Ablation § Multifocal Atrial Tachy

[kirilll]

I have been dealing, off and on, with what my cardio (electrophysiologist) called MAT for over 10 years. Been on Verapimil 240 mg for over a year. After about 6 months of nothing I got palpitations (for lack of a better term) again. I understand that this is not fatal, but I am loosing the strength to "keep sucking it up". Cardio tells me Ablation is not for me cause of the multifocal aspect. I am on a 30 day Halter to see if we can narrow down the source, but he insists that trying other medications, with "managemeble side effects", for another year or two is the way to go. He has alredy suggested a T***olo* (I cant read his writting) that I will take when the MAT acts up.  I don't expect a quick fix. Naturally, I will live with this, if I have no other choice.  However, if Ablation can get me back to normal or close I, want to vigorously explore the option. I am a 36yo male in good health and no pulmonary or coronary conditions (nuclear sterss and echo came back normal). When is or is Ablation effective for MAT?  Would an EP help identify if Ablation will work? What other options should I be aware of?  Your advise and comments will be greatly apprecviated.
Thanks.

[CCF-M.D.-RCJ]

kirilll,

Thanks for the post.

MAT is not an ablatable rhythm, but it is also an extremely unusual rhythm for someone without other illnesses.  In fact, this scenario that you describe is so unusual that it deserves a second opinion regarding the rhythm.

Atrial tach (non-multi-focal) is certainly possible, and is amenable to ablation therapy at least 90% of the time.  It certainly might be worth seeing an EP to help sort this out.

Best of luck.

[adey cartoonist]

HI,
I WANT TO SHOUT FROM THE ROOF TOPS!!!!AS A REGULAR VISITOR TO THIS SITE I THINK YOU ALL SHOULD BE TOLD!! AFTER TWENTY FIVE YEARS OF FEELING LIKE A BUCKET OF SH*T I'VE FOUND HOPE. FOR THE PAST TEN YEARS I'VE SUFFERED PALPITATIONS,EVERY DAY, SOME TIMES CARRYING ON FOR WEEKS. RACING HEART, MISSED BEATS, NEARLY PASSING OUT...ETC... ETC.. HAD EVERY TEST, EVERY DRUG (NEARLY)
AND (WAS )DUE FOR ABLATION IN AUGUST... WELL TO CUT A VERY, VERY, LONG STORY SHORT - LAST MARCH (2003) I WENT TO MY DOC AND SAID WHAT IF THIS IS ALL IN MY HEAD AND REALLY I'M SUFFERING FROM ANXIETY? SO AFTER ALONG CHAT SHE PUT ME ON A DRUG CALLED EFEXSOR AFTER SIX WEEKS I NOTICED A CHANGE, I WAS STILL GETTING PALPS BUT NOT TAKING ANY NOTICE OF THEM... BY XMAS ...GONE..
I STIL GET THE OCCASIONAL FLUTTER BUT I'M HAPPY AS A PIG IN SH*T.. MY WHOLE LIFE HAS CHANGED COMPLETLY!!...I DON'T WAKE UP IN THE MORNING THINKING OF DEATH IWAKE UP HAPPY HAPPY HAPPY!!!
I COULD WRITE A BOOK ON A MILLION REASONS HOW THIS WONDERFUL DRUG HAS TURNED MY WHOLE LIFE AROUND!! I THINK THE WHOLE WORLD SHOULD BE PRESCRIBED EFEXSOR!! -THINK!! NO MORE WARS!! GO AND GET SOME NOW!! I'M OFF TO CARRY ON WITH MY NEW FOUND LIFE!! ALL THE BEST I LOVE YOU ALL!!

[dquenzer]

I am glad that you have found the solution in a SSRI, however what the question is related to has nothing to do with PAC's or PVC's caused by anxiety.  The question has to do with SVT that is multi-focal.

One person's solution is not another's cure.

[adey cartoonist]

I wasn't responding to any particular question.My comment was aimed at everyone. Sooo soooorry if I approached it in the wrong way. I was merly trying to give another little bit of hope to anyone who has suffered with this debilitating condition and believe me mate I've tried everything over the years to stop these palpitations, from standing on my head, holding my breath to
jumping in a freezing cold river etc ..etc... and with your negative attitude pal, maybe you should go and see your quack
i reckon you're an ideal candidate for these tablets.

