Worries about ablation etc

Posted , 14 users are following.

Hi all,

I've had infrequent SVT episodes for about 8 years. In that time, through fear of reoccurring episodes I have cut down on pretty much all forms of exercise, which is impacting my lifestyle.

I caught the SVT on an ambulance ECG about a year ago. Since then I’ve seen two cardiologists who have both, without hesitation, said I should have an ablation (even with the knowledge that my episodes aren’t that frequent). Both dismissed the use of drugs as they thought that the side effects would outweigh the benefits, and both downplayed the seriousness of an ablation (one says if he completed the procedure on Friday I should be back at work on Monday, the other compared it to a dental procedure).

I’m terribly scared of an ablation, but also live in fear of SVT episodes (which can be triggered by simple things like lifting heavy objects or bending down).

Are drugs really not worth it? Is an ablation now so safe that it’s the go-to option even if the episodes aren’t that bad?

Thanks in advance. I’d really like to talk to some people that have had ablations on the phone if possible... if anyone can think of a way to make that happen that would be great.

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  • Posted

    I did an EP study with possible ablation but the doc did not do the ablation because he couldn't trigger the episode long enough. I had sever anxiety before the procedure but it was so easy, I wondered why I was so worried after lol. Ablations are now so common, they are becoming first line treatments for SVT's. When I went to the hospital for mine, there were like 5 or 6 others scheduled. All though there are some inherent risks, the complication risk is low. If your sporadic SVT episodes are impacting your life, I would do the ablation if I were you. Since they could not ablate mine, I am now on beta blockers, which absolutely suck. Not only do they make me tired, they cause my PVC's to be worse I think. My EP doc doesn't want to give up on the beta's so he won't switch me to a calcium channel blocker until I've tried a few different ones. I'm on my second beta blocker, and think within the next few weeks, I'm gonna ask him to switch. He wants me to try at least two more before the calcium blockers, which sucks lol. And, calcium channel blockers have their own list of side effects. If you can take care of your problem and not be on meds for the rest of your life, that would probably benefit you in the long run. Of course, everyone responds to medication differently so if you want to try the meds first, you can do that and always fall back on getting the ablation done in the future.

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  • Posted

    Hi Chris,

    I have heard bad and good results for ablation. First, research your selection of surgeons. Please, PLEASE DO NOT TAKE THE WORD OF THOSE WHO CLAIM TO HAVE HAD SUCCESS OF ANY SURGEON. I just made this huge mistake in selection of a surgeon to perform an endoscopy carpal tunnel release. This maniac surgeon went nuts doing such an easy surgery. He took a cylinder shaped probe and continuously and violently jabbed it in and out of the home in my wrist. His nurse told me I wouldn't need any pain meds and sent me out to drive on the interstate a 2.5 hour drive to my home. Once on the interstate the analgesic wore off and my wrist light up like a torch. It was hell getting by home. Pain like I have never felt before. I am now getting an MRI to see what damage this guy did to me.

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  • Posted

    Our University Hospital electrophysiologist estimates chance of ablation error/failure at no more than one percent. Pharmacist Ben Fuhks of Critical Health News considers ablation an atrocity. You might be able to talk to him when he's on CoastToCoastAM (once a month). Ben says SVT is a back problem so instead of bending over, squat. See my other comments on topic. Get the CHNewsletter to find out when he's on C2C.

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  • Posted

    They tried an ablation on me but it did not work. They also tried me on a beta blocker, which made me nauseated. Then they switched me to a calcium blocker 240mg every morning. That worked a little, but still had some episodes so they added 120mg in the evening and it's keeping it all in check with no side affects . I have not curtailed my activities at all, but watch what those activities involve. I may have an episode if I bend over to pick something up or lift my hands too high. I also cannot have caffeine. Even Starbucks decaf has too much caffeine for me.

    Start keeping tabs on what triggers you episodes. Try not to curtail your activity, since that will lead to a host of problems, especially weight gain.

