Ablation for avnrt - questions!!

[mattpp]

Hi
I'm a 27 year old male with AVNRT. I have attacks about 5 times a year with heart rate up to 280 bpm lasting from 5 mins to an hour max. I occasionally have skipped beats which I'm assuming are pac's/pvc's.  

I'm due for an ablation Monday 22nd Jan and I still have a few things i'm not sure about.

Firstly i'm worried about the proarrhythmic side effects of the procedure - pac's, pvc's, atrial flutter etc. Judging by the posts on this forum, it appears that very few patients undergoing the procedure come away completely cured (although I imagine those who are fully cured would be less likely to post). Specifically I was wondering what percentage of patients come away completely cured and what percentage come away experiencing new arrhythmias caused by ablation lesions. Also, would these new problems have already been present before and would I be less likely to be affected as I only present avnrt symptoms?

Secondly my electrophysiologist also performs cryoablation. I met with him last week and we discussed both cryo and rf. He performs both but has only undertaken a handful of cryoablations compared with 40 rf ablations for avnrt a year. He hasn't had an occurence of permanent heart block for 7 years so I have every faith in him.  My question is whether cryoablation carries less risk of the above side effects (new arrhythmias) compared with rf ablation. At the moment I am erring on the side of rf because I do not want my avnrt to return and my electrophysiologist appears more comfortable with this, although he is fully prepared to go either way.

Many thanks, Matt

[CollegeGirl143]

i had a successful ablation for avnrt in april... Avnrt RF ablation has a 98% chance of success in AVNRT cases, and the complications (such as new arrhythmias) are less than 1 percent. Best thing i ever did for myself. Cryoablation is usually only used when the part of the heart needing to be burned is too close to the avnode, because it is less likely to produce heart block or for the patient to end up needing a pacemaker, but it is also less likely to bring success.. Avnrt RF ablations are extremely successful, ide go with the rf personally, and stop worrying about all the "what ifs" that probably wont happen. If your ep starts the procedure and the re-entry loop is too close to the avnode, hes not going to do the procedure anyways and hurt you, he'll either schedual another time for a cryo, or pursue other options.

[mattpp]

Thanks collegegirl, it's reassuring to hear from someone who's had success with this procedure! Also, glad to hear you're free of avnrt now!

Out of interest, did you get any side effects in the weeks after your ablation and also how long before you were back on your feet to work etc?

[CollegeGirl143]

I had some residual tachycardia that lasted about 4 days..I also had a regularly irregular heart beat for a few days (every other beat was premature) This is normal, and didnt cause me any discomfort. A few days after the procedure i also had one final tachycardia attack (completely normal, due to all the medications left in my system) I felt physically better almost immediatly..I unfortunaly was moved too soon after my procedure and i started bleeding from the groin. They had to apply alot of pressure, as well as a pressure bandage, which injured my groin area pretty bad and i was not able to walk for almost 2 weeks.. Keep in mind this was VERY rare, and also, not bad.. WELL WORTH the benefit ive recieved from the ablation... It is a VERY safe procedure and it will change your life almost immediatly! i get much fewer palps as well, and can actually walk across the room without being out of breath! hehe, ide suggest for anyone suffering from avnrt.. the only thing that REALLY bugged me was not being able to take a bath for a week, LOL.

[mattpp]

no bath for a week! i'd better make sure i scrub up well then before i go in! so when you say you have fewer palps, do you mean skipped beats/pac's/pvc's? i was wondering, have you had any avnrt attacks since your ablation are or you totally free of it now?
sorry for being nosy!!

[CollegeGirl143]

i dont mind at all..

Yes, by less palps i mean less pvc's, skipped beats, all that stuff.. I still get them sometimes, but i dont feel them now..Ive felt one in the past 4 months. I dont know why the ablation made a difference, but it did..

I have not had an svt attack since the ablation, and once you have the ablation, there is only a 2% chance the the svt will ever come back.... And yes the bath thing sucked lol.. Showers are ok, but while those catheter entry points are healing, they doctors dont want them submurged in water.

[epelc]

Just posted a comment about ablation surgery.  I also had AVNRT... I went in for the ablation surgery on Monday... I am a big baby when it comes to pain... did not feel a thing through the entire procedure.  It is well worth it!  I am a 30 year old female that was sick and tired of worrying my husband, family, and friends.  Worst of all I had to call in to work three times this year because of the episodes to rush to the ER!  Having to scrabble to put together sub plans for my 7th and 8th grade students stunk!  They were worried... I never want to do that to them again.  Honestly... everyone is different.  I felt ABSOLUTELY NOTHING through the entire procedure.  They say it can range from 2-4 hours... my procedure was more like 45 minutes.  I did not feel the needle in my upper thigh to numb the area, did not feel the tubes leading to my heart, did not feel them burning my heart tissue, all I felt is them putting me into a few of my episodes... which I was already use to.  They give you sedatives, and make you feel as comfortable as they can.  It was nothing!  I really do not even feel that sore... I did not feel sore on Tuesday (the day after), yesterday, or today.  If you are considering getting this procedure done... go for it!  If you are in Michigan... ask for Dr. Morady who is out of U of M hospital... he is one of the best at performing this procedure... truly!  I was referred by a Dr. Lynn Miller in West Bloomfield... he is great as well!