Re: Is ablation necessary??

Posted By Kate Boffey on June 28, 1998 at 00:12:55:

In Reply to: Re: Is ablation necessary?? posted by CCF CARDIO MD - CRC on June 27, 1998 at 00:20:00:






I am 22 yrs old and have regular palpitations and a resting heart rate of 108.  Just a walk from one room to another can cause my heart rate to jump to 170.
I have had two hospital admissions in the past two months, as I was having palpitations and a continued heart rate of 220 per min.
They have performed two holters, which showed up only a little bit of SVT, and I do not have a result for the second holter as yet.
Echo was normal.   The Stress test showed severe tachycardia, (190 bpm in the first 15 secs) but no arryhthmia before I passed out.
I am taking 240g of verapamil daily, but it doesn't seem to do much.
I am now scheduled for an ablation in OCtober, but my worry is, Is it really necessary???  What if they can't find a pathway????  With such a small amoount of SVT shown on the Holter, is an ablation jumpung the gun??
Thanks
Kate
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Dear Kate,
The answer to your question depends upon the cause of the tachycardia. If it is caused by an accessory pathway (extra conduction pathway in the heart) then ablation is indeed the treatment of choice.  If the etiology is not clear then an electrophysiology (EP) study may still be in order to help with diagnosis and possibly with treatment.  
I have answered your other questions below.
What if they can't find a pathway????
A: This is a possibility and they would have to try different medications.

With such a small amount of SVT shown on the Holter, is an
ablation jumping the gun??  
A: No.
Thanks for your response.  I have some more questions.  I am still concerned abou what will happen if they can't find the accessory pathway.  Other medications are not really appropriate for me as I am a sever asthmatic, and beta blockers are contraindiacted.  I have tried Flecinide and now verapamil without success.  What then, if they can't find any accessory pathway??
Q2.  My cardiologist doesn't seem to think that such a small amount of SVT was a problem at all.  He was very blase about it.  He referred me to an electrophysiologist for evaluation for an EP study.  Instead, he scheduled me straight away for an ablation.  Why so soon, do you think???  Should an EP be done first??
Thanks so much
Kate Boffey