Ablation

[pms_barbie]

I have a couple of quick questions.  I am scheduled for a pvc ablation in Aug there at the Cleveland clinic.  Can you give me some odds about this procedure.  I have already had one in Lexington.  The dr ablated one place but told me up front I had two more and he didnt get them.  I realize I wont be asleep during this and that frightens me to no end also.  Because during the first one I had no sedation at all.  I have already been told by a dr there that I may need epicardial access.  Also I have a mitral valve issue and the dr seems to think these are were these things are coming from.  Will or can this procedure damage my mitral valve more than it already is?  I have to have another echo because he said he couldnt give a grade to my leakage from the echo I took him.  I also have very mild reg of the aortic valve.  Well this has gotten me scared both valves may need replacing.  It is thought I had rhuematic fever at some point and time.  Can this process stop where it is with the aortic valve?  I doubt it will stop where it is with the mitral valve but is that possible also?  Also could my mitral valve be causing the mild leakage of the aortic valve? Also after the ablation say these spots are found what are the odds of other cells saying ok its my turn to try and be pacemaker?  My heart isnt enlarged yet and my ef is between 60 and 65 percent.  Also I was on effexor when I was there for my visist and since then I have gone off of it because it was making me sick and causing the bigeminy to be worse.  Is it possible for this drug to cause pvcs to be worse?  Thank you.

[Cleveland Clinic]

barbie,

wow. thats alot of information in a short space.

1) Will or can this procedure damage my mitral valve more than it already is?

generally not.

2) Can this process stop where it is with the aortic valve? I doubt it will stop where it is with the mitral valve but is that possible also?

It is impossible to tell without several points in time and the exact mechanisms of your leaking valves. Serial echocardiography is generally how to tell if it will progress.

3) Also could my mitral valve be causing the mild leakage of the aortic valve?

Most likely not.

4) Also after the ablation say these spots are found what are the odds of other cells saying ok its my turn to try and be pacemaker?

There is always a chance that PVCs can recur after an ablation.

5) Is it possible for this drug to cause pvcs to be worse?

Effexor to my knowlege is not associated with PVCs but could certainly effect how you deal with them

good luck

[Kristin391]

There is always a chance that PVCs will continue from another focus after an ablation.  Even the most expert of electrophysiologists will say that there is no certainty and that the arrhythmia may continue from another site.  They usually use some sort of a sedative for ablation procedures.  I had some anesthesia for mine so don't remember anything.  Even when they put in my pacemaker, I had some sedation which was great.  I am not sure why they would want you fully awake for an ablation but there must be a reason for that.  I am told you really won't feel anything anyway except for some rhythm changes etc. Ask for some sedation to help you relax.

[pms_barbie]

I was fully awake because the dr said he didnt want to put the pvc to sleep.  He didnt give me anything til he went to ablate....Itwas very nasty feeling.

[dquenzer]

I have heard different protocols for ablations.  Some are awake, but sedated.  Others are put to sleep, but not with anesthesia, and others have been anesthetized.

I was put to sleep, but not with anesthesia.  I was on the table for over 7 hours, and had lots of work done for afib, atrial flutter, and pac's, plus they checked for PVC's.  Didn't know a thing was happening except at the earliest which was very uncomfortable.

When I woke up I recovered quickly, although my back was killing me.  So they gave me some pain meds.  Was out of hospital the next day, but was pretty sore.

The doctor told me that being asleep was not a problem, but being under anesthesia was, since that would hinder finding the foci.  I could tell immediately when they increased my heart rate at the beginning.  

God's speed.  Since you have been through this before it can be trying.  But the second time around usually produces good results.

[Lamar1]

I have a question for all of you guys. If after ablation other cells may take up the job and cause PVCs, then is it likely that a person with just one focus will develop more foci causing PVCs simultaneously, without ablation? If so, are they dangerous?

Thanks much

[pms_barbie]

It would be my guess that there is no way of telling what can happen after the ablation.  The dr said other cells could very well do it.  I have 2 foci and the dr said that the chances of me going into vtach were small.  I think vtach has to have a circuit in which it can travel.  Where as only having one place I dont think would do anything like vtach.  I think a lot of things depend on if there is any underlying heart diease.  If you have a normal heart then I think the chances are neal of anything dangerous.  However this is just my take on it.  Only going from what I have been told by many drs.

[Lamar1]

Thanks Barbie. What matters is that generally they're not dangerous. Everyone seems to agree on this. I wish you the best of luck with your ablation.

[laceychuck]

Hi everyone.  I am a 22 year old female and had an ablation last oct.  

My situation is a little different because I have WPWS.  But my comment is that when I had the ablation, I was awake.

The process took about 6 hours, and those of you who have had one know it is not a comfortable position.  They said they would give me mild sedation, which they did, but I was awake through all of the procedure.  I do however think that it would have been better for me to be put out.  For starters, I was very agitated after the first two hours.  My arms were cramping from the position I was in, and it looked to me like the doctors and nurses were just sitting around talking.  I think the meds altered my mood some.  I begged the nurses to massage my shoulders and begged them to take the catheters out, that I was done.  This is not my true personality at all.  

I feel that if I had been asleep I wouldn't have been as much trouble to them, and I wouldn't remember the pain.  

I need to have another one but I have been putting it off considering the pain I had with the last one and the recovery.  

