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Post Cardiac Ablation Questions

Hi. I had a 5 hour ablation last week for focal atrial tachycardia. My EP had thought I had IST (Inappropriate Sinus Tachycardia) for 16 months but when he did my EP study last week he actually found I had focal atrial tachycardia instead. This was great news as, if he found I had IST, he was planning to do a sinus node modification which has a pacemaker risk!

My question is this.....what did you feel after your ablation in the weeks recovering? I had ectopics last week & today had a 10 minute episode of tachycardia after climbing our stairs indoors. Is this normal in the post ablation phase? I don't really know what to expect in the weeks ahead. I know it takes 3 months to know if the ablation has worked. Why is this? Is it because it takes this time for the heart to heal?

I have felt SO much better since my ablation in that I no longer get breathless on exertion, I have colour in my face now (before I looked so pale), no more chest pain like before. I'm just concerned about the ectopics & this tachy episode today.

I have to say that having been terrified of having the ablation done, I would definately have it done again if I had to. The fear is worse than the procedure & the EP & his team were excellent in their care & skill. I live in the UK.

Please can anyone tell me of their experiences post ablation? Thanks.

Best wishes
JaneML93
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1124887_tn?1313758491
I think it's normal to have short runs of tachycardia, as well as an increase in ectopics (PACs) after an ablation, without indicating the ablation failed. The heart muscle get irritated by the ablation, triggering ectopics.

The heart needs a few months to recover. It's really nice you're feeling better. It's even better they ablated the right problem, as sinus node ablations are risky, as you know, and wouldn't cure anything in your case.

Atrial tachycardia originating close to the sinus node is almost impossible to differ from sinus tachycardia on an EKG, because the P axis is close to similar. The rhythm changes is the only indication (start/stop of the tachycardia, and rhythm changes).

Best wishes!

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Hi. Thank you for your reply. I was really interested in what you said about it being hard to differentiate between atrial tachycardia close to the sinus node, from sinus tachycardia on the ECG. This would explain why my EP thought I had IST but it turned out to be atrial tachycardia near the sinus node. He suspected it from a treadmill result I had in November, when I had an episode of atrial tachycardia recorded as the test finished. It lasted 10 minutes. But all my other tests didn't show it. Very interesting. I am fascinated by the technology that they can do these ablations, from going in via the groin, & you can feel SO much better afterwards. I can't believe how well I feel just a week after.

Thank you too for reassuring me on the ectopics & tachy episodes.

I managed to go for a long walk with my husband last night, to a local park & back, & had no arrhythmia symptoms. Before my ablation I couldn't even walk across the road without getting breathless & chest pain. I was really pleased last night, so was he. He has worried about me LOTS these last 16 months.

Thanks again for your reply.

Best wishes
JaneML93
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1124887_tn?1313758491
Hi,

Concerning seeing the difference between sinus tachycardia and ectopic atrial tachycardia:

If you have seen an EKG, you can see the P wave (little bump before main complex) is positive (flipped upwards) in lead II (and most of the others) during sinus rhythm / sinus tachycardia because the sinus node is located up right in the atrias, thus electricity is conducted downwards and to the left (spreading through the atrias).

If the ectopic focus is located, say, low in the left atria, electricity is conducted upwards and to the right, causing the P wave to be inverted (flipped downwards). Then it's easy to see the difference, that the heart beat doesn't origin from the sinus node.

If the ectopic focus is located near the sinus node, the P waves will be similar to normal P waves in sinus rhythm, and it's hard to see the difference.

In such cases, the doctor must look at the frequency and heart rate variance. An ectopic atrial tachycardia often starts and ends instantly. And it doesn't vary with exercise as sinus tachycardia does (for example).

I hope this was somewhat understandable :-)
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