    I agree on the ablation. It really worried me and if I had it to do again, I wouldn't do it.

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  • Posted

    Hi, I am scheduled for an ablation next week. I used to just have very infrequent episodes but then they became frequent so I was put onto daily Flecainide about 8 months ago and it has been great, but it does make me tired. Then the Health Board decided I should have ablation.

    I live in a country that has a free national medical service, so I just go along with what the hospital experts say and don't have to worry as to whether someone is spinning me a line just to get my business. The two people I know who have had ablation have been really happy with it. My hospital does ablation every day. The risks are pretty low these days and the success rate is pretty high.

    My ablation will be done as day surgery. I go in in the morning and then go home in the evening.

    I have been advised to take two days off work after the ablation, but some people in sedentary jobs can return to work earlier. I will work from home on my 2 days off if I feel up to it. I am looking forward to the interesting experience, and I hope, not having to take Flecainide every day.

    My advice is try flecainide or metolprolol first if one of them is right for you, then if it doesn't work out for you, have an ablation. In the meantime,I would not advise limiting your physical activity. I exercise every day and have done so through all my heart's ups and downs. A strong cardiovascular system is important in limiting the effects of SVT.

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    • Posted

      Thanks for the advice. I don't really fancy taking the medication - it seems to be the case that doctors are so confidence these days about abation that it's their number one option.

      I'm guessing you're English (either that or your english is great). I am too, and I trust the NHS, of course.

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    • Posted

      Hi, I had my ablation yesterday. The surgery was done in my local hospital (I live in New Zealand) as day surgery. It is very routine, they do several a week, and the surgeon is world-class.

      I found the surgery quite fun, watching on the screen the instruments moving round in me and conversing with the 6 staff involved (senior surgeon, junior surgeon, and I think 2 techies for the x-ray and whatever else, 2 nurses to administer the cocktail of drugs to rev me up, slow me down, etc. at different parts of the op). There is a huge amount technology involved, demonstrating the pinnacles of human mental, scientific and technological abilities. Something to be truly grateful for.

      The worst part of the day was lying completely still for 4 hours after the op, a small price to pay.

      The surgery barely deserves the term because it is quite a minor operation. I was awake throughout most of the procedure. (I dropped off at some point when the mild sedation they use to keep you calm overcame me.) I went to hospital at 7 am and was home by 7 pm. And now, after a good night's sleep the only thing to show for it is a plaster on the groin.

      I intend to log into work and have a normal working day (at home) soon.

      Enjoy your day. I know I will enjoy mine!

      Katherine

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    • Posted

      Hi Katherine,

      So wonderful to hear your ablation went well. Enjoy some down time and rest.

      Did you find out what type of SVT you had?

      Unfortunately, My experience has not been as successful as your. I have had 3 attempted ablations but never ablated.

      I have AT, and do not take any meds. I did take Bisoprolol for about 3 months when this first started Feb 2016, but could not handle the side affects. I am 64 years old.

      Congratulations on your success and enjoy a SVT free life

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    • Posted

      Hi Katherine,

      how's it feeling today? May I ask whether you were on any medication - CCBs or BBs? If so have they stopped these immediately or will they be phased out? I think I have SVT and AT and I'm taking Diltiazem.

      I am having a repeated attempt next week and while I wouldn't call it fun I did find it fascinating. I had no sedation last time.

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    • Posted

      Hi, I don't exactly know, but they were expecting to initiate focal atrial tachycardia, which they did. But then they also initiated AF, which surprised them. They had to ablate right round the veins that go from the left ventricle to the lungs to get rid of that.

      Unfortunately the surgeon, who was going to talk to me in more detail after the op, once I was a bit more alert, got called away to an urgent op, so I didn't get to grill him on the details, so I am only going on what I saw and what his off-sider told me.

      I have been on Flecainide for the last 6 months. It made me tired so I cut the dose right down. But I had to stop last week in preparation for the ablation, and I was surprised at the feeling of well-being that returned. And luckily I didn't have an episode during those few drug-free days.