[kirilll]

Dquenzer - Thanks for refocusing my question.  Nice to see you on this forum too.

Adey Cartoonist - thanks for your post and congratulations on finally finding a solution.  Unfortunately, my problems don't stem from and is not associated with anxiety.  Dquenzer is correct; your success is not for everyone.  A quick story for you and others that may be tempted to find the solution in a happy pill.  When I had my first episode of arrhythmia/MAT about 11 years ago at the age of 25, medicine knew much less about these disorders and far fewer options were available.  Naturally, the first time this happened I panicked.  In addition, because my MAT was not constant docs had trouble catching it.  After 3 days as the youngest patient in the cardiac unit of the hospital, and echos and stresses that revealed that I was in excellent condition, I was released and told I had had an anxiety attack.  I did not accept this diagnosis and started a quest to find what was really wrong with me.  I saw every find of specialist, except a cardiologist.  Many of them also told me about an anxiety disorder.  This continued to **** me off because the only time I felt anxious was after I started having palpitations and chest pain.  I finally agreed to take Xanax.  I lost over a year of my life as a zombie on this pill, all the while having palpitations that I no longer cared about.  The prescribing MD did not bother to tell that the drug was highly addictive, so when I quit taking it I went through 3 days of violent withdrawal.  I actually felt better afterwards and did not have palpitations for a long time.  From the time of my first episode to the time I quit Xanax was 3 years of my life.  In was only at the age of 35 (10 YEARS LATER!) that I was finally properly diagnosed.  Those that are desperate to find a solution should very seriously contemplate taking a happy pill.

[Momto3]

Thanks for sharing your story.  I was also prescribed a number of "anti-anxiety" meds, including Xanax, to try and treat my pvcs.  When I finally found a compassionate EP, I shared with her that I was prescribed Xanax, and that they made it so I did not care about the palps...She said, that's what they do..."YOU won't care!" She also explained the high rate of addiction, etc. Fortunately, I only took them (daily) for about 2-3 weeks when I realized I NEEDED more, and more often. BIG CLUE for me! Since that time, I have had 2 ablations for my pvcs. Personally, I believe the doctors when they say that pvcs are almost always benign.  Strangely enough, I was one of the RARE exceptions. I had two ablations last year because my pvcs actually caused a cardiomyopathy. Don't worry, it is EXTREMELY rare. Had that not happened, I would have been tooling aruond with many thousands every day...Since the ablations, I only have rare pvcs and my ejection fraction is up to 55%. Feeling much better : )
Wishing you the best of luck!  By the way, what is "MAT"?
connie

[flipflop]

I would take it MAT means simply(Multifocal atrial tachycardia).

flip(Lyn)

[flipflop]

I would take MAT to mean (Multifocal Atrial Tachycardia)

flip(Lyn)

[kirilll]

CCF-MD-RCJ - thank your for your time and advise.  I am in the process of getting a second opinion.

Momto3 - thanks for sharing your story too.  I am glad to to see that you are better and that you did not waste as much time as I on Xanax.  You know, we too often blindly trust our docs.  What we don't realize is that no doc is trained to say "I don't know".  Instead, some docs frequesntly resort to a default or what ever is "pop medicine" at the time.  In the '90's anxiaty disorders were the latest craze & Xanax was the most widely prescribed drug.  I guess I just got caught up in that "pop medicine" movement

[hopenprayers]

WOOOOHOOOO FOR YOU!!!!!!

What a wonderful thing!!!!!!

It makes me want to call up my doc and say GIVE ME THAT EFFEXOR!!
(which I WILL be doing!!)

I, for one,  am READY to MASK the syntoms I have had for over 30 yrs... They have gotten much worse in the last few months, and contiue to worsen with each "EVENT". Yet my doc STILL insist that the skipped beats, pvcs,& bigeminy that last for hrs on end is NOTHING TO WORRY ABOUT>>>>

I am currently on a 30 day _event monitor..... My gosh this thing could drive anyone NUTS. First you _feel the "event" ... THen you call in the "event" Then you sit and wait while they go over the "EVENT"....Then you here them say, I will have to call your doctor about _THIS EVENT.....THEN.... You sit and wait for the doctor to call you.....Sometimes hrs sometimes the next day..... If THAT wouldnt put someone into an anxiety attack I dont know what would.

