Supraventricular tachycardia

[Lola1023]

My boyfriend is shortly to undergo surgery involving electrophysiological investigation to try and remedy svt. He is relatively young (27) and has previously had an ultrasound which revealed no damage to his heart.

We have recently received literature on the operation which mentioned the slight possibility of damage being caused to the heart, possibly resulting in the necessity of a pacemaker.  I understand that there are no definite answers but we would like to know what sort of odds there are on this outcome.
Also on the chances of him actually having a heart attack as a result of thier investigations.

If, during the operation it comes to light that the problem cannot be cured then will it be possible for him to continue taking his prescribed medication (sotalol) indefinately.

We'll be grateful for any feedback.

[Cleveland Clinic]

Lola,

Thanks for the post.

There are few procedures in medicine that can be curative. Ablation of pathways is one. The procedure involves delivering radiofrequency energy to burn the circuit that is the cause of the arryhtmia.  The main complications relate to access of the circulation and the delivery of the energy. Block is one that can result in a pacemaker. The incidence of complications are low, generally less then 5% with the incidence of block requiring a pacemaker much less then that.  With any procedure, the more experienced the operator the better the outcomes tend to be.

There is a remote chance of a heart attack, but this is extremely small, and again related to the delivery of the radiofrequency energy.

If the procedure doesn't work, there would be no reason he couldnt continue on medication.

good luck

[njrob]

It would be very worthwhile to do a search on this site on "Ablation" - you will find numerous valuable questions/ discussions on this procedure.

[Clenn Camp]

Find a good EP and get an ablation if necessary.  Sotalol is only effective for a period of time....believe me, I have already taken it and its' effectivity diminished and I had to switch to flecainide and it doesn't control irregular beats entirely, only helps somewhat.

Glenn

[Gem123]

Hi Lola,
Your post really struck a chord. My boyfriend is also 27 and in January was admitted to hospital with SVT, and subsequently placed on sotalol (40mg 2x daily). It worked for a while, but from April he's been getting lots of ectopic beats - the sotalol still stops his heart going into SVT, but isn't controlling the ectopics.
The difference is that he had his aortic valve replaced in December, so we assume the ectopic beats and ensuing SVT are due to scarring.
Glenn - what you said about the sotalol becoming less effective seems to be true. His GP suggested trying 40mg 3x daily as apparently increasing the dose is supposed to decrease ectopic beats - no difference, in fact it seemed to make it worse. Currently he's taking 40mg 8am and 6pm, and 20mg at around 10.30pm. He's been getting really achy legs though and I understand this can be caused by sotalol.
The only alternative I can see is that the SVT was a "one-off" and it's the sotalol that is now causing the ectopics ???
We're wondering about ablation also, so would be interested to know how your boyfriend gets on, Lola. Suppose it's early days yet and we could try a different beta blocker (atenolol was suggested by cardiac rehab) to see if that's the problem, but a permanent cure would be preferable (also wouldn't need drugs forever).