      Sorry to hear you were not able to be ablated. THREE times! It was an interesting experience but not one I would want to repeat in a hurry.

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    • Posted

      Hi Fex, I was on Flecainide for 6 months but was told to stop taking it 5 days before the op. Now I have to take blood thinners (Dabigatran) for up to three months and avoid contact sports or anything that could cause bruising. No other meds.

      I have generally low blood pressure so would not need CCBs.

      Before I went on to daily Flecainide, I carried metolprolol as a 'pill in the pocket' for if I had an episode but I don't think it ever did me much good. I suspect that suppressing my heart rate made it harder for me to resolve the episode through valsalva or whatever.

      No sedation? At one stage, because my heart was racing I started to feel a bit panicky but I figured that I really didn't have anything to worry about. I am not a fan of drugs but during the procedure they seemed to be administering all sorts. I didn't have any say in that. The sedative was fentanyl. The only thing I know about it is it kills rock stars, but since I have no musical ability, I was safe 😃.

      I really hope your next attempt is successful.

      cheers

      Katherine

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    • Posted

      Hi Katherine, I'm in the UK and asfaIk they don't do the "pill in pocket" thing here which would be reassuring. I don't have high blood pressure I take CCB for the SVT. I'm off them now for five days and so far so good. It's nice to feel what it's like without the drugs (and side effects).

      Did they ablate the AF as well? I have both SVT and paroxysmal AF but I have been told that would require a separate procedure as you have to be given anti coagulation before an AF ablation.

      They didn't give me sedation as they were struggling to trigger an episode and that makes it harder. They never managed it which is why I'm going in for round two.

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    • Posted

      Ok, sorry about misunderstanding the role of CCB. I think 'pill in the pocket' is a good approach but I should have had Flecainide rather than Metolprolol for it, to regulate the heartbeat rather than slow it down.

      Once my episodes got too frequent I went to daily Flecainide, which gave me back my life but made me tired. And I was put on the waiting list for ablation.

      I am not 100% sure that they got to ablate the SVT. I hope they did. The complicating factor was that once they had initiated SVT, resolved the SVT, and put in the ablation catheter, when they went to initiate the SVT again they got AF. They definitely went after and ablated the AF, which took a long time as they had to ablate circles around the pulmonary veins. I only remember feeling one episode of SVT during surgery. For me it causes massive fast thumps, rather than what I assume to be AF, which causes a little fast pulse I can barely detect if I try feeling my pulse.

      They had not previously known that I had AF although I suspected it. Only trouble was the first time I went to ED because I couldn't resolve the AF, some months ago, at the time I thought it was just an SVT that felt different. After a few hours they told me to go away again because there was nothing wrong with me. They didn't seem interested in engaging with the cardiac staff or checking my hospital notes. They told me that a heart rate of 89 was in the normal range, never mind that 1) I had achieved it by taking metolprolol, bringing it down from 130, and 2) my resting heart rate is 55. So there I was with a normal rhythm within the 'normal' range, and no diagnosis of AF, with and ECG output not showing an abnormality.

      So when I was on the table on Wednesday that was the first 'official' recognition of AF. Such is life.

      During the surgery I was given the blood thinner heparin as well as everything else.

      I'm not sure why they sedated me as I was happy to hang in there. Perhaps that was the only way they could resolve the SVT while they were getting the ablation instruments in.

      Good luck!

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    • Posted

      Your case sounds similar to mine. As far as I knew I "only" had SVT which as you say feels like very characteristic regular thumps.

      I was taken to A&E last year with SVT and a HR of 240 . While in resus it seems to have changed into AF. Since then I think I've had a few short bursts of AF which feels more like a buzzy sensation, like you I can't really tell from my pulse whether it's AF.

      Cardiologist plans to try and ablate the SVT first and map the AF if it's there.

      We will see!

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