Ablation

[VTBen]

I've had 24 burns applied to my heart over several radio frequency cathter ablations.  They were done to correct SVT and an attempt to correct non-sustained Idiopathic VT.

24 burns seesm like a lot.  My questions are:


How many burns can the heart handle before it would be to much damage?

How many burns have been applied in these procedures in the past?

Are there any problems that may arise from all these ablated spots in the future?(I have no problems a year later)

Should I avoid further abaltion attempts due to "too many" burns in my case?

Thank You

[CCF-M.D.-CRC]

Dear bmh,

There is not really a set number of burns that is "too many".  Remember that ablation catheters are only about 4 mm at the tip and the surface area of the heart is well over 5000 square mm. It depends on where the location of the burns are as well as the duration and temperature of the ablations.  The number of burns we do per case varies greatly depending on the complexity of the case from 1 to over 100 spots. One ablation in a critical spot can result in a cure whereas hundreds of burns in other areas may do nothing at all.  Hope this helps out your mind at ease.

[ter]

I was wondering if you felt any pain in your chest after so many burns? I had an ablation done a week ago and am still feeling a slight pain.  My cardiologist said its from the burn and I was wondering if anyone else felt this?

[mrsally]

I had an ablation back in October and am not sure of the number of burns administered, but it hurt like heck during the procedure. Yes, I was quite aware of most of the goings on until they put me under a bit more. At one point they sent me into Vfib and I had to be shocked back into rhythm. I still felt slight burning pains for nearly 2 months after the procedure, and now I'm fine in that regard. The ablation was not entirely 100% successful so I may be put on medication. Calcium channel blockers were not helping in the past and I have asthma so cannot take Beta blockers....so what else is there?!!
Anyway, for anyone considering having an ablation done, in my opinion it's really important to have it done in a large medical center where they have the best and newest equipment and have done many, many ablations before yours. There is so much than can go wrong and you have to be able to trust their reactions.

[tachy]

