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Heart Disease  (Expert Forum)
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Ablation Created a New Tachycardia
Answered by
Cleveland Clinic -
Cleveland - OH
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MedHelp Member's Question

Ablation Created a New Tachycardia

by glassheart46, Dec 10, 2003 12:00AM
I posted before about all of my post ablation problems in particular, sinus tachycardia. I am now 6 weeks post ablation. I was to my EP for a follow-up the other day.  I had worn a Loop monitor for 3 weeks prior.  My doc stated that I may now have Innappropriate Sinus Tachycardia as I had captured a 20 minute episode of 160bpm 2 weeks earlier of sinus tachy.  He feels it may be temporary or could end up being permanent.  I was burned three times near the mid and lower crista termanalis region and he pointed out that it was near the sinus node.  I was ablated for avnrt (240bpm), atrial tachycardia (140bpm) and extrasystolies.  All of the three problems ablated for were a success he stated. I am disappointed that I now have to be medicated for a new tachycardia as it causes me to be depressed and very tired which is why I had an ablation in the first place as I had been on Verapamil. I have only had the one episode but was put on Toprol XL (50 mg one per day)right after that episode which does help. My question: How often does IST happen after ablation?  What are my chances of it being post ablation irritation? Is there a possibility that my sinus nerve was damaged? Can I drink at least 1/2 cup of coffee per day or will that irritate the sinus tachy even on Toprol. I was able to drink coffee before the ablation without any problems. Also, what, if any, are the long term effects of Toprol? How long before I'll know if it is temporary or permanent?  Thanks for this forum and Happy Holidays!
Doctor's Answer

by Cleveland Clinic, Dec 12, 2003 12:00AM
glassheart,



Some of the side effects of ablation is the unmasking of other arrythmias and the creation of others. I'm not sure how often inappropriate sinus happens afte ablation, but its frequency is increased by manipulation around the crista terminalis.



The longer you go from your ablation the less likely your arrythmias are from irritation. One rule is that they should be occuring less frequently as time goes on.



The only way to tell if caffeine makes a difference is to try to go without it. 1/2 cup isn't too much, but if it triggers, then its too much.



Long term effects of toprol are just the side effects of the medication which some experience and some dont which will go away with stopping the medicine, mainly fatique.



good luck
Member Comments (22)

by BlueHeron59, Dec 10, 2003 12:00AM
I am anxious to hear a response to this.

I had a Isithmun flutter ablation done 7 weeks ago and

life has never been the same. I was put on Flecanide and Toprol

and since have had numerous tacycardia episodes with

extreme feelings of blacking out. After numerous ER visits

and back to the cardiologist, noone has any answers.

We caught it on an event monitor and it was simus tachyacrdia and not flutter or afib again.



So now they have me off the Flecanide and almost

off Toprol to see if the medications are causing it.



Being 44 I am still wondering if this is hormone related and

HRT might help.??

by DottyCece, Dec 10, 2003 12:00AM
I had an atrial flutter ablation attempt im August but it failed.  For a two month period of time, I was AV paced or V paced for the most part.  Then I developed atrial flutter again and have been cardioverted three times since Sept.  Even though they were unsuccessful with the Atrial Flutter ablation, my electrophysiologist said that I may stay out of flutter since he cust many of the pathways..thought I may just develop other flutter origins.  I have had periods of atrial fibrillation since the ablation attempt.  Bottom line, I really expect to have a number or arrhythmias in the future.  Nothing is absolute and we are all so different in response to interventions.  I was taking amiodarone and have quit on my own. It has made no difference one way or another and with all the side effects, I really felt that nothing is better.  If I take anything in the future, I may ask to go back on a low dose of sotolol since I have the pacemaker so the rate wouldn't be a big issue.  I did well with sotolol and had no arrhythmias during the time I took that drug.  



Yes, this is all very frustrating and I wouldn't wish this on anyone.  No matter what they say, one never feels right with all the drugs etc. etc.

by bama jane, Dec 10, 2003 12:00AM
I will be very intersted in hearing what the doctor says as well.  I had an ablation attempt 4 years ago and it failed. I have numerous atrial arrhythmias and it really affects the quality of my life as it does everyones.  I have not heard of too many successful ablations on the internet, but as my husband says if you were fixed or controlled you wouldn't still be on the internet looking for things to help your condition because it would be over and you would want to forget about it and move on.  That is true but it would be nice to hear some success stories.  Everyone is different and I guess no one knows how burning a little place on your heart will affecct it until after it is done, but I have heard that it takes a while for your heart to settle down after this procedure. Good luck to everyone.

by glassheart46, Dec 10, 2003 12:00AM
To: Hank and others
I agree with you totally Hank.  I only wish I'd have know about the possibility of new arrhythmias before I was ablated.  I have myself to blame as I did not do much research prior to ablation.  I think If I had looked into it further and asked my EP more questions, I may have choosen not to be ablated.  It is too late now and I cannot look back.  I only hope that my situation will aide someone else.  I, like a lot of people, stupidly think that doctors know everything. They are only human like the rest of us but I think we loose site of that fact when we are ill.   I trusted my cardiologist.  After all, HE IS A HEART SPECIALIST!  Well, I have learned a valuable lesson.  We are our own advocates of our health and must rely upon ourselves to figure out what is best for us and use our doctors as a means of making an informed decision.  I think individuals with an arrhythmia should do their homework before jumping into the frying pan.

by Momto3, Dec 11, 2003 12:00AM
To: bama jane and others
It does seem as though we only get to hear the bad stuff on these boards...Thought I'd let others know, when ablations are recommended, they can be very successful! HERE HERE!! For those of you who have pvcs and/or pacs, have the standard tests to rule out anything serious, and trust the good doctors. If you cannot talk with your doctor, find another one...There are MANY, MANY wonderful doctors out there.



