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Heart Disease (Expert Forum)
failed ablation yet another run of tachycardia
Answered by
Cleveland - OH
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failed ablation yet another run of tachycardia
by Dawn2112, Aug 01, 2004 12:00AM
I am a 36 yr old female and have had palpitations for years. Never did anything about it until one day I came just short of passing out. I was sitting one day when I thought I was going to pass out. (vision shook, hands and neck sweaty, shaking, something going on in head, very pale) My pulse was 146 and BP was 168/120. Sister drove me to a hospital in my home town 35 miles away. When I got there BP was 196/94 and hr was 100 (this was 2 hours later). After they hooked me up they told me I had irregular heartbeats (PVC's in a row) they admitted me and that night I had multiple PVC's in a row (an alarm went off) Next day they did an echo (mild leaky valve but otherwise normal) and sent me home on Metoprolol 25 a day. Here are my questions.
1. Was eventually sent to an EP specialist. Had a Holter and said he saw the PVC's but did not have a fast heartrate episode while wearing it. What is the difference between an irregular heartbeat and a run of tachycardia which makes me almost pass out? Why does it make me so dizzy and have sore chest for the whole day?
2. I had a failed ablation. But he only looked for 45 minutes and told me he "thought he knew where it was" and was sorry. He only used one catheter in right leg. Did he not look in all 4 chambers?
3. He is "mailing" me an event monitor, in the meantime had another episode yesterday, almost passed out again, had to call my doctor he told me to take 50 of metropolol (I stopped taking my meds). I don't understand why ablation failed, I know its there. Could it be somewhere else?
1. Was eventually sent to an EP specialist. Had a Holter and said he saw the PVC's but did not have a fast heartrate episode while wearing it. What is the difference between an irregular heartbeat and a run of tachycardia which makes me almost pass out? Why does it make me so dizzy and have sore chest for the whole day?
2. I had a failed ablation. But he only looked for 45 minutes and told me he "thought he knew where it was" and was sorry. He only used one catheter in right leg. Did he not look in all 4 chambers?
3. He is "mailing" me an event monitor, in the meantime had another episode yesterday, almost passed out again, had to call my doctor he told me to take 50 of metropolol (I stopped taking my meds). I don't understand why ablation failed, I know its there. Could it be somewhere else?
Doctor's Answer
by Cleveland Clinic, Aug 01, 2004 12:00AM
, Aug 01, 2004 12:00AM
dawn,
Thanks for the post.
1) What is the difference between an irregular heartbeat and a run of tachycardia which makes me almost pass out? Why does it make me so dizzy and have sore chest for the whole day?
The question is what is the nature of the rhythm you have? There are different types of arrythmias. Tachycardia means multiple beats in a row. FOr simplicity, the beats can either be from the ventricles (ventricular tachycardia) or above the ventricles (supraventricular tachycardia). The former tends to be more serious in the long run. Both are amenable to antiarrythmics and ablations. An irregular heartbeat simply refers to extra beats, which also can be ventricular in origin or elsewhere in origin.
2. I had a failed ablation. But he only looked for 45 minutes and told me he "thought he knew where it was" and was sorry. He only used one catheter in right leg. Did he not look in all 4 chambers?
He most likely did an ep-study or electrical mapping of the heart. The vessels in the leg access the heart directly. These vary in complexity. I cannot comment on the duration of your study.
3. He is "mailing" me an event monitor, in the meantime had another episode yesterday, almost passed out again, had to call my doctor he told me to take 50 of metropolol (I stopped taking my meds). I don't understand why ablation failed, I know its there. Could it be somewhere else?
Noone is doubting your events. An event monitor can give your physician valuable information as to the nature and even location of your arrythmia to clarify treatment options. You can wear it for longer then a simple holter, so hopefully you catch an episode.
good luck
Thanks for the post.
1) What is the difference between an irregular heartbeat and a run of tachycardia which makes me almost pass out? Why does it make me so dizzy and have sore chest for the whole day?
The question is what is the nature of the rhythm you have? There are different types of arrythmias. Tachycardia means multiple beats in a row. FOr simplicity, the beats can either be from the ventricles (ventricular tachycardia) or above the ventricles (supraventricular tachycardia). The former tends to be more serious in the long run. Both are amenable to antiarrythmics and ablations. An irregular heartbeat simply refers to extra beats, which also can be ventricular in origin or elsewhere in origin.
2. I had a failed ablation. But he only looked for 45 minutes and told me he "thought he knew where it was" and was sorry. He only used one catheter in right leg. Did he not look in all 4 chambers?
He most likely did an ep-study or electrical mapping of the heart. The vessels in the leg access the heart directly. These vary in complexity. I cannot comment on the duration of your study.
3. He is "mailing" me an event monitor, in the meantime had another episode yesterday, almost passed out again, had to call my doctor he told me to take 50 of metropolol (I stopped taking my meds). I don't understand why ablation failed, I know its there. Could it be somewhere else?
Noone is doubting your events. An event monitor can give your physician valuable information as to the nature and even location of your arrythmia to clarify treatment options. You can wear it for longer then a simple holter, so hopefully you catch an episode.
good luck
I certainly cannot comment on your EP. All I know is that when I went to Mayo for my ablation I had an extremely thorough analysis. I was in the EP room for over 7 hours. He checked for PAC's, atrial flutter, afib, and PVC's. I had a catheter in each leg, plus a catheter down my neck. He found numerous spots to ablate for PAC's, atrial flutter, and AFIB although none for PVC's which I didn't have very many of.
I'm certainly not an expert on ablations. But after doing a significant amount of reading and investigation all I can say is that not all EP's are created equal.
I would certainly seek a second opinion. I would especially go to a large university and teaching medical facility like Mayo, Cleveland, etc. They tend to have more up to date equipment and procedures. I WOULD NOT GIVE UP on getting the problem resolved.
Best regards.
connie
I would like to ask your situation is VT from Left Ventricular Outflow Track?