Consequences of a failed EPS and ablation

[JoseI]

I have a conective tissue disorder that has produced a moderate aortic insufficiency. I had a coarctation of the aorta corrected 20 years ago. I am 42 now. Last week I had a severe tachycardia (218 pulse) which was my third or fourth in my life and did not end very quick as the others but lasted until I could get to the hospital. I then had a catheterism and EPS with ablation. The doctor could not burn the nerves that produce the tachycardia and prescribed Cartia 125 mg, Toprol 25 mg and Accupril 20 mg. I was only in Accupril 40 mg before. Since I had the EPS I feel sudden palpitations or changes in my heart rythem which I never felt before. Is this a consequence of the EPS with ablation? Thanks for your help. JoseI.

[walkare]

Just wondering if, after a failed ablation, anyone was told that the wrong av nodal pathway was ablated?  My records show this, and I continue to have PSVT, albeit not lasting as long.  Constant "flips", arrythmia...very frustrated. On Toprol, 100 mg. a day.  Been on two different heart monitors, doc has yet to call me back after a month on the the last one.  Any suggestions??
Kari

[JoseI]

Thanks all of you for your very helpful comments.
I had a holter this week following the Dr. recommendation and it showed that palpitations were due to the irritation of the heart after the ablation. Today I feel better and only had two or three palpiations during the day. I will definetely look for a second opinion.

Happy holidays!

[dquenzer]

I concur with the doc.  

First of all after an ablation it is common to suffer arrythmias due to the irritation of the heart.  These should subside over time.  I had ablation for AFIB and for the first week had periods of wierd irregular heart beats.  These subsided completely over time and I no longer have AFIB.  Whenever an ablation is done it will cause some irritation of the heart.

I also would suggest going to a research or university hospital.  I went to Mayo.  I was on the EP table for 7 hours, and I have heard of others only being on the table for a few hours for the same thing.  It was pretty spendy.  Thankfully my insurance was good about it. But my EP was very very thorough.

[pms_barbie]

I guess the dr kind of explained why my first ablation was only a couple of hrs and never did any good at all.  The second on was 9 and half hours and helped more than the first one did.

[CCF-M.D.-MJM]

HI JoseI,

Sorry to hear about this.  218 certainly is a fast heart rate and unlikely to be anything but some form of reentrant tachycardia.  I think it may be time for a second opinion. Did you go to a major academic center for your EP study.  Private practice docs. can be very good, but they are on a bottom line sometimes.  We have procedures that last 10-12 hours here sometimes.....private practice cannot afford this.  That is one reason it is sometimes a good idea to look at academic centers for second opinions.

It sounds like a holter or event monitor is also indicated to determine what these new palpitations are.  

That is how I would approach your problem.

Hope this helps and good luck.