Have got my date for ablation. 4 weeks away!

What was your SVT Frequency before the ablation? Have you had any SVT's since the procedure?

Hey James, 

1st SVT was about 2.5 years ago. Didn’t know what they were until my 1st ER trip last Labor Day last year.  2016, I don’t know if I had any after the first incident. Last year I probably had 6-10 episodes, always while exercising. I was also drinking coffee daily and chewing way too much nicotine gum and a lot of stress with my company shutting down.  This year before ablation(7/16) I had probably 10-15 SVTS. Big one on plane that put me in ER on other side of country.   

I’m two months out from ablation and zero SVTS. Doc said he was confident he got all of the aberrant signals,(3 spots on my left atrium, crossed septum). They said I was easy to get into SVT and I basically stayed in them until they got all three triggers.  I’ve had pacs and pvcs occasionally but that’s it. The 1st 2 weeks after ablation we’re a little rough cuz I’d get Tachycardia between 100-120bpm wile resting. I wore holter monitor a few weeks ago and did a stress test two weeks ago just to be sure my heart is A OK and everything is great according to cardiologist.  Anxiety/fear has been the biggest thing I’ve been dealing with post ablation. The fear that I’m just going to have a heart attack now. Probably irrational as I’m healthy male, great diet, exercise 4x/week, stooped nicotine gum and coffee 3 months ago...over thinker.  

T​hanks for the perspective! I have tried everything to get them to stop on my own, but nothing works.

Of course! I feel ya. I did lifestyle modifications first (no caffeine, no nicotine, more sleep-7-8hrs, stress reduction, praying, meditating,  whole food diet, more consistent exercise) it helped but I’m not sure how much because I don’t have a lot to compare.  After several months of that went to drugs,  they rxd Cartia 120mg XT. Worked but again, not much more than lifestyle. Finally said going all out. With such a high CURATIVe rate and low risk it was worth it to do it. I aam amazed at some people’s stories on here and where that people have dealt with their SVTS for decades. It was too disruptive for me to continue on without more permanent intervention.

I suppose if I was very active outside the home, I would have dealt with this long ago. The past 10 years I haven't got out much, working a lot (desk job) and raising a family. I am now averaging twice a week and I am ready to get it done.

Can i ask about post ablation. I have read a few people who said they got sinus tachy in the weeks after ablation. You said you got this 100-120 bpm at rest. Can i ask how long the episodes lasted and how often you had them. I find if i know what to expect i cope better! Drs are notorious for not explaining.

Well in my opinion after doing research for a month it was well worth it for  VMS the anxiety and fear the svts were causing me, disrupting every facet of my life. I became too fearful to go to movies, go out to eat, go camping, mountain biking, flying.  All because these became triggers for me mentally since I had svts in each of the aforementioned situations.  I highly recommend you do your due diligence in finding an EP that you feel you can trust with a good amount of experience doing ablations.  

Hi Deborah, 

Just saw this and responded on a different post from you.  I had 2-3 sinus tachy events post ablation.  The worst one was the day I was discharged (had to stay overnight because they crossed my septum. 1st time sleeping in hospital. Decent food, family around, annoying having nurse Check my groin every hour, especially when sleeping at night..I digress). That 1st night I was resting on couch when tachy started. It got up to 105-120bpm and lasted for about 30-45 minutes.  I had A LOT of fear because I wasn’t sure my heart could handle it so soon so that probably elevated it and prolonged it more due to fight or flight response. Only had 1-2 more over next couple of weeks.  The other 2 were barely over 100bpm while at rest and lasted for several minutes.  I was also less scared after talking to cardiologist and teledoc. They assured me my heart can handle beating fast during recovery.  Even with septal puncture and 3 ablated spots in my left atrium the cardiologist said I could begin working back into my normal activities and exercise after 1 week.

He said he had been doing it for 11 years. The part I am uncomfortable with is that I wanted it captured on tape to see how many different types of SVT I have. I get the Sinus Tach too, but rarely. The feeling is that my heart rate steadily increases for 5 seconds, then comes steadily decreases to normal within another 5 seconds. Most of the time, it just takes off (between 130 and 160) and goes away on its own within 30 seconds, or I do a valsalva maneuver and it is usually resets it within a minute or two.

