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Heart Disease (Expert Forum)
Ablation Procedure
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Ablation Procedure
by Cashiers, Dec 03, 2004 12:00AM
Wow finally got one in! 44 female was in good shape until last abaltion, just have not been able to do much, I get all kinds of symtoms worst one dazed and confused feeling, will hit mid sentence with customers. Very embarassing
I am scheduled to go to Duke (Dr Bahnson) next week for second ablation, 1st ablation was in April 04 for PSVT, re-entry loop was happening. Since then have had only one event of psvt end of Sept. but very symtomatic to point of not being able to drive at times, rate all over the place with PACs / PVCs.
Since end of sept event something happened it was really tough one like no other. So had all tests, monitor reports event and holtor shows definite issues and they want to do another for eptopic atrial tach, each time i stand or use any effort the rate goes up to 150's and stays. They say they will get the PVCs hopefully too.
My Questions
An EP study is neccessary for each ablation isn't it?
Will the PVCs kick in harder if the tach is ablated and they don't get all PVCs or can one develop more?
In most cases do you give some kind of beta blocker or something else right after procedure besides aspirin?
Are there different cathetors used to ablate diff foci?
1st ablation dr said he couldn't get the PVCs didn't have right cath. Saw them all over. I have terrible pressure and discomfort in chest to point of not being able to wear a bra for year or so.
I am a builder and outside and in office. I'm trying hard to ignore all this discomfort but there are days I just can't do it
Thank you so much for your time
Laura
I am scheduled to go to Duke (Dr Bahnson) next week for second ablation, 1st ablation was in April 04 for PSVT, re-entry loop was happening. Since then have had only one event of psvt end of Sept. but very symtomatic to point of not being able to drive at times, rate all over the place with PACs / PVCs.
Since end of sept event something happened it was really tough one like no other. So had all tests, monitor reports event and holtor shows definite issues and they want to do another for eptopic atrial tach, each time i stand or use any effort the rate goes up to 150's and stays. They say they will get the PVCs hopefully too.
My Questions
An EP study is neccessary for each ablation isn't it?
Will the PVCs kick in harder if the tach is ablated and they don't get all PVCs or can one develop more?
In most cases do you give some kind of beta blocker or something else right after procedure besides aspirin?
Are there different cathetors used to ablate diff foci?
1st ablation dr said he couldn't get the PVCs didn't have right cath. Saw them all over. I have terrible pressure and discomfort in chest to point of not being able to wear a bra for year or so.
I am a builder and outside and in office. I'm trying hard to ignore all this discomfort but there are days I just can't do it
Thank you so much for your time
Laura
Doctor's Answer
by CCF-M.D.-MJM, Dec 03, 2004 12:00AM
Hello,
Sorry you've had trouble posting, it seems the demand is pretty high.
An EP study is neccessary for each ablation isn't it?
There are different variations to EP studies depending on the target. For example, if you know someone has atrial flutter, there is no need to try to induce sustained VT. The methods will vary depending on the target.
Will the PVCs kick in harder if the tach is ablated and they don't get all PVCs or can one develop more?
Good question, but I don't know if such a relationship exists. There may be some more feed back from other posters later today.
In most cases do you give some kind of beta blocker or something else right after procedure besides aspirin?
Not usually for atrial arrhythmias that we think were succesfully ablated.
Are there different cathetors used to ablate diff foci?
There are many different types (sizes, shapes, etc) of catheters. Anyone catheter can usually do the job as long as it has the shape to attain good contact with the area of interest.
I hope this next ablation works for you. Thanks for posting....
Sorry you've had trouble posting, it seems the demand is pretty high.
An EP study is neccessary for each ablation isn't it?
There are different variations to EP studies depending on the target. For example, if you know someone has atrial flutter, there is no need to try to induce sustained VT. The methods will vary depending on the target.
Will the PVCs kick in harder if the tach is ablated and they don't get all PVCs or can one develop more?
Good question, but I don't know if such a relationship exists. There may be some more feed back from other posters later today.
In most cases do you give some kind of beta blocker or something else right after procedure besides aspirin?
Not usually for atrial arrhythmias that we think were succesfully ablated.
Are there different cathetors used to ablate diff foci?
There are many different types (sizes, shapes, etc) of catheters. Anyone catheter can usually do the job as long as it has the shape to attain good contact with the area of interest.
I hope this next ablation works for you. Thanks for posting....
I'm curious to know at what age you began to have symptoms of the SVT, if you don't mind me asking. I'm also curious to know what you thought of the Cardios at Duke. I have been there once, and am also a Carolinian!! Are you from the Cashiers area?
Sincerely,
Uptown
I first went to charlotte Cardio. Had 1st ablation there seemed to help with the wild svt. Until end of sept had an event after wearing event monitor for month this showed alot going on many diff arrythmias from all over.