ABLATIONS DO HURT I HAVE HAD 3 UNSUCCESFUL ABLATIONS FOR IST, AND AUTOMATIC ARTIAL TACH,  THE FIRST ONE  I WAS OUT OF IT BUT I WOKE UP BECAUSE MY CHEST STARTED TO HURT,  THE NEXT DAY AT HOME MY CHEST STILL ACHED AND MY EP DR. SAID I REALLY SHOULDN'T FEEL THAT WAY BUT MY CARDIOLOGIST SAID IT WAS PROBLY RELATED TO THE BURNING, WHICH I THOUGHT BUT WASN'T FOR SURE, NEEDLESS TO SAY I AM ALSO A CARDIAC NURSE AND HAVE THE ABILITY TO TALK MYSELF OUT OF ANY THING, THE SECOND ABLATION WAS THE SAME AND I WAS BURNED A LITTLE OVER 16 TIMES IN THAT ONE AND THEY SAID I WAS ZAPPED MUCH MORE THE FIRST TIME.  THE 4TH EPS, THE 1ST WAS JUST A STUDY, THEY COULDN'T PROVOKE ANY THING I HAD BEEN IN THE HOSPITAL FOR 11 DAYS AND MY HR WOULD JUMP INTO THE 160S 4-5 TIMES ADAY LASTING 30 MINUTES TO HOUR, WITH FREQUENT SHORT BURSTS OF PAT'S. SO THEY KNEW IT WAS STILL HAPPENED BUT TOO MUCH VERSED AND MY HR WOULDN'T GO ABOUT 120 BUT THEY SAID I HAD MULTIPLE FOCI AND THAT MY RIGHT ATRIUM LIT UP LIKE A CHRISTMAS TREE..  BEFORE THIS HOSPITAL STAY THEY HAD TRIED FLECANIDE, WHICH WIPPED ME OUT AND TREMBLE TERRIBLE, I COULDN'T START IV'S OR GIVE INJECTIONS, AND COME I AM A NURSE SO WE CHANGED IT TO RHYTHMOL IT HAS A BETA BLOCKER IN IT AND I HAVE ASTHMA AND ALL OTHER BETA BLOCKERS MADE ME SHORT OF BREATH BUT ONE OF MY EP DR. WAS CONVINCED THE SIDE EFFECTS WERENT RELATED EVEN WITH THE FLECANIDE BUT THEY SIDE EFFECTS STOPPED WHEN THE MED STOPPED, MY PRIMARY CARDIOLOGIST ONLY PRESCRIBED 10 PILLS OF THE RHYTHMOL AND AWAITED MY CALL WHICH CAME 3 DAYS LATER AND I SAID I COULDN'T BREATH, SO OFF TO THE HOSPITAL I WENT AFTER SEVERAL MORE SVT ATTACKS THEY TRIED ETHMOZINE IT DIDN'T TOUCH ME AND THEN AMIODARONE, I AM TOO YOUNG TO RISK THE SIDE EFFECTS, 28 YEARS OLD, BUT IT DIDN'T WORK EITHER BESIDES BY HR WAS NOW TOO LOW WHEN IT WASN'T FAST PROBLY FORM THE MULTIPLE SA NODE MODIFICATIONS,  THEN BACK FOR ANOTHER ABLATION, THIS TIME WITH OUT MEDS, THE FENTYNL DIDNOT KICK IN IN TIME BEFORE THE FIRST ZAP AND ALL I CAN SAY IF FELT AS IF SOME ONE STUCK A BURNING CIGERRATE TO ME FOR 30 SECONDS WHICH IS HOW LONG THEY APPLY THE BURN, IT HURT LIKE HELL THANK GOD MY ARMS WHERE TIED DOWN THE 2ND ZAP A LITTLE BETTER THE 3RD WORSE THE MED WORE OFF BOY DID MY CHEST HURT FOR DAYS,  3 DAYS LATER HR UP TO 160 AND THEN WOULD TERMINATE AND DROP TO THE 50'S I WENT IN FOR A DUAL CHAMBER RATE RESPONSIVE PACEMAKER AND NOW TAKE VERY VERY HIGH DOSES OF CALCIUM CHANNEL BLOCKERS. AND FEEL LIKE I HAVE A NEW LEASE ON LIFE I STILL HAVE VERY SHORT BURST OF PAT'S BUT LASTING A FEW BEATS TO A FEW SECONDS. I HAVE ALSO TRIED THAT NEW MED DOFETILIDE OR TYKOSIN BUT IT DID NOT WORK FOR ME.  SO THERE ARE OTHER CHOICES OUT THERE YOU JUST NEED TO FIND THE ONE THAT WORKS FOR YOU.  GOOD LUCK TO YOU ALL      TACHY

[ter]

Thanks for the comments it feels better to know I am not alone in feeling this.  I had the pain in the hospital and the ep doc thought it had something to do with my valve (I also have a problem with my aortic valve).  Then when I saw my regular cardiologist he said it was probably the burn. I kinda feel like no one wants the reponsibility and I don't know who to talk to about it.

[mansim]

Hey Tachy.  Interesting story.  What is Automatic Atrial Tach??  I have never heard of it.  I suffer from AFib and PAC's.  Started on Rhythmol, moved to Sotalol and now am trying out a heavier dose of Sotalol before we schedule an ablation.  I can imagine that your mental strength must be huge after going through that!!  Good call on the amnioderone, I hear it's not a great choice unless you absolutely need it.  Take care and best wishes for a healthy recovery.  Mansim.