I think the only way you’ll get it captured is if you wear a holter monitor or 30 day event monitor.  Unless you happen to have SVT then get into cardiologist office or ER and have EKG done.  Outside of that I think the only way to know for sure what type of SVT you have, AVNRT, AVRT, AT IS to have an electrophysiology study done which is basically everything done in an Ablation minus the actual ablation.  I can’t imagine doing an ep study without doing ablation too.

As I mentioned in an earlier reply, I have been to the cardiologist twice in the last 4 years. I have had EKG numerous times, Nuclear Stress Test twice, Echocardiogram twice, and now the Table Tilt Test. 4 years ago and probably about 10 years before that, I wore a monitor and they never captured the SVT because they were far and few between. Now that I average one a week, the EP doesn't want one done.. He thinks it is unnecessary.

James, 

They prescribed me 325mg enteric coated aspirin for 2 weeks after my ablation.   Pretty normal for any type I think since they are putting catheters into your veins.  Keeps post op risk of clots low(already at <1% I believe).   In addition, if you have insurance you shouldn’t have to pay anything out of Pocket. I aren’t even gotten the hospital bill yet ($3200 my portion). Cardiologist bill was separate ($419 my portion) and I got that a month ago.  

I can totally relate to the fear part and the procedure itself was easy compared to how much I was worked up the month leading up to it.  

They put me on 81mg of enteric coated aspirin for 2 days when they some blockage in my artery and my stomach couldn't tolerate it for 2 days without pain from it. I'm just sensitive to it. I am sure they must have an alternative. I guess my biggest concern is all the money spent so far (Echo, Stress Test, Table Tilt), and then to go through with this procedure to tell me that they couldn't trigger the SVT or it didn't take. It's funny how terrified I was about getting the SVT's once a year, then 5 times a year, etc. Now I have had over 50 this year alone. It's all perspective I guess. You just get used to it. Thankfully, I am able to get them to stop on my own. 98% of them I can get them to stop within 30 seconds. Thanks for the perspective.

Well that’s awesome that you’re able to stop them. Modified valsalva, I’ve face, gagging, all the different things to stimulate that vagus nerve.  I found the best one was someone’s suggestion on here about fetal position on right side. That coupled with belly breathing technique helped me a lot before ablation.

The right side fetal position is my last resort. First I try and hold my breath. I then try coughing. I then try touching my toes. I then try just laying on my back. If those don't work, I lie on my right side and bring my knees to the chin and it goes away. Actually, today when it happened, I touched my toes and flexed my chest and it went away. But who wants to do all that when you are out in public? LOL Only about 30% of the time will it go away within 30 seconds by just sitting still and waiting. I am just surprised that my Cardiac Electrophysiologist wanted to skip the monitor to determine exactly what kind of SVT I have and assume that it is the typical SVT. He basically said he knows what it is based on my description and super easy fix.

Have you asked your EP why they know what you have? Did they already do an ekg when you were having an svt? From my understanding the only way to tell what arrhythmia you’re having is to see it on an ekg. In addition I don’t think an EP can tell what type of SVT youre having until they are in your heart with catheters.  Since my SVT was captured on an ekg first time I went to ER, my EP was able to diagnosis the type of svt based on what he saw on the ekg but he said he was pretty sure but wouldn’t know for sure until I was getting ablation done. I had an accessory pathway svt and that was his thought too based on ekg.  Point being, I would ask your EP how they know. And if you don’t feel good rapport or trust, it’s always a good ide to get a 2nd or 3 or 4th opinion until you comfortable with the EP. it took me 2.  First EP was arrogant, aloof, his staff also mirrored that behavior. I didn’t like the culture and didn’t feel cared for so I bounced and found another. 

He based it on his experience and my description of my symptoms, but like you said, he would do the ablation based on his opinion, but no for sure once he starts probing around, I guess.