Ablation

[Linda123]

Sorry to be asking another question again, hopefully others will be interested too.
I am hoping to have an ablation shortly to 'cure' my atrial tachycardia.  As far as I understand my atrial tachycardia is being caused by the scar tissue found there in my EP study. I am confused a little in that I understand ablation can get rid of extra pathways in the heart, and rogue cells, etc. but how does an ablation get rid of scar tissue?  From what I understand my particular problem?
Can I also ask you a question about my 17 year old son.  My son has had many, many virus during his life, and 3 months ago he was very ill with chicken pox which took him a good while to recover from.  My son has told me that he has had a few palpitations just lately and now I am wondering if perhaps his heart has been damaged in some way by the viruses and chicken pox.  Do you think it would be an idea to book my son in for an echocardiogram to check him ouot or am I worry needlessly as my son does seem to be in very good health now.
I promise I will not ask any more questions for at least two weeks!!!!
Thanks very much in advance again.
Best Wishes, Linda

[CCF-M.D.-RCJ]

Linda,

Thanks for the post.

An ablation procedure actually creates scar (dead tissue equals "scar").  Scar tissue can create two paths in the heart from one larger path, analogous to a large one-way road being made into a two-way road by putting a median in the center.  Having 2 paths in the heart instead of one creates a mechanism by which a "re-entrant type" arrythmmia can occur.  So obviously, one of the potential compliactions of an arrythmia ablation procedure is the creation of a re-entrant type arrythmia.  Ironic, huh?

Most palpitations are totally benign.  I would recommend that you not act as your son's heath care provider.  Lord knows that I don't act as my kids doctor -- I won't even prescribe them antibiotics!  If you are concerned about what your son told you, then take him to see his doctor, but I would avoid questioning him about his symptoms unless he is complaining to you about them.

Hope that helps.

[Linda123]

Thanks for your answer doctor, but it took me a while to understand it!  I think from what you have written you are saying that I have re-entrant atrial tachycardia which an ablation may cure but that the ablation may also cause another atrial tachycardia because of the new scar tissue it would produce.  Blimey, this is depressing and makes me wonder if it's worth having the ablation done!
Talking about my son by the way - I would never have just arranged for him to have an echo myself, I would of course gone through my local doctor first.  There's been quite a bit of stuff on TV over here (UK) about supposedly fit young men suddenly dropping dead with somekind of heart problem after having viruses, etc. and this sort of thing is obviously rather disturbing.
Thanks again.

[Richard_W]

If it were me I would make the trip to the Cleveland Clinic and get a second opinion just to be sure. I'd take a copy of your records along with you. (The echo results and that sort of thing)  

My doctor discussed the ablation route with me but I opined that since the Betapace was keeping the Afib away, perhaps we should let well enough alone.  He concurred.  We are in a "watchful waiting" mode right now, just as they do with prostate cancern. Sometimes the cure is worse than the disease.

[Emmaj]

Hi Linda,

Have you had an ablation before? Your post doesn't say. I think the doctor was assuming that you have -- otherwise, why would you have scar tissue there? If you've never had an ablation, maybe there was a misunderstanding between you and the doctor who told you why you need one. Maybe the doctor was explaining what the ablation procedure would achieve, namely that it would cause scar tissue to develop that would stop the tachy that is actually being caused by an accessory pathway. Anyway, it was news to me that an ablation could cause a new problem, but it goes to figure! Good luck!

[quint]

I think the doctor was focusing on the question "I am confused a little in that I understand ablation can get rid of extra pathways in the heart, and rogue cells, etc. but how does an ablation get rid of scar tissue?" in the first paragraph of the answer. In addressing the fact that an ablation actually creates scar tissue, its fairly obvious that a problem caused by present scar tissue is not likely to improve much from an ablation. The mention of re-entrant tachy is just one example of one of the possible undesired effects of an ablation (which in this case would be an outcome similar to the reason the ablation is being done in the first case; to cure tachycardia - thus the irony). The current scar tissue could have been caused by any number of things such as a past viral infection or cardiac ischemia, not just a previous ablation. Personally, if the tachy is the only problem and can be regulated fairly effectively with medication, I would just go ahead and do that (providing the doctor has no concerns with that option of course).

As far as your son, I am 17 years old as well and lately have been having palpitations more frequently including several runs of alternating PJCs and PVCs (very uncomfortable). I was sick *all* the time as a kid, and it took me several weeks to get over chicken pox when I had it. All that considered, I have had a cardiologist and EP look at my event monitor reports, had an echo done, a V/Q scan, I dont know how many blood tests, and still they dont seem to think there is a serious problem. People have palpitations, especially when they are sick. It by no means indicates a probability of serious damage to the heart (heh, although the next time I have a palp and I try to tell myself everything is ok, it will still take me an hour to settle down :p). If you or your son are worried, an appointment with a GP wouldnt hurt, if for nothing else than to put your mind at rest.

[Linda123]

Thanks for your replies Richard, Emma & Quint.  
I have never had an ablation before - my cardiologist believes the scar tissue I have in my right atrium has most probably been caused by a virus (no sign of any heart attack).  I have had heart disturbances for 30 years and these disturbances started not long after I had an Asian flu which made me extremely ill and my cardio thinks this flu is most probably the cause of my heart damage.
I have tried drugs to help with my palpitations but they did not help at all, infact they made things worse.
So, it looks like I'll either have to stay as I am, not a great thought, or risk an ablation.
Best wishes, Linda