Dear Firegirl -

You sound like my wife did five weeks before she went in for a cardiac ablation procedure, one done with extreme cold rather than a strong electrical signal. Assuming you become significantly symptomatic once you're hooked up to the recorder, I would suggest having it "read" long before the 30 days runs. I assume your machine will be set up so that you can press a button (or use a paper log sheet) every time you have what feels to you to be a significant "episode."

In the meantime, are you on any antiarythmia drugs or are they waiting for the test reports?

What concerns me is my (non-RSD) wife's experience, where she was on some old calcium channel blocker until the evening of January 1, 2009, when (while wired up) her pulse jumped to 300 but the doctor on call just told her that if she felt worse, she should go to the ER. A couple of hours later she thought it had passed then she suddenly developed nausea and acute GI distress. She still didn't think anything of it until she lacked the strength remain seated on the toilet. For a while she just wanted to lie on the cool bathroom floor, with a pillow and her robe, but it was soon apparent she was not regaining her strength, at which point we finally called 911, and when the operator asked me what her skin was like, I realized she was in shock. Moments later we had six firemen in our bathroom. Her pulse was still over 270 and she had no measurable BP in her extremities. They managed to thread a catheter up her arm and gave her a large shot of Adenosine, to no effect. Worse, in front of my 11 year old son, who had been woken by the arrival of the trucks, the lead paramedic kept saying she was "too unstable to transport." (Think about that one.) Fortunately, after considering his/her options, the ER doctor on the other end of the line finally told the paramedics to administer another full injection of Adenosine and this one did the trick. They then took her by ambulance to the local community hospital (as usual, UCLA wasn't accepting incoming ambulances) but no matter. Between her response to the Adenosine and hours of continuous EKG monitoring, they had a working hypothesis that would ultimately be confirmed as a diagnosis: AV nodal reentrant tachycardia. And 2 hours after she got there, she was discharged with a prescription for a better drug, what I believe was a "Class Ic " sodium channel blocker of some sort http://en.wikipedia.org/wiki/Sodium_channel_blockers which kept her more or less stable until she had her successful procedure a month later.

Wikipedia has a decent article under the heading "Antiarrhythmic agent" with good links from there at http://en.wikipedia.org/wiki/Antiarrhythmic_agents As soon as you think that "an episode" has been recorded on the halter monitor, I would move Heaven and Earth to get an ASAP reading so that you can be given the appropriate antiarrhythmic drug, before things get more interesting. In the meantime, if s/he can give you something, pending a final diagnosis, it may well be a good thing.

You should also have gotten a high-end ultrasound of your heart (aka 3D echocardiogram) to measure the efficiency of your heart valves, as this may limit the range of some of the newer medications which may be available for your use. I stand prepared to be corrected by any healthcare professional - which I am clearly not - but if your doctor has yet to order an echocardiogram, especially in light of your pulmonary function tests, you might think to politely raise the issue. Sooner or later, your doctor should want to know how your "ejection fractions" are looking.

Hang in there,

Mike