Negative EP Study/ILR

[IlovePSU]

I am 32 yrs old and for about two years now I have been dealing with abnormal heart rhythms. On my 30th birthday I had severe fluttering in my chest followed by shortness of breath and almost passing out. At the ER my heart was in the 140's but they said I had anxiety. This continued on and off for several months then on November 15th I experienced a fluttering in my chest and passed out at my desk. I was intially just told I was anxious and to move on. I went back to my PCM who referred me to a cardiologist/EP that finally listened to me. I underwent an EP Study in December and he was unable to provoke any abnormal rhythms. At that time he implanted a St. Jude ILR. I have gone now three times to have it interrogated and have been found to have had two episodes of bradycardia at 44/46 bpms and my symptoms during that time were being very, very lightheaded, sweaty and nauseous. It also captured an 10 second run of SVT and my symptoms were shortness of breath and dizziness.

My EP has not returned my phone calls and is leaving me hanging as to what this might be. I have since had another 30 + second run of what I am assuming was SVT while on an airplane two days ago. Then last evening I was awoken feeling horribly dizzy, my left arm was numb, short of breath heart was racing and I had mild chest pain for about five minutes.
What are your thoughts about what might be happening? Since I cannot get in touch with my EP, what do you think I should do? I was unable to sleep last night after that happened as it scared me so very much.

I don't know if this is of any signifigance but it was noted on my EP study paperwork that "Programmed stimulation revealed concentric decremental VA conduction with and without isuprel. Given that there was normal AV node physiology with no echo beat or inducible SVT ablation was not performed. What does this mean?

[CCF HeartMD-2]

During the EP study he was looking in particular to see if you have a condition known as AVNRT or AV nodal reentrant tachycardia.  This is a condition in which there are two speeds of conduction in the conduction center located in the middle of the heart, in which extra heart beats may provoke a sustained supraventricular tachycardia or fast heart rate. This is the most common cause of fast heart rates in young people coming from the upper chamber of the heart.  The decremental VA conduction was looking to see if there was any bypass tract between the upper and lower chamber of the heart. Basically, the EP study was normal so it did not make sense for him to do an ablation which could be associated with risks if there was nothing convincing to treat.  
With regard to the low heart rates, it would be important to know if these were sinus bradycardia or another rhythm.  Also, if this happened in the middle of the night or while awake and during activity before jumping to conclusions. In general, physicians are very hesitant to implant pacemakers unless absolutely necessary, as there are associated long term risks such as infection, etc.  
Best of luck.

[IlovePSU]

I had a stress test two years ago and my heart rate shot up quite quickly and the test was stopped after six minutes because it was over 200bpm. My heart does go up quite quickly even with normal activity it is usually 120-130bpm. I just wonder about the low, lows and the high, highs and what that might suggest.

[CCF HeartMD-2]

Not unusual to have both fast and slow heart rates.  Another test that may be done to assess the so called chronotropic response, or heart rate response with activity, is called an exercise stress with EKG only.  Given your age, you maximum predicted heart rate would be around 182 beats per minute, and then they would try to get you to achieve around 85% of that maximum predicted heart rate.  If you are able with exercise to get your heart rate up, it would be a good sign that your heart rate goes up as needed with activity.

[IlovePSU]

Both times it was sinus bradycardia and was during times that I was awake and going about my daily activities.
Thank you for your response=) What are your thoughts on the brady and the SVT having both of them?