Can an ablation have caused this?

[pms_barbie]

Hello and thanks for taking my question.  Ihad a vt ablation at the Cleveland Clinic back in Aug of 2004.  I just returned home Friday from an appointment there.  I had a stress echo done because of Mitral valeve prolapse.  Anyways My left ventricle  dia was 5 and sys it was a 3.  The last echo I got was in August of last year right after my ablation.  My left ventricle then was a 5.4 dia and sys it was close to 4.  The echo says my ventricle is normal size and normal ejection fraction.  Last time it said I had mild chamber dialation.  This time its not present.  Could have stopping most of my pvcs have caused this?
Also im slightly confused about my mitral vale.  Its says my mitral valve is normal the leaflets are thickened and redundant there is a 2 mitral leakage caused by prolapse.  However the leakage doesnt get worse under stress.  How is the mitral valve still considered normal?
Also under the stress part of the echo.  It says The left ventricle cavity size is drecreased with stress.  Is that normal? It says no significant PISA, and normal trnsmitral e wave velocity.  Could you please explain what that termanology means.  Thanks for your time and you reply.

[Cleveland Clinic]

barbie,

thanks for the post.

If you were having frequent episodes of rhythm disturbance, then an ablation could reverse any structural damage from the arrythmia.  The difference between your echo measurements is not that great and probably represents normal variation between the 2 test.

Some people have normal valvular structure and still have regurgitation.  However, the statement about prolapse and thicken dod mean that the valve is not normal.

The LV increases contractility with stress and thus decreases in size.

PISA and E-velocity are measurements of severity of the amount of regurgitation flow which help grade the severity of leakage.  These are normal in you.

good luck

[Momto3]

WOW!  We have a very similar history!  I had two ablations in 2003 for frequent, consistent pvcs. But for an occasional blip, the pvcs are nearly non-existent.  I also have MVP and 2 - 3+ MR.  Prior to the first ablation, I was showing definite signs of cardiomyopathy with a significant drop in EF.  For me, the pvcs are thought to be the culprit of the changes in ventricle capacity, etc.  Since the ablations, echo indicates "normal" ventrical size and normal EF of 55% (+/- 5%).

According to my EP, it is a good thing when the leakage does not get worse under stress.  That is something they actually look for in people with MR.  

How are your pvcs now?  

I am back on a monitor because of a few "blips," but I think all will be good.  Contrary to in the past, anxiety may be a factor this time around.  My doctor and I sometimes refer to my cardiac idiosyncrasies as those associated with an "irritable heart." Even my heart gets cranky : )

Hope you are doing well!!

[uptowngirl]

Hey Barbie,
Always good to hear from you, and I'm always interested in mitral valve questions.
What is your amount of MR, and has it stayed consistantly the same???
Talk to you later.
Regards,
Uptown

[pms_barbie]

Momto3 my pvcs on some days just dont exsist.  Others I have some but my ep dr says they are all normal now.  I was just amazed but the measurements in the echo.  I tried to get as many questions as I could while I was there.  However it was snowing and I so desperatley wanted to get on my way back home.

Uptown the leakage has been 2 and hasnt changed in a year and a half.  Thats as long as I have even known that I had the mvp.

[Kapybaren]

To Momto3:

Where did you get your ablation for PVC:s?
I live in Sweden, and here they donīt ablate PVC:s, just certain types of tachycardia.
Doctors belive I have an extra circuit who causes paroxysmal tachycardia, and maybe they can ablate it. But not the frequent PVC:s, unfortunately. So I was thinking of saving some money to have a PVC ablation in the US.

[Momto3]

Hello

I had my ablations in Cleveland Ohio.  Here in the U.S., the doctors are also reluctant to ablate for "benign" pvcs.  However, after years of persisten pvcs I ended up developing a cardiomyopathy.  The consensus of the doctors was that because of the CM, I would need to remain on antiarrythmics for life or they could try to ablate the irritible foci. I was multifocal, but there appeared to be two predominant areas of trouble. Two ablations later, I am nearly pvc-free and my EF is back to normal!! Generally, I had accepted the pvcs as benign, but bothersome. However, when I began to have structural changes because of them, it was time to get serious.  My doctors said I did not "technically" have VT. I did have NSVT and apparently that was part of my problem.

