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Heart Disease (Expert Forum)
Epicardial Ablations
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Epicardial Ablations
by mnwhitehouse, Oct 05, 2004 12:00AM
I am a 34 year old male who has been diagnosed with idiopathic left ventricular tachycardia, after experiencing spells of lightheadedness 2 � years ago. I have undergone 4 unsuccessful ablations over that time period by 2 different eps and clinics. I have tried flecanide, sotalol, and amiodarone. I currently take amiodarone (200mg)and nadalol (25 mg) daily. I continue to have periodic bouts of irregular and sometimes rapid heart rates. I have read that there has been some success with epicardial ablations and that there may be some noninvasive way to ascertain whether the problem area is on the exterior of the heart. Is this true and how can I best obtain and use this information? How would one go about getting to a clinic, such as in Cleveland, to determine if such an ablation could finally help me lead a normal life. Thanks very very much for your response.
Doctor's Answer
by CCF-M.D.-MJM, Oct 05, 2004 12:00AM
Hello,
The first question is is it still the VT causing your symptoms. VT is usually not an irregular rhythm. Let's assume that is the VT so I can answer your question. We have catheters that can map where the heart beats initiate--localize the VT. Once that site is localized, we can try to ablate that area. I do not know of a noninvasive test to help determine the site.
Bob Schweikert is the doctor here that does the most epicardial ablations--there are not many places that do this. If you can come to Cleveland, the best thing to do is schedule and appointment to see him, obtain your old records and recordings from your previous doctors and bring them with you. If you ship them, he may never see them. The best thing to do is bring them with you so you can hand deliver them.
It may be necessary to map your left ventricle with a mapping catheter to try to determine if you can reach it from the inside (endocardial) or if he needs to approach the outside (epicardial). Dr. Scheweikert's office number is 216-444-3160. If you call there they can help you set an appointment.
I hope this helpful. If you decide to come to Cleveland, I hope we can help!!
The first question is is it still the VT causing your symptoms. VT is usually not an irregular rhythm. Let's assume that is the VT so I can answer your question. We have catheters that can map where the heart beats initiate--localize the VT. Once that site is localized, we can try to ablate that area. I do not know of a noninvasive test to help determine the site.
Bob Schweikert is the doctor here that does the most epicardial ablations--there are not many places that do this. If you can come to Cleveland, the best thing to do is schedule and appointment to see him, obtain your old records and recordings from your previous doctors and bring them with you. If you ship them, he may never see them. The best thing to do is bring them with you so you can hand deliver them.
It may be necessary to map your left ventricle with a mapping catheter to try to determine if you can reach it from the inside (endocardial) or if he needs to approach the outside (epicardial). Dr. Scheweikert's office number is 216-444-3160. If you call there they can help you set an appointment.
I hope this helpful. If you decide to come to Cleveland, I hope we can help!!
If it was me I would not give up on trying to get that tachy ablated. I have heard for ideopathic there is a much higher success.. I can tell you I've heard terrible stories about this drug "amiodarone" and it would definently be my last choice for a drug. I would consider it if I had was having constant vt's and getting shocks from my ICD and only then would I consider it.. Good Luck
Marilyn (runner)
I wish you the best on your Oct 13th visit and am anxious to hear how it goes. In fact, I'm excited for you, knowing how difficult this can be to live with. I need to hear some success stories! All 4 of my ablations were done in Minneapolis. I'd like to speak with you afterwards if you're interested.
Good Luck and God Bless!
Mnwhitehouse: I actualy find out the date of my ablation on the 13th. I'll keep you posted on how it goes. If your from MN, you should really go to the Mayo clinic for care. Dr. Munger or Dr. Hamill are great doctors. They all are really. I had three ablations in Duluth from a doctor who works in a minneapolis hospital. Dr. Richard Taylor. He's a good doctor too, but none of the hospitals you may go to, have the tool box and technology that a place like mayo or cleveland have. I feel it was a complete waste of time having my first three ablations and wish I would have just went to the mayo to begin with. Would have saved me a good chuck of my heart. I've had 36 burns over five ablation. most of those shouldn't have happened at all. Hope you are feeling well and will be cured.
You've had 4 ablations? How many burns hvae you had placed in your heart?
My e-mail is ***@**** if you want to keep tabs on how my procedure goes or have any other questions for me.
Ben
The American Heart Association has a web site that has the 'criteria' for ICD inplantation. You could possibly find your answer there in as to whether ideopathic VT's warrant ICD inplantation. But, I'm quite sure they've had much higher success rates with ablation for these types of vt's.. I don't think ideopathic vt's are as life threatening as the other vt's.. But you can do all kinds of research on this.. Heartcenter has a good web. But the AHA has alot of criteria for certain procedures.. Very informative..
Good Luck
Marilyn (runner)