I come back with my patient, who has bradycardia, our colleagues are mentioned this T-inversion is not significant. The 2nd question, is this patient need pacemaker for this bradycardia, since holter study showed the rate mean 42b/m for24h. EPS study showed corrected sinus node recovery time is normal less than 600msc. Carotid message done twice at Rt and Lt side reveled no significant bradycardia, but usual pulse of her basic rate of 42-55bpm.
Hi, Nasser.
I'd like to ask a couple of questions, if I may. Since you didn't mention it, is the patient on any medications that could produce a slower heart rate? Also, how old is the patient, and how active is she? Do you have previous EKGs or medical records to tell us what the baseline is? Is it possible this could simply be a normal heart rate for her?
I looked at the PR interval in the EKG, and it looks normal. I don't see any indication of a 2nd degree or 3rd degree AV block.
I'm a nurse, not a physician, so I really can't answer your question: it's out of my scope and experience. However, the question has me curious to learn something about the treatment process. So, if I may, let me ask a question of my own: what are the risks of treatment vs non-treatment? A pacemaker is an invasive procedure, and there can always be complications. On the other hand, if the patient is symptomatic, maybe the pacemaker is needed to prevent an injury from a fall, or a motor vehicle collision from passing out. Is there a standard set of criteria used by cardiologists based on symptoms to determine when or if a pacemaker is necessary?
What does the patient want?
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