Second Visit to the EP....

The EP said that there is a scar on my heart from the surgery I had when I was 4 yrs old and it comes up as an old wound or an old trauma to the heart ASD - atrial septal defect (hole in the heart) that I (as was my dad and my son) was born with>. The surgery is the cause of these electrical problems.

For what it's worth, the EP did say that aside from these things, I do have a very strong and healthy heart. The muscle itself is strong.

An education on the heart's electrical system...

Your heart’s electrical system is made up of three main parts:
The sinoatrial (SA) node
The atrioventricular (AV) node
The His-Purkinje system

My problems are with the AV node and then affect the ventricles.

I think this is a good website that explains the electrical workings of the heart.
http://www.nhlbi.nih.gov/health/dci/Diseases/hhw/hhw_electrical.html

The signal arrives at the AV node near the ventricles (see red burst on picture), where it slows for an instant to allow your heart’s right and left ventricles to fill with blood. The signal is released and moves to the His bundle located in the walls of your heart’s ventricles. (My signal is very delayed and sometimes blocked)
From the His bundle, the signal fibers divide into left and right bundle branches through the Purkinje fibers that connect directly to the cells in the walls of your heart’s left and right ventricles (see yellow on the picture). This pushes blood through the pulmonary valve (for the right ventricle) to your lungs, and through the aortic valve (for the left ventricle) to the rest of your body. As the signal passes, the walls of the ventricles relax and await the next signal. This process continues over and over as the atria refill with blood and other electrical signals come from the SA node.
(The EP said that because my electrical shock sometimes never reaches the ventricles they are forced to try to pump on their own but this is a very weak and slow beat and may fail)

Shown on an EKG
From the SA node, the signal travels to the right and left atria. This causes the atria to contract and pump blood into the heart's two lower chambers, the ventricles (VEN-trih-kuls). This is recorded as the P wave on the EKG.
The signal passes between the atria and ventricles through a group of cells called the atrioventricular (AV) node. The signal slows down as it passes through the AV node. This slowing allows the ventricles time to finish filling with blood. On the EKG, this is the flat line between the end of the P wave and beginning of the Q wave.

On my EKG there is a loooong delay between the P wave and the Q wave. In the last two years since my last EKG the delay grew to three times as long as it was. The electrical signal then leaves the AV node and travels along a pathway called the bundle of His. From there the signal travels into the right and left bundle branches. On the EKG, this is the Q wave.
On the EKG, R marks the contraction of the left ventricle and S marks the contraction of the right ventricle. The ventricles then relax (shown as the T wave on the EKG). This entire process continues over and over with each new heartbeat.

Third-Degree Heart Block
In this type of heart block, none of the electrical signals reach the ventricles. This type also is called complete heart block or complete AV block. When complete heart block occurs, special areas in the ventricles may create electrical signals to cause the ventricles to contract. This natural backup system is slow and isn't coordinated with the contraction of the atria. On an EKG, the normal pattern is disrupted. The P waves occur at a faster rate than the QRS waves http://www.nhlbi.nih.gov/health/dci/Diseases/hb/hb_understanding.html. Complete heart block can be fatal. It can result in sudden cardiac arrest (this is different from a heart attack - check out the link) and death. This type of heart block needs emergency treatment. A temporary pacemaker may be used to keep the heart beating until you get a permanent pacemaker. Key Points about Heart Block http://www.nhlbi.nih.gov/health/dci/Diseases/hb/hb_summary.html

So this has nothing to with arteries and is not affected by what I eat or cholesterol levels. There is nothing I could've done to prevent this. For some reason that's an important point to me!

Christopher, who also had his ASD repaired (at 11 months) should not have these problems thanks to advances in surgical procedures. But he does continue to go to the cardiologist for an annual check. I think this is important. I had not gone for two years and in those two years the delay in my heart's conduction grew significantly. The delay would've come up on the EKG reading. Now that I have a pacemaker I need to go to the cardiologist every three months. So I guess this means I will be super healthy from now on!

My life seems to be on hold lately, my blog has gotten very boring with lots of text and no recent pics of my beautiful boys! We are all getting quite the medical education!

I have a list of books that I am anxious to read. I am reading one now called "The Heart Speaks: A Cardiologist Reveals the Secret Language of Healing". It is about how the heart reacts to certain things including love, stress, etc. I love the way it is written and had a hard time putting it down last night. I think it would be a great read for anyone.

Next I am going to read You Can Heal Your Life by Louise Hay. It is a beautiful book - each page is so artistic, colorful and uplifting!

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