January 4, 2005 - Tuesday | 6:41 PM, CST

Normal Sinus Rhythm

I am relieved to report that I visited the cardiologist today, and was reassurred by her preliminary diagnosis of my heart palpitations. The word "palpitations" is actually the wrong word to use, since what is actually occuring are PVC's, or Premature Ventricular Contractions. I have taken the liberty of making you all a crude sketch of what a regular heartbeat (or "Normal Sinus Rhythm") should look like on a monitor. The first small spike on the line, labeled "P - Wave," represents the heart's atrial depolarization. For those of you who have forgotten their anatonomy of the heart, remember that it is divided into four chambers, the Left Atria and Left Ventrical, and the Right Atria and Right Ventrical). The second set of squiggles, labeled "QRS Complex" represent ventricular depolarization. And finally the last solitary spike on the line is labeled the "T - Wave", which indicates that the heart has repolarized itself (basically it hit the reset key).

Remember now, that is how a normal heartbeat should look. The P - Wave is the atria firing off their electrical charges, which in turn cascades down the heart and into the ventricals, causing them to contract. Finally the electrical impulse reaches the bottom, or apex, of the heart into the perkinje fibers, and it realizes that it needs to reset itself for another beat. What my heart is doing, a Premature Ventricular Contraction, basically looks like the picture below.

First of all, forgive my crude drawings. And if you already have a working knowledge of basic arrythmia, and you have found something wrong with my explanations or drawings, remember that I learned this in EMT class, not cardiology school. Notice how the heartbeat labeled PVC does not have a P - Wave. The cardiologist explained to me that a PVC is an irregular heartbeat, but is something that occurs normally in everyone. The only thing odd seems to be the fact that I notice mine, and there are many more than what should be. I asked if this was related to a congenital defect of the heart that is slowing damaging me, and she reassurred me that this was not the case.

My cause, she explained, was not due to an abnormality of the heart itself, but as a result of an abnormality in the way my body supplies my heart with electrolytes. I was very glad to hear that my heart was not slowly killing itself with these strange beats, but nevertheless it is still disquieting how well I can feel them. She has given me a heart monitor to wear, which consists of two electrodes attached to my chest (they shaved patches of chest hair off, it looks pretty weird), and connected to a small device that resembles my pager. When I feel "symptoms," I am supposed to hit the record button on the monitor. After three such recordings, I have to call a toll-free number, talk to a foreign-sounding operator, who asks me what I was doing at the time, and whether or not I am ok. I then hit the send button on the monitor (it has a built-in speaker which you place on the telephone's mouthpiece), and it sends out a tone similiar to a computer dialing up to the internet. Presto-chango, thats it.

When I am done with the heart monitor, the cardiologist will review the data and determine the severty of the PVC's (they could also be Premature Atrial Contractions). Based on the findings, I may be prescribed a beta-blocker, but this will be done either at a very low dose, or not at all. The side effects of which being fatigue, and impotence.

Yikes.

But at least I'm not dying, so thats rather blamshit in itself!

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