Just thought people should know that there are success stories out here :)



Happy Holidays everyone!

by Momto3, Dec 11, 2003 12:00AM
To: hankster
Hank,



Boy, you got that right!! I couldn't agree more. To anyone facing the possibility of a cardiac ablation, do your homework and be sure it is being done for the right reasons!! In my case, it was done for medical reasons, NOT for symptomatic relief. In fact, when I first broached the subject of an ablation for symptomatic relief of my pvcs(years ago), I was told it was "not necessary". AND, I was having bizillions of pvcs/day...Learning to "live with it" was the best decision I ever made :)



Hey Hank, send some of that sunshine up here to Cleveland! It's getting chilly....Happy Holidays!

connie

by Scientist, Dec 11, 2003 12:00AM
I too have had a failed ablation (for flutter, which got worse afterward -- does anyone know the statistics for this, other than "rare"?), but I have some hope, as I have looked into a comment by my EPS about a complete cure of one patient through Chinese medicine.  It turns out that Chinese physicians and some alternative western doctors both believe that many arrhythmias are caused by a chronic viral infection (I have Epstein Barr).  While mainstream physicians know that some arrhythmias are caused by a viral infection, I understand that they do not tend to follow this path for other cases (but rather treat the symptom only).



Because I've learned about antivirals (not pharmaceuticals, but rather certain herbs and particularly ionized silver  -- it's easy to find claims about them on the web, and not only by commercial interests) and because of their relative safety, I have been experimenting.  The jury is still out, but I suspect I'm improving.  Progress is very slow; I've been working on it for one and a half years (I also have chronic fatigue and was initially limited by the strong Herxheimer reaction).  The CRS is better.  But it's very tricky to assess results, because improvement is preceeded by worse arrhythmia.  Moreover, I have discovered the need for other supplements such as cysteine and magnesium.  I am not a physician, so this information is only information, and not to be trusted for personal use.

by Scientist, Dec 11, 2003 12:00AM
I think it's important to contact professionals from varying backgrounds or somehow to learn about different approaches to health.  I've found both wonderful help and also great deficiencies in every area.  I'm grateful to my mainstream EP/cardiologist for his knowledge, and Norpace keeps me out of flutter.  Yet (for example) the mainstream doctors I've seem less aware of magnesium as a natural calcium channel blocker, than the nutritionists who studied its effects decades ago.  The person who probably helped me most was not a mainstream doctor (tens of whom had failed to diagonose my chronic problem), but someone who had studied with a Chinese physician (after examining me, she simply stated "You have an active virus" -- that was later confirmed by standard tests).



I also find I need to weigh the sometimes conflicting views of various professionals.  I've had to learn a lot.  It's been worth the constant uncertainty and pain.  I couldn't have come this far without the help of caring from experts several backgrounds, nor without my own judgment and wisdom.  I'm saying this because I'd like to encourage anyone who has health challenges to pursue her/his own path to health, relentlessly, with the belief that answers can be found.

by KarenSA, Dec 12, 2003 12:00AM
To: CCF Doctors
I think it would help a lot of heart forum readers if there were more feedbacks from successful ablation patients.  I agree with the comments earlier in this thread that the successful ablations probably don't read this forum but this will be negatively skewing the results of a potentially lifestyle improving procedure.  Is there any chance of building a webpage like this one and asking successful ablation patients to post their stories on the site?

by Momto3, Dec 12, 2003 12:00AM
To: KarenSA
Karen,



What a GREAT idea! When I was facing my first ablation, I also searched for "good" feedback....not much out there.  I reminded myself to return to the forum and post, especially if I had something good to share. Count me in among the lucky ablatees....have had two successful procedures this year...Keeping my fingers crossed.



Happy Holidays!!



Connie

by Momto3, Dec 12, 2003 12:00AM
To: Hankstar
I was happy to read your post about the number of success stories.  I'm with you...If the doctor is not advocating strongly for an ablation, forget it! There are some risks with the procedures, but the decision for me was easy since the CM was a bigger risk...It was kindof good (in a weird way) because I have a hard time making decisions :)



I consider myself very lucky since an ablation was never really an option even will all those pvcs. However, when the story changed and my options came down to staying on the anti-arrythmics (YUK) for life or trying an ablation, I decided to give it a try. I asked the doctor what she would do, and she said she would have the ablation. That helped since she is very conservative and empathetic. I'm actually surprised at the number of people who want ablations for occasional pvcs, etc. Maybe they have pain or something, but I'm with you...not unless I needed one! For years, I was one of those patients who thought that the pvcs HAD to be doing some damage to my heart...they just had to be! How could anyone have an arrythmia that was considered benign? I just couldn't accept that until I found this new EP. She actually has pvcs so she GETS it! She understands what I am feeling and she convinced me that they truly are benign.



Thanks so much for your thoughtful and educational responses. As my uncle would always say, "You do good work!" lol...



Thanks for the sunshine! It's shining beautifully on the 6 inches of new snow : )

Connie