Pursuing Interventional/EP With ET

[tbrep]

Hi guys,

I know similar questions have been posted in the surgical forums but I wanted information specific to cardiology.

Here's my situation: I'm in first year of IM residency and interested in cardiology. My problem is: I have a moderate essential tremor (amplitude decreased but not eliminated with Propranolol), which is why I did not pursue surgery.

I've been to the cath lab and seen procedures been done. But having never participated myself, my question is: How problematic is a slight tremor in PCI or EP procedures? Is the catheter very sensitive to motion or is a degree of tremor tolerated?

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[FreakofMeds]

EP has a lot of suturing involved, and moving an ablation catheter too far can be the difference between slow pathway AVN modification and complete AVN ablation with permanent pacemaker. Also when you deploy a PCI you have to have a very steady grip of the stent and the wire to avoid missing the lesion. Not saying what you can and can't do, it all depends on the extent of your control / tremor.

Cardiology is a great field. I think even if you have tremor you should be able to do TEEs and diagnostic caths too. If you are able to suture with no issues, then device implants are very doable too. Also Non invasive cardiology is just as much fun in my opinion, even thought I am going into interventional.

 

[tbrep]

Thanks for the reply. Really appreciate it.

I can suture ok (in med school the attending sometimes noticed my tremor but I got the job done). But if I'm honest with myself, it seems EP and interventional are probably beyond my manual ability. I used to think the tremor wouldn't be too much of an issue because I can place arterial lines etc. without much issue - but I didn't realize just how responsive the catheters were to tiny movements.

 

[yolo1990]

I did a cardio rotation and from what I saw I can't imagine how tremor would be all that problematic. Once you get the catheter in, it's anchored to a secure point and that would theoretically attenuate any mild hand tremor. If your hand is shaking, you can also rest it on the patient.

I'm only a student so take this with grain of salt. But on my rotation, one of the EP guys hands weren't all that rock steady.

 

[EddieIndy]

2nd year cards fellow here: I would not let the tremor stop you for being a cardiologist. I would not even think about it now. If and when you start your fellowship, you will find out quickly how big of an issue the tremor is.