I am ready to toss this monitor out the window!!!!!!!!!!

I woke up this morning Feeling I had to get to the phone before I was even fully awake....I was reaching for HELP..... I sat up with phone in hand calling my husbands cell phone before i knew what i was really doing....... I was thinking "THIS IS IT" and I wasnt even awake good. Was I dreaming?  or was my heart acting up in my sleep? or was I simply having a panic attack over this MONITOR thing???

I don't know which of the above..., but I DO know I am willing to try ANYTHING to feel better.

I realize that for _some anxiety does not play a part in their pvcs etc....., but for most of us I believe it is a big part of our problem. Maybe not the REASON for having them entirely, but never the less a factor in how we deal with them. If a "happy pill" works for what our docs call _BENIGN pvcs & bigimeny, than for ever more BRING IT ON!!!

I mean if they REALLY _are benign, then why all the FUSS?? The MEDS??? The monitors?? and the APPOINTMENTS to keep track???

If they ARE benign, then what would a "happy PILL HURT???"

Thanks for your post of HOPE and BIG CONGRATS TO YOU!!!!!!!

Hope
<ironically>

[dquenzer]

Let me make a comment about Effexor and SSRI's in general.  My doctor subscribed that as well.  It actually made them worse!!!
So I wouldn't get too excited about a quick solution to PAC's etc.  Indeed one of the side effects of SSRI's is ANXIETY!!!

I agree that anxiety may be a culprit. But when I was in the thro's of large numbers of PAC's I found that bio-feedback actually worked better than most of the drugs.

I would say that if you are really suffering from PAC's etc. and it's real important for you to get rid of them, I would suggest you see and EP.

I had an ablation for AFIB and the doctor took care of one major foci for PAC's.  They are nearly eliminated.

That's probably a little radical for something benign, but if "happy pills" worked for PAC's there would be a huge market and cardiologists would dole them out.

[hopenprayers]

Diquinser...


_IF_ a "happy pill" DID work for one, why think it might not for another? Just because it didn't for you? I am sorry it didnt work for you, but it is certainly worth a try before one goes through ablation for benign pvcs (imo) ...

I am glad ablation worked for you, and I am glad Effexor worked for Adey... I think I will TRY the Effexor before TRYING ablation with its extremely invasive side affects. That is not to say I would never consider ablation, It's just that I woud prefer to try non-invasive thearopy for my benign pvcs at this time.

THis morning when the nurse called me back, I asked her about me seeing an EP... She said the cardio wanted to try different beta blockers first.... I am not sure at all I am happy with my cardiologist. I DO want to see an EP doc....just for a second opinion, but you have to be referred..thus I wait in fear, knowing that changing meds might help, but then again they just might WORSEN the pvcs(as did the last time he changed my meds).....

....so I was thrilled to read Adeys post, it did give me hope that maybe Effexor or something similar would help me cope with all these pvcs and the related anxiety producers they bring with them. Yep they COULD worsen the pvcs, but so can changing beta blockers etc...
But OH... just what IF they worked, what a blessing that would be!!
What works for one just MIGHT work for another.
& That is something definetly worth sharing!

Thanks again Adey cartoonist!

[Momto3]

"Happy pills" may not be the appropriate solution for someone with pvcs/pacs.  They will likely inhibit an ability to care, but you will still have the arrythmia.  In some case, SSRI's can be medically beneficial, but is it really worth taking them for benign pvcs/pacs?

Seriously, I agree with the previous poster who suggested you get together with a good EP. Perhaps biofeedback or yoga would be helpful. It's free and it's healthy too : )

[adey cartoonist]

I'd just like everyone to know I have been on more different drugs over the past twenty odd years than I can remember, some with horendous side effects. The only side effect I have had with effexsor is I can't stop shopping! the doc started me on a very low dose just to see if I would tolerate it. oh, come to think of it, it did make me feel a little queasy to start with.
Another thing I've noticed on this site is (like I used to be) you're all full of negativity. as for me being addicted to this pill, I couldn't care less if I have to take it for the rest of my life it's worth it if it makes me feel this good. Another point to quenzer. you can suffer from anxiety in your sleep and not know a damn thing about it!! or are you just to proud to admit you are an anxiety head?

