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Heart Block after Catheter Ablation
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Heart Block after Catheter Ablation

Hi I am a 43 year old female. I've had PSVT since 18 years old. Over the last eight months noticed having an attack once a month then seven weeks ago had the big one that put me in the emergency room with 203 HR. Advised to see cardiologist about treatment. I did not know such treatment as catheter ablation was available so set up appt. with EP Specialist. He explained this was a simple procedure they do it everyday I would probably be able to go home after procedure. Risk factors was one percent the AV node could be damaged and pacemaker would be required. After consideration I decided to have ablation. Was told everything went well but he wanted to keep me overnight for observation. Everything was good so I went home the next day around 11:00 a.m. then 3:00 p.m. felt bad I thought it was acid reflux so called and was advised to take antacids over the weekend then come in if not better on Monday. Advised by EP nurse to see primary dr. she did EKG and immediately saw heart block was rushed back to hospital where the word pacemaker was the choice word of everyone. I was scared to death. EP's partner told me to watch it for about 2 to 3 weeks 50/50 chance it would correct itself. Went back to my EP last week and still have heartblock. Discussed pacemaker.
My question is have I give it enought time (4 weeks) for the ablation to heal to see if heart will correct itself?
Is a pacemaker my only option if it doesn't?
Am I at risk for heart failure or attack if I don't do something soon?
I do have an appointment scheduled for a second opinion on
Thursday.
Thanks so much.
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239757_tn?1213813182
grateful,

When complications happen after procedures it is very difficult as the procedure was designed to help in the first place. As someone who performs procedures, this is something I can greatly relate to.

After ablation, there is often inflammation which can subside over a period of days to weeks. As you get further out from the procedure the overall risk of recovery diminishes though.

The main risk of having heart block is how it effects you as far as symptoms go and whether having the abnormal underlying rhythm effects you. Overall, it will not predispose you to a heart attack as it is a different process (artery blockage) that results in this.

In a young person, you may be able to tolerate complete or intermittant heart block for a period of time without symptoms. If this is the case, there may be no rush to pacemaker. Without evaluating you its impossible to tell what the best option would be. I would recommend close followup with your EP.

good luck
4 Comments
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Avatar_n_tn
I have cronic (chronic) a-fib and heart block was always thrown around during the ekgs, stress tests and echos.  What is heart block and why isn't a bad thing?
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88793_tn?1290230777
I believe that I had a heart block after the His bundle ablation.  Was connected with an external pacemaker immediately.  But later on, a pathway grew and join up by itself.  Look at this website.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1540-8159.1992.tb06493.x?journalCode=pace

I don't know is good or no good if the pathway grows again?  It said need a permanent pacemaker too.
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Avatar_n_tn
I was 25 when I had an EP study for ARNVT...by heart would race upward of 170-240 when I had the "episodes". After finally passing out from it, my GP took me seriously. She didn't beleive that such a young lady who was pretty healthy could have such a problem. They only way to prove this was to have an "episode" and get it caught on an EKG.
I saw a cardiologist who recommend the EP study for 2 reasons:
1- I could not take beta blockers long term because of the adverse reaction it has with asthmatics(makes asthma much worse).
2- Because it is a routine procedure with little to no complications and you can go home the same day.(He did go over ALL the risks, which is anything from no change to death...so pretty big spectrum.)
I had the EP study and did not go home the same day. My AV node was "accidentally" ablated in the procedure, and I went into heart block. I was observed for a week and then had an EKG at my GP's office to see if my normal rhythm would return, which it didn't. During that time I was short of breath, and couldn't really do anything that would cause my HR to go above like 80 BPM.
I had a pacemaker implanted a week after the EP study. I had complication with the pacemaker because my cardiologist put it in a bad place so my left arm would go numb, and it was painful to wear a bra or seatbelt. You could see it under my skin, because I am a thin gal, and he put it way up next to my collarbone. I lost range of motion with my left arm because the location of the pacemaker restricted the movement of that chest muscle. He told me that they were all things that I would just have to learn to live with...
I eventually had another surgery by a plastic surgeon(wonderful doc) to have it relocated to lower under my breast. It took me telling my Cardiologist multiple times that it was painful, my arm would go numb, etc...before he agreed to see about having it moved. I even had to go to a physical therapist to see if I had really lost my range of motion due to the placement of the pacemaker before he would consent to it needing to be moved. He(cardiologist) treated me like I was crazy.
Now I am 29 years old...with a pacemaker. I am by far the youngest person that sits in the waiting room of my cardiologist. I get stared down everytime I go by the other, much older patients. I travel a lot less because I hate being frisked by the airport security. But I am alive, and for that I am grateful.
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