Whats next? Another ablation?

[ccu nurse]

I have wrote the forum in past but my condition has worsened since then. I am a 25 year old female who works as a CCU nurse. I have been almost totally unable to work in the past year due to my condition and am despirate for some help. I passed out at work last July and my HR was 200 (SVT) when taken to E.R.. I work at a hospital that does not offer any E.P. studies or ablation(although we have a very good E.P doc who came about this same time and has been my doc here) so I went to Jewish Hospital in Louisville last Aug. where I underwent my first ablation which lasted 10 hours (over 100 burns). When I returned home it was only a few weeks before my symptoms and very fast H.R. returned so I went back at first of Oct. for my second ablation and the doc said he again made many burns (around 100 burns). He said he had significantly modified my sinus node and that hopefully the inappropriate sinus tach was gone. Went home and with in few days my rate would drop down to 30's and then  back in 160's. So I received my dual chamber pacemaker. I have been hospitalized to numerous to count over last year and tried all meds.My H.R. over last few weeks has constantly remained over 130's and each day has episodes over 200 despite Verapimil, Sotalol, and Tenormin max doses. Rhythms have been very fast sinus tach, junctional tachs, and ?atrial rhythms.I have had many syncopal episodes and neck beats all the time.Should I consider another ablation and if so, what is chance of recurrance again after that? What options do I have,I
cannot live like this? I read aboutDr.Natale could he help?

[nancynurse]

CCU,
  I'm in a similar situation.  I was dx with WPW, had sycope, SVT, and had an ablation.  Did fine for 3 weeks, was so excited to be "cured" and then the SVT returned but worse along with A-Flutter, etc.  Had a 2nd ablation in which my heart ended up being purferated during the procedure, lost a lot of blood, pericardial effusion, cardiac tamponade, in ICU and Tele, and then rehospitalizations and multiple ER visits during the next 5-6 weeks.  I thought I was going to die. Seriously.  I was so ill.  And I hate getting the Adenosine for the SVT but what could I do. I'm sure you've had that too. I'm now on Rhythmol 300 mg TID and Digoxin 0.25 mg qd and feeling much better.  The doc wants to do another ablation eventually.  My worst pathway is on the left side of my heart which makes a pacemaker difficult and makes the ablation difficult as well.  Anyway, the meds are working for now.  They had to try me on several (Flekinide, Betapase, Verapamil, etc) prior to finding one that worked.  I'm still recovering but I'm going to return to work next week (I'm a hospice nurse...hope I don't end up the hospice patient too soon).  Anyway, I'm 47 and the Rhythmol and Dig are working for now.  God bless.  Nancynurse

[lisa33]

Dear CCU,
I understand completely what you are going through.  I am a 33yo nurse who has been dx w/atrial tachycardia originating from my SA node.  I am on Cardizem CD 240 in am & pm, Digoxin 0.25 hs, Atenolol 100 hs, Aldactone 75 am & potassium for Hypokalemia.  The medicines make me feel awful.  They have recommended an ablation but since my tachycardia originates in my SA node I will need a pacemaker when they are through.  What a tough decision that can be.  The medicines do not help & you want to feel alive again, but at what cost.  I know for myself I want to have good quality of life again.  I hope that these doc's can help you!

[Irene]

Dear CCU
I recently had an AV node ablation, and though I am now dependent on the pacemaker I am not on any drugs (apart from aspirin).  If you are offered this I would consider it very seriously, as I certainly feel a great deal better being off the drugs.  The chances of pacemaker failure are very small indeed.  Good luck!

[WJS]

I don't want to make you feel any worse, but it sounds like the doctors have taken you down a bad road already.  The "do no harm" mandate, certainly didn't result here.

I'm sure there were good intentions, but as they say, "The road to hell is paved with good intentions."  Unfortunately, if you give these doctors another crack at you they might make you a complete invalid.

My advice would be to not let them damage your heart any further.  You don't want to live on a pacemaker from age 25.

If it were me, I would try some natural methods such as meditation, stress reduction, dietary changes, vitamins and supplements to see if the problem can be reduced.  Also perhaps you can outgrow it or outlive it.  The heart has a tremendous capacity to heal itself.

[stevebu]

I hope you can get to the cleveland clinic because you need the best.  I feel so bad for what you are going through.  I don't understand the hundreds of burns?  Isn't that going a little overboard and couldn't that irritate your heart to make it worse?
Is your heart now totally pacemaker dependent?  If so, I thought it would control the rythm better?

I hope the doctor will advise you to come in to see Dr. Natale  

Steve

[CCF-M.D.-CRC]

Dear ccu,
It sounds like you have a very complex case.  I would recommend coming to Cleveland for a second (third?) opinion from Dr. Natale.  He has a several month back-log but I think it would be worthwhile for you to come.  More than likely he will recommend another ablation attempt since you have still not had any relief of your symptoms.  A last resort would be an ablation of the AV Node.  This would mean that you are dependent on your pacemaker but you would not be plagued by the rapid heart rates anymore.  I hope we can find some solutions for you here.  You can make an appointment with Dr. Natale directly by calling the number below or your doctor can make arrangements for you.  (Dr. Natale does have contacts in Louisville as he used to work there).