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Question
Posted by: lynne | 2011/09/19

congenitle corrected transposition

Hi Doc
i seek further information on my condition. I have congenitally corrected transpostion of the heart, which was discovered when i was 2 yrs old. i am now 43yrs old.
i suffered with pulpitations and was put on sotacor at that time then changed to tenormin, i had a bad case of tracacardia nealy 4 years ago and was put on isoptin 240mg. in december 2010 i was battleing with fatugue and battling to have energy. on visiting my cardiologist in johannesburg, i was told i now have AV block, i was weened off the isoptin and tenormin as was heart rate was too low (determined by dooing holter) during the night. since being off the tablet i am not showing any of the same symtoms and have been feeling alot better and doing alot more work etc.
although i have been advised that i should look at having a pacemaker and an ablasion done to correct the heart rate and block. i am very nervous as i have this condition and have one weakish valve, how would this affect me and would your opinion be?
regards lynne

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Our expert says:
Expert ImageCardiologist

Hi Lynne:

Congenitally corrected transposition refers to the situation where the left and right ventricles (“main pumping chambers”) have in effect swapped places. This in itself is not necessarily a problem, but congenitally corrected transposition is often associated with other anatomical abnormalities, such as holes in the heart or abnormal valves, and with cardiac arrhythmias. (You mention you also have an abnormal valve.) It sounds like you now have an abnormal heart rhythm, probably atrial fibrillation, which your doctors treated with Sotacor and subsequently Tenormin and Isoptin. This then caused electrical block between the upper chambers (atria) and the lower chambers (ventricles) and as a result the Tenormin and Isoptin were withdrawn. This is a common problem in patients with atrial fibrillation, namely how to control excessively fast heart rate, at some times, without aggravating a tendency for excessively slow heart rates, at other times. Drug therapy is often unsatisfactory and a good alternative strategy is the so-called “pace and ablate” strategy which involves putting in a pacemaker, followed within a week or two by an ablation procedure which isolates the atria from the ventricles and therefore prevents the ventricles from going too fast. The pacemaker can then easily be programmed to ensure optimum heart rates both at rest and with exercise.

Pace and ablate is a very effective strategy and need not be influenced by the fact that you have a “weakish valve”. If drugs cannot achieve a good balance between palpitations on the one hand and heart block on the other, then pacing followed by an ablation is a very good treatment. The probability of success is very high and it sounds as though your cardiologist knows exactly what he/she is doing. Most patients who have this procedure feel very much better afterwards and are very pleased with the treatment.

Best wishes for future health, JT.

The information provided does not constitute a diagnosis of your condition. You should consult a medical practitioner or other appropriate health care professional for a physical exmanication, diagnosis and formal advice. Health24 and the expert accept no responsibility or liability for any damage or personal harm you may suffer resulting from making use of this content.

2
Our users say:
Posted by: Lynne | 2011/10/06

Hi
i have not had a reply in more than 2 weeks? not sure if this has gone to anyone or not?

can i then ask if you may refer me to a cardiologist in Johannesburg who deals with congenitle corrected transposition?

regards
lynne

Reply to Lynne
Posted by: Lynne | 2011/10/06

Hi
i have not had a reply in more than 2 weeks? not sure if this has gone to anyone or not?

can i then ask if you may refer me to a cardiologist in Johannesburg who deals with congenitle corrected transposition?

regards
lynne

Reply to Lynne

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