Do you have frequent pvcs?  How long have you had them?  What about ablating the extra circuit? Maybe you would get some residual relief...You might want to have your records sent to the Cleveland Clinic for a second opinion.  

Good luck!!!

Connie

[pms_barbie]

Boy we really do sound a like.  I was multifocal too.  I had three spots that were relly causing me problems.  All three of mine were around my mitral valve.  Do you know where yours were located?

[Momto3]

LOL!!!

According to the ablation reports, there were 4 different foci, but 2 of them were predominant.  First procedure successfully ablated for RVOT.  Second time around they thought I had another trouble spot on the right side.  Turned out to be left side and LVOT.  That was also successfully ablated!!  It is so strange because now when I get a pvc, I really notice it.  Whereas when I had thousands, it was sort of "normal" for me and I was not quite as aware.  Don't get me wrong, I knew my heart was flipping around, but didn't really catch my attention like they do now.  Strange.

[pms_barbie]

Trust me I know the feeling.  I mean for like 3 or 4 years I would have this weird sensation but I never dreamed it was coming from my heart.  I worked all the time and just never gave it a lot of thought.  I guess when my sister died I couldnt over look it any more.  You know I was like man she was younger than me and they were not certain and still not of what she died of.  I was like there is something wrong and I have got to know what it is.  I just wish I had gone to Cleveland to begin with instead of wasting so much time here where I live.  I could have been better a year ago ....oh well you live and you learn I guess.  Now when I get a pvc Im like oh no.....lol  At least its not the 10,000 plus a day I was getting.

[pms_barbie]

Mine was also a pvc ablation however it was listed as vt ablation.  I had short runs of vt.  Like 4 or 5 beats.  Mostly I had bigeminy.  I had my done at the Cleveland Clinic also.  Most drs wont do a pvc ablation unless there is a great number of pvcs or unless they are causing structual damage to your heart.  Good luck and just keep your faith and youll find some relief.

[Momto3]

pms_barbie - How I can relate!  When I get a pvc now, I'm like...."HEY, what was THAT?"  lol.  Sounds like the doctor is OK with your recent echo.  Now, that's what we like to hear : )

Hi uptown!!

Like you, I am always interested in reading the questions and answers that relate to valve issues.  How have you been doing? I'm wearing an event monitor, but things seem to be pretty calm...whew!  I may have found an EP in NC...YEAH!  I'm going to plan on interviewing/talking to her and her staff sometime soon. I will still keep my EP in Cleveland, but she thinks I should also have one at arms reach...probably a good idea.  Scheduled for an echo at the end of April - fingers crossed.  I have been taking lisinopril and it really seems to be helping with BP and shortness of breath.  Cool!!

Talk to you soon : )

connie

[uptowngirl]

Hey there.  I've been doin pretty well.  Glad to hear you got a good lead on an EP in NC.  Tell me how it shakes out.  Have you been down here lately?  I had an email change lately.  Did you get my last one?  We had reload our computer a couple times and a few people have not been gettin my emails.  Just curious.
My heart has been tickin along just fine.  Saw my cardio in Charlotte about 3 weeks ago.

Take Care girl,
Mary

[jennann]

Ablation has been recommended to me for SVT (brief episodes - like 7 secs long, but rates of 200 and I'm ON beta-blocker) and a possible quick afib episode.  I'm completely scared of the procedure, and would love to hear your (and anybody else) experiences of the ablation.  I would go to an extremely highly recommended EP in Utah - Dr. Hwang, tho I live in S. Calif.  Feel free to email me directly, or write here.  THANK YOU!!!  I'm sure you understand the fear...
Jennifer
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