The doc at charlotte felt it was to much to deal with for him so got referred to Duke and I located chief of ablation services. Dr Bahnson Been there once and liked him seemed very efficent. Had many tests next day, echo, stress, blood work. Had already had Heart cath, new I was clear. Went home with 48 hr holter which showed alot. He did put me on prescribed potassium, magnesium, these levels were very below normal. Checked thyroid (normal). All in all so far so good with Duke. I will see him on 13 then 15 is procedure.
Where in Carolinas do you live you can email ***@****
I have a question: What is ablation used for? I have an area of blockage in the distal LAD that they told me they stented until I found out otherwise. They said there is no hope to unblock this area as it is too small of a vessel and no by pass either. Does anyone know if abalation would help me. I am in Houston. The mid LAD was stented for 99% but they left the distal LAD.
Thanks to anyone who can answer this. I have no idea if blood is getting through this area. EF fraction is around 70%.
Ablation is radiofrequency waves of heat used to burn a specific foci or focis causing arrhythmias, such as renrty loops or bypass tracts such as AVNRT, AVRT, WPW syndrome , atrial fib and atrial flutter, even some type VTs.
Unless you have an arrhythmia, an ablation will not help, you apparently have a blockage in your LAD (Left anterior descending artery), they apparently took care of the blockage that could cause significant problems and left the other one alone, if I remember your post correcrtly , some blockages don't require treatment as they don't lead to significant reduction in blood supply to the heart muscle and will cause no damage, they are best left alone.
Plaes NOTE: I am not a medical doctor , this only my understanding of ablation and of the problem you described. Your doctor doctor could provide you with much more accurate information.
Good luck with posting , try between 7 am EST and noon EST., you are on central time, if in Texas, one hour behind, clue, if no questions are posted for that day, just keep hitting the post a question slot about every 2 minutes if you have the patience, usually it takes luck and persistence, the window of opportunity is approximately 5-10 minutes, if no questions are posted when the window is opened , no questions will be posted for that day.
Best wishes and Good luck.
I got more information from you ( a stranger) than my own docs at a reknowned Medical Center. I have been worried sick about the residual blockages left in the distal LAD. Unlike Clinton who aced his tests but had smart enough doctors to go ahead with a Heart Cath, doctors here do not listen to women and their heart complaints. It was not until I saw a female heart doctor on ABC news in August that I got really mouthy and finally after 3 years of severe chest pains, had a Heart Cath. By this time, I was 99% blocked in LAD and RCA. This wonderful female doctor wrote me and said "my mouthiness" saved my life. No, she saved my life.
Thank again Hank, I will try and post per your instructions. (-:
They put me on 50 mg of Atenolol to primarily help with the irritation issue. Wanted to put in me on an anti-arrythmic drug, but I didn't want to stay in the hospital for 3 more days.
I was also put on coumadin to prevent blod clots developing.
As to catheter size, I really don't know mucha about. All I know is that they used three catheter openings. One by each groin and one down my neck.
So far so good.
I had albations for pvcs and they used a couple of different sizes. I know they had to remove one of the catheters because it did not "fit over the aortic arch." Exchanged it for another...
How do you guys like the EP program at Duke? I may be looking into their program. Any suggestions on doctors?
Usually when someone first presents with a-fib at the ER, they usually give them a diltiazem(cardizem) drip to restore normal sinus rhythm, it is usually very effective in lone atrial fibrillation, but not as effective when secondary causes are present.
You are very wise after reading this thread to reassess the accuracy and true amount MR you have, slight swelling of the ankles, an enlarged atria all give suspicions to some degree of heart failure be it only mild, while most echocardiograms are fairly accurate and give a fairly accurate picture of a normal heart structure, sometimes other testing is required, it would perhaps in your case be wise to have the severity of the MR assessed more accurately!!
Happy Holidays and Happy New Year to everyone, I might not be commenting on the forum for quite sometime, not at least for a few weeks.
Take care,
Hank.
Happy Holidays and have a great New Year!!
Regards,
Tony
I've only been to Duke once and have heard very good comments on Dr. Bahnson. The individuals in the medical field that we inquired of all directed us to Dr. Bahnson. I did not see him because he has a long appt. wait list. But then again the good Drs. ususally do!!
I did not need an ablation or EP study since mine was more of a structural problem, (valve) rather than electrical issue. My cardios here are able to treat me just fine, but wanted to refer me over for one visit to cover all bases.
I'll say Duke is not the friendliest place I've been. (It's in kind of what we call the "new south", not real reminisent of the real south!) I felt like it was very sterile, serious, and technical. Our particular Dr. was not very good. He was very domineering,rude (took cell phone calls in our exam room while we were there) and impersonal. I couldn't wait to get home. Now, I DO believe that my experience would have been different had I seen another Dr., but I could not wait 6 months.
Cashiers--I'll contact you on your email address to answer your other questions.
Thanks,
Uptown