Connect
← Return to What's a nuclear stress test like? Is it safe?
Discussion
What's a nuclear stress test like? Is it safe?
Heart Rhythm Conditions | Last Active: Oct 5, 2023 | Replies (70)Comment receiving replies
Lori, thank you for your post. My biggest concern about the scan comes from this note in the Lexiscan prescribing information: "Do not administer LEXISCAN to patients with:
• Second- or third-degree AV block, or
• sinus node dysfunction
unless these patients have a functioning artificial pacemaker [see Warnings and Precautions (5.2)]"
I don't know if I have sinus node dysfunction or not. My doctor told me this was something that would be determined by the scan. But maybe there is some other test that should be performed first?
I should mention that I live in an area classified as "medically under-served." The cardiologists' reception room is almost always standing room only. I think the doctors are doing the best they can with an overwhelming patient load. Still, it is unsettling to be told, "Call if you have any questions," when voice mail may or may not produce a response.
Replies to "Lori, thank you for your post. My biggest concern about the scan comes from this note..."
I had a nuclear stress test in 2018 after having "failed" a conventional one (the attending dr. stopped it because he thought he saw my HR begin to descend after reaching 112 bpm; I did not notice this). They were testing my asymptomatic bradycardia (my HR had gone as low as 21 bpm on holter while in sleep). I was so conflicted and terrified to do the nuclear test that I didn't sleep the night before, but the experience itself was not bad and in some ways revelatory. The attending doctor (same person as before) warned me that they may need to give me drugs to make my heart pump fast enough, but on this occasion a nurse was present by the heart monitor who spoke reassuringly as I got on the machine. I was almost in tears as I walked, but she kept reassuring me and my HR reached 140 without drugs. Maybe it would have anyway, but I felt incredibly lucky to have had her by my side.
Connect
Hi again! After reading the information from the Lexiscan site (5.2 and 5.3) and doing a little more research into your situation, I can see your hesitancy in regards to having this test done with your current symptoms. I misunderstood before. I thought it was regarding the test itself.
You’ve already been diagnosed with Afib and arterial fluttering after wearing the monitor and have tachycardia/bradycardia symptoms, both of which can be complications of sinus mode dysfunction. And that is definitely on the contraindication list of this test, unless those conditions are being corrected with a pacemaker.
If this were me, I’d certainly want reassurance too before going ahead with this.
Digging a little further on various sites, sinus mode dysfunction or, it’s also called sick sinus syndrome is determined with an ECG, an event monitor-ECG which you wear for a few days, a Holter monitor, or an implantable loop recorder that records your heart over a longer period of time if you have irregular episodes of symptoms.
Here’s some information from the Mayo Clinic site on Sick sinus syndrom.
https://www.mayoclinic.org/diseases-conditions/sick-sinus-syndrome/diagnosis-treatment/drc-20377560
In my unprofessional but concerned opinion, it’s in your best interest to get further information from your cardiologists office. I know you’re not very comforted by the fact that they seem overworked. But that should have no bearing on how you should be treated, if nothing else it is all the more reason for you to ask for clarification. Is there a patient portal where you can contact the doctor or a member of his team, Nurse practitioner, to address your concerns?