[tachy]

THANKS FOR YOU COMMENT.  I DON'T REALLY FEEL STRONG AS A PERSON SOME DAYS, I THINK I HAVE JUST LEARNED TO COPE, BUT I DO FEEL IT HAS MADE ME A MUCH STRONGER NURSE, I AM A CARDIAC NURSE AND FEEL I HAVE SO MUCH TO OFFER MY PTS. WHO HAVE TROUBLES WITH ARRHYTMIAS, FACING EPS, PACEMAKERS, AND TAKING THE SAME MED'S THAT I HAVE TAKEN, SOME DRS. DONT KNOW WHAT SOME OF THE SIDE EFFECTS ARE REALLY LIKE BUT I DO AND CAN REASURE MY PTS.  AUTOMATIC ATRIAL TACH, IS BETTER DESCRIBED BY A LITTLE A AND P, IN YOUR HEART ALL THE CELLS HAVE THE CAPABILITY OF TAKING OVER AS THE PACEMAKERS FOR EXAMPLE PACS CAN FIRE FROM ANY WHERE IN THE HEART AND CAUSE A VERY FAST RYHTHM, IN MY HEART THE TACHYCARDIA CAN AND DOES COME FROM ALL OVER MY RIGHT ATRIUM, IT IS A DIFFICULT ONE TO TREAT AND DO ABLATIONS ON BECAUSE YOU USUALLY CAN NOT INDUCE IT IN AN EP LAB IT JUST HAPPENS AUTOMATICALLY, THE AREAS THEY WERE ABLE TO ABLATE WHERE AROUND MY SA NODE WHICH THEY THOUGHT WOULD CURE ME BECAUSE THEY COULD MODIFY MY SA NODE AND THE INAPPROPRIATE SINUS TACH WOULD BE GONE UNTIL THEY DISCOVERED I ALSO HAD THE AUTOMATIC ATRIAL TACH.

ANOTHER AFIB MED IS CALLED TYKOSIN, IT IS STILL VERY NEW JUST
APPROVED IN OCTOBER OF 1999,  I WAS THE FIRST PERSON IT WAS TRIED ON IN THE BALTIMORE AREA BUT IT DID NOT WORK FOR ME, IT
IS CONSIDERED A MED FOR AFIB, I DO NOT HAVE IT BUT SOME A FIB MEDS ARE USED TO HELP SVT'S IT WAS WORTH A TRY,  MAYBE YOU CAN ASK YOUR DR. ABOUT   I WISH YOU ALL THE LUCK,  HANG IN THERE,   TACHY

[Lyn2]

It is good to hear from many of you who have also had ablations.  I have gone through it twice.  I was completely unaware of the pain of the burns.  My doctors both said you can't feel it.  Well, I was out cold, but everytime they did a burn I woke right up.  Some took longer than others.  I don't want to scare anyone who really needs an ablation, I would do it again if necessary, it's just that I think it is best to tell patients that in fact, they may feel the burns.  It is quite uncomfortable.  
     It is also so interesting to hear stories that I can relate to.  I also ended up with a rate-responsive pacemaker.  I am only 33, but I don't regret it.  I developed sick sinus syndrome as a result of the ablation, which means my heart beats way too slow or way to fast.  I now have a-fib and I'm treated with amiodarone. I have gone through many anti-arrythmics with no change in rhythms, including the new tykison.  Now Im on amiodarone which Im not too happy about.  Too many serious side-effects.  I may end up having to have another ablation.
     Anyway, it is good to hear about all of you.  Regular people hear my story and are shocked, but with all of you I just feel normal.  Like we are just all in it together, really.

[mansim]

Yeah, I think I'm in line for Tikoysin.  My Cardiologist had been talking about there being a pill that was on a clinic trial (in Canada).  He's apparently getting together the info and will have them contact me.  I also get to see another Cardiologist who is apparently the "best in the West" and he told me that the reason alot of people are loving Tikoysin is because the current Rx level is the MAX and most people are on a low dose of their current drug.  I just went from 80mg sotalol x 3 a day to x 4 a day.  Anyone else on that level of sotalol???  Keep pumping (Bad Joke!!) Mansim.

[creamy12]

A related discussion, Pace Makers was started.