I had three holes in one leg and four in the other and they had a hard time getting one to clot.  Even after sutures.  Maybe I am a pain wussy but having them press on the sores hurt badly.

The next problem came when one artery started to bleed after I left the hospital.  I had a hematoma from my knee to my stomach.  I went to the ER with severe abdominal pain and bloating.  The did a cat scan and found that I had blood in my abdominal cavity and that was the cause for the pain.  I think maybe the thrashing I did in recovery (due to the pain from the pressure they were applying) may have caused the extra bleeding.

I guess my point is, maybe I would have had a better experience if I had been sedated.

[Momto3]

OUCH!!

So sorry to hear of your ablation experience.  I can't help but wonder if all that discomfort was really necessary. I'm just wondering if more could have been done to ensure a more positive experience :(

I had 2 ablations last year and I have very little recollection of any of the EPS' or actual procedures.  Each time, I was given a combination of Versed and Fentynl prior to going to the EP lab.  Perhaps it was because I had enough ectopics for them to study even under mild sedation...not sure.  Also, everyone was VERY well aware of my anxiety :) (that may have played a significant role)

The first procdure took about 7 hours and I had a few entry points in my right groin. After the procedure the doctor applied firm pressure to prevent bleeding. There was some pain associated with the pressure, and I would have to say that was the worst part.  But, they applied pressure for about 20-25 minutes, and I only remember feeling uncomfortable for a few minutes. Stayed flat for 6 hours with a 10# sandbag on my groin to prevent bleeding.

Second time was also about 7 hours and I had 3 venous punctures and 1 arterial (femoral) and they used a St. Jude's "plug" to close off the artery. I definitely felt that, but again, it was relatively short-lived. Despite the plug, I still laid flat and used the sandbag -- figured I might as well give myself a little added insurance :)

For those of you facing ablations, ask your doctors about what to expect.  Prior to my procedures, I read and asked a ton of questions!! My doctors were wonderful and provided all the information I needed to be informed and comfortable.  I am the BIGGEST chicken in the world and I'm hear to tell you -- I would do it again in a heartbeat if it became necessary. It is not an easy decision, so it is best to make it with as much information and medical support as possible.  Good luck everyone!
connie

[pms_barbie]

I know the feeling as I had mine awake with no sedation.  I cried the whole time.  I once started to ask him to take the cathers out and lets just forget it.  Finally they gave me sedation and out I went but it was like 2 hrs after we began.  I remeber waking up and my mom was trying to help feed me.  I was so mad.....the food was awful....lol I remember telling her isnt it bad enough I had to go through that awake and now eat this ****....lol  I was really nasty because I remember the dr telling my family that he didnt think he got the spot causing my bigeminy.  I was like all this **** for nothing.  I hope this next ablation goes off pretty good and I sure hope they give me some sedation......Stephanie

[laceychuck]

Thank you for letting me know that I am not the only chicken out there.

The doctor gave me the same combination of medicine they gave you, but it must not have been as much.  I still remember everything very well.

I am hoping next time, they might sedate me a little more.  I will know a little more about the procedure so I will be able to ask questions.

I think because I am only 22, the doctor put everything in "electrical" terms when he explained the situation to me.  I didn't know enough about the eps to look it up on the internet.  I just knew that I was possibly going to have an ablation.  

I am not blaming my doctor for my ignorance, he probably thought I would understand it more in laymans terms, but I could have researched it more if I knew the actual terms for what was going on. I wasn't actually told the term for my condition until I asked at the last appointment.  I just thought they didn't know what was wrong, so I asked and he said "Oh honey, you have Wolfe-Parkinson's-White syndrome."  "We have known that from the start."  But like I said all I was told is that I had a piece of electrical tissue that was short circuiting my heart.  I guess my point to that is, if you type that into google, you never know what you'll come up with.

This forum has been a blessing.  I like to know stories like yours of how people have had really positive experiences in the same situations as I.  

Thank you again.

[cbks]

I just wanted to let you know. My husband is 28, he had an ablation. The dr got what was causing his problem, but he also got some of his conductive system. My husband went into heart block and had to shocked back into rhythm. The dr keep him overnight to monitor him which was a good thing. The next morning they found my husband had a second degree heart block and need a pacemaker to be able to walk out of the hospital. So now my husband is a 28 year old man with a pacemaker. The dr assured us this was the first time this had ever occured in one of his procedures not much comfort for my husband who know relays on a pace maker. Just be fully aware of the risks, PLEASE!!

[pms_barbie]

Thanks for posting.   I have already had one ablation and it wasnt successful at all.  I know of the risk I have thought through them....its a hard choice.  Live with bigeminy that sometimes goes on for hours or take a chance to maybe be normal again......Thanks for your story though....it gives another perspective to think about....

[carolena]

Sorry to hear that your first ablation was not successful.  I was wondering if you mean it wasn't a success because they only got one place and left two others, or because even the one they got is still troublesome?  I live in Lexington and was being treated for pvc's with inderal and now with sotalol.  My doctor told be about the possibility of ablation but did not recommend it now.  If it comes to needing an ablation, I would then wonder whether to have it done where I live or go to a place like Cleveland where they do many more of them.  

I Pray that God will give the surgeon the skill he needs to make your August ablation a successful one.

Love,  Carolena