55 to 75 percent of the blood that enters the heart gets pumped through and out the other side. With heart failure, it means that your heat can’t efficiently pump the blood through the chambers of the heart. Last September, my heart was operating at 27 percent and had improved to 49 percent in January. But, I had not had it measured since then. The goods news from yesterday, is that my heart looked great and that it was operating at 66 percent. While the TTE can reveal simple things like heart muscle damage, etc, it’s only a means of eliminating what isn’t causing the heart rhythm disturbance.
I then met with an Electrophysiologist. Heart doctors are generally divided into two main categories, although they have many specialties within these categories. A Cardiologist is typically labeled as a plumber (not because they don’t tighten their belts), because they typically deal with problems relating to the mechanical movement of blood flow. This would be things like blockages, heart failure, etc. An Electrophysiologist is thought of as an electrician, as they typically deal with problems relating to the electrical signal that charges and discharges making the heart muscle pump. The Electrophysiologist was nice and indicated that he and the cardiologist both believe that the next step is to undergo a Left Heart Catheterization. Based on the ECG of the events that I recorded, the believe that the irregular rhythm originated out of the left ventricle, and would like to go in and look around at the heart on the inside. While this procedure can have complications, it is considered minimally invasive compared to other procedures, and allows the doctors to get a birds eye view of the heart from the inside. While they don’t think it is likely, there is a possibility that I have some blockages on the inside that could cause the abnormal rhythm. Like anything else, this would be additional information, and allow us to make better treatment choices.
The Electrophysiologist really thinks that the cause could just be something as simple as stress, as I lead a fairly stressful life at times. We are a household in transition right now (technically, an RV-Hold). While I’m never really aware of stress, I tend to over do things. And, I’ve probably done that. But, it’s also probably safest to make sure that I don’t have any blockages or damage in the heart muscle or valves that would be only really evident from the inside.
Since I am a self pay patient, we want to be cognizant of the costs to acquire this additional information. In a hospital setting, your time is their money. The longer you stay there, the more it costs, and I don’t believe that someone else should pay my direct costs involuntarily. So, I made the decision last night to check out of the hospital against medical advise. While the doctors all agreed that there is a risk of having another event, and that it could be fatal, I’ve lived with that risk for 52 years. From a logical perspective, I may be wrong and I may have another incident, but I’m hopeful that we’ll get the cost information to have the procedure done on an outpatient basis in the next couple of weeks.
While I’m sure many people would disagree with my decision, both my wife and I are comfortable with it, as I have been living with the seriousness of heart disease for a couple of years. I don’t want anyone to be either alarmed or offended by my actions, but we want to have more information before we proceed.
I hope this recap helps those here, and I will try to provide a more detailed post in the future regarding my past experiences with Heart Failure and Atrial Fibrillation With Rapid Ventricular Response.
I appreciate George posting this here, as I find it as a valuable tool that may benefit others. My EP and my Cardiologist spent at least 15 minutes reviewing the detailed ECG in the app and were impressed. I also have the Kardia Alivecor device, but it requires that I trigger a reading during or before an event to capture it. IN this case, I would have missed recording both events.
Thank you.
