EP study and ablation for atrial tach

[LynnSB]

After years of trying to find out what caused my brief but scary and lifestyle-if-not-life-threatening arrhythmias,an event recorder revealed atrial tach.I am amazed that a 2 lead recorder could reveal so much info but my doc says I have"very frequent PACS,atrial runs, non-sustained for along atrial tach, and inappropriate sinus tach, rare PVCs." In consult with an EP doc,he says the focus of the atrial tach appears to NOT be reentry but ectopic and coming from the pulmonary vein and is, they believe , amenable to an ablation.
I'm very excited about having the EP study/ablation and they think there is a "good chance" of a cure for my problem which would eliminate these horrible feelings ( the a-tach and atrial runs make me feel momentarily scared and sometimes weak).
Questions: 1.isn't a pulmonary vein focus a more difficult location for a successful ablation?
2.In general,what's the recovery time like for an ablation?
3. I live alone and just wonder what i have to avoid or watch out for afterwards.. how soon i can go back to work, etc. I know i need to talk to my docs about this and will when i see them but for now, any info in general would be greatly appreciated.

thanks so much!

Lynn

[LynnSB]

thanks SO MUCH for responding. That's very encouraging! I'm going to a major, major heart center very skilled in EP and my cardiologist who is very well known ( not an EP) will be there, too, which makes me feel good.. he's chairman of the dept. of medicine and great cardiologist so I think I'll be well looked over!

[LynnSB]

I forgot to mention that my doctor said that because I have such extremely frequent ectopic activity, coupled with the runs of a-tach, that he thinks this raises my risk of a-fib as I get older and that that's another good reason to go ahead and do the ep/ablation.

[arthur]

I had paroxysmal AFib, a demented form of atrial tachycardia, which was due to pulmonary vein foci.  It was successfully rf ablated.  The procedure can take some time (anywhere from a couple of hours to 9 hours in my case), depending upon how many foci are found, where they are, and which one(s) are the bad guys.  It's conducted with a mild sedative, so you might just sleep through it.  I was back home the next day (care is generally taken to assure the site(s) of the catheterization clot up well and no complications show up).  Talk with your EP about the complication rate in his lab...complications include pulmonary edema (swelling of the vein) and stroke (due to loose clots)...in my case, the EP had a zero percent complication rate because he was careful to only ablate the offending focus and no other.  Lots of places today like to toast all the foci they find, and this may be because the technology keeps the complication rate down (typically 0-2%).  

Outside of occassional PACs (due to several foci left alone), for the past three years since the ablation I have had no recurrence of the AFib.  This is despite being extremely physically active, which used to be a sure way to trigger the AFib.

Do your research and ask a lot of questions.  I tend to agree with you, that atrial tachycardia stemming from a PV focus, should be easy to ablate.

-Arthur

[Cleveland Clinic]

Lynn,

I hope your ep study works out, thanks for the post.

The difficulty does depend on the ability to locate the focus and subsequently ablate it. Pulmonary vein isolation is a little different the ablation of a site of ectopic activity and from ablation of a accessory pathway. The important thing will be to locate the focus during the mapping procedure.  While it is possible to get an overall idea where the focus is from the outside, the mapping procedure during the EP study will really tell how difficult the procedure is.

It sound like your doing the right thing by visiting a center with a high volume and expertise. The success rate will be higher and complication rate lower.

There is alot of debate over the role of atrial premature beats in the genesis of fibrillation.  I cant give you a definite answer with confidence.

Your recovery should be quick. They will probably watch you in the hospital for a day or two and then you will be able to get home and back to work with a few physical restrictions.

good luck!