[adey cartoonist]

hi, I'm no quack but I've been a visitor (looking for answers) for years to this site and in my opinion (as someone cured) a good 75% of the people on this site are suffering an anxiety disorder. you're all full of negativity) maybe it's time some of you started thinking laterely
(like I did) your doc has said there's nothing wrong with your ticker? but you still carry on whingeing (like I did) taking those heart pills (like verapamil, betablockers, atenol..rthymdol.. blah.. blah.. blah.. yawn ..I've had them all pal...there doing you no good.. it's all in your mind.. face facts..do you wake in the morning thinking of death? do you worry constantly about everyday life? (I don't, I used to, but now I don't give a sh*t!) I used to watch the news (but now I don't give a sh*t) I used to, read the news (..I don't give a sh*t)I'll say it in big letters ANXIETY ANXIETY ANXIETY take a different approach lose your negativity get treatment for ANXIETY.... live life... love life... breath in breath out and say... great I'm alive!! I love you- I love everyone! p.s. if you take effexsor and you think your palps are worse - carry on it's all in your mind - just go with the flow.. man.... pps robbie williams takes it (or should it be take that?) xxxxxxx

[adey cartoonist]

p.s do not expect overnight miaricles miric.. mirica..(oh bolox) with effexsor - it has taken a good six months to realise any change - just persevere...you never know!!

[adey cartoonist]

ppps... we're all going to die.. but at least I'll die happy!!
(will you?)

[adey cartoonist]

twenty years ago i used to play lead guitar in a succsseful band(for ten years)
I had to quit because of stage fright.. now, twenty years on, I'm playing in a local pub (on my own)and  loving it.. i couldn't do it without this drug.. thankyou god ... thank you effexsor!

[adey cartoonist]

by the way... i smoke like a trooper, i drink like a fish.. all bad signs of getting a really good palpitation trip the next day.... me? nothing ....the only trouble is.... I'm turning into a pisshead but life's great... love you.. love everyonexxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx

[adey cartoonist]

12 months ago, I couldn't see it, (as my glass was half empty)but today (now my glass is half full) I can. Reading the majority of postings on this page, whinge, whinge, whinge, blah, blah, blah. Doctors, consultants, SPECIALISTS can't find anything wrong with your ticker? these people are spods, they've studied for years, does that not ring a tiny bell in your mind that you are looking at the wrong part of your body that is causing your palpitations? (like your brain) no one likes to be labled a depressive, physcotic, mental, or whatever,
but if you've got it, it won't go away until you sit down, admit it and do something about it. a classic example of how my life has turned around. I didn't go to bed 'till 2 a.m. last night (as I was writing posts for this page) I should have been in work at 7 a.m. this morning (it's usually my day off but the manager done me a favour and gave me a shift change as I needed Friday off) anyway to cut a short story long, he phoned me at 7.30 a.m. ranting and raving.. did it bother me? will I sit here and fret untill I go back to work? I don't think so.. It just went zooooooom! over the top of my head and today I can carry on loving life without a care in the world.. ah ..bliss..

[arthur]

You're bound to get some negative comments ... but, in principle, you are 100% right on about anxiety and many of the posters herein.  It's definitely part of the problem, and maybe most of the problem for many.  Having said that, there are also folks with "palps" herein that have serious arrhythmias that occur regardless of their state of mind...I'm sure you they understand where you're coming from and won't be offended.

I've brought up the anxiety issue before, so this is an easy one for me.  For folks with "skips" in an otherwise normal, healthy heart, be they PVCs or PACs or any combination thereof, it's my opinion that an unavoidable level of anxiety pops up and keeps on going, until such time as you have so eloquently stated, "if you've got it, it won't go away until you sit down, admit it and do something about it."  In my case it took a good year to ignore the "skips".  The benefits are amazing.  I could no longer notice typical skips during the day and I was not kept awake at night with what seemed like a pounding pulse (waiting for that inevitable skip).  Breaking the cycle of awareness reduced the level of anxiety big time.  And, on top of that, the amount of skips was reduced as well.

I've commented previously as to why this would happen (the nervous system and its effect on cardiac signals).

Just like you, I'm able to embrace life and enjoy each an every day.  I did lose a year in high anxiety mode...never again.  Finally, I was able to do this without drugs.  I'm glad to hear that you were successful, and if it took a little help from an anti-depressant, that's fine.  Live the good life!

-Arthur