Trying to decide about radiofrequency ablation

[danicalifornia]

Hi, I'm a 37 year old female with the history of a lot of medical problems including fibromyalgia, IBS, Anxiety & Panic, ADD and Superventricular Tachycardia.

Right now, the Tachycardia has worsened and the doctors want to do an ablation, as I do not tolerate beta blockers well and have been off of anxiety meds for the last three years (I try  to stay away from drugs as I have a tendency to get bad side effects)  I have been experiencing a lot of anxiety lately, as well as dizziness, tachycardia, weakness, etc.

I am not sure whether the anxiety is causing the tachycardia or vise versa, but my worry with doing the ablation is that my doctor mentioned that if anxiety was the root of the problem, then the ablation might not rectify the problem...ie...the anxiety could cause irregular impulses in other areas of the heart.  I really do not want to go on medication, but I don't want to have a surgery if it's unlikely to have success.  The other issue that he mentioned was that he would have to trigger the tachycardia while I was on the table in order to locate and eliminate the problem...so I am wondering how likely this is to be able to get it to trigger when it doesn't happen every day.  

I am just confused...and also worried about post surgery induced problems that could happen.  I would welcome any advise or opinions.

Thanks so much,
Dani

[Momto3]

I remember asking my EP if my PVCs were anxiety-driven.  She told me they were not, and that she was able to tell by the appearance of the beats on the EKG and monitoring strips. It had something to do with how quickly the episode occured, and resolved.

I've had two ablations, but neither was for SVT.  My procedures were for PVCs, and each time I was put into a state of conscious sedation.  The procedures took 6.5 - 7 hours, but I was not aware of the time so it didn't really matter (to me).  

I can related to the anxiety and the IBS, so I understand your concerns, but in my case, the ablations actually helped to calm things down.  Not having such a goofy rhythm seemed to lessen the degree of the anxiety and IBS symptoms.  Does you doctor believe your tachy episodes are a direct result of anxiety? Do you have a lot of episodes?  It's kind of like the chicken and the egg...which came first.  The good news is that in the hands of a skilled EP, the risks from ablation are minimal and the possible benefits are enormous.

Take care
Connie

[kimmie28]

is it at all possible what they thought was anxiety was actually svt in the early stages?, I only ask as this happened to me, i was told i had anxiety for 2 years before it became that severe i was diagnosed with svt and had the ablation within a few months within diagnosis.

at first the ablation worked i felt like a new person but slowly the palps or psvt's have returned it's been 4 months since the ablation and i'm back on meds, due to have another 24 hr monitoring tomorrow.

the ablation is very uncomfortble and can take up to 6 hrs but in my opinion it was worth it, although my svt's have returned they are no where near as often as they were, i used to have episodes and need adenosine most days, 3 days in a row once.

they wouldnt suggest this proceedure if they didn't think it wouldn't help.  i would suggest speaking with the surgeon at the initial consultation before he even puts you on the waiting list and talk through all your concerns and take it from there, good luck !!! kym

[ireneo]

From my understanding, anxiety induced tachycardia tends to come on rapidly but then tapers off slowly as the person settles down. PSVT is an electrical glitch in the heart that turns on and off at its own whim, sometimes triggered by activity or cold medications for example. Most of the time it's just a nasty surprise. Have you tried any of the vagal maneuvers to break the tachy (splashing cold water in the face, holding breath and bearing down as if having a BM)? Also, have you worn a heart monitor? That's very good at showing how the tachy comes and goes. The doctors like to see a tracing of the start of an episode and the end. That gives them a good clue as to what's going on in there.

[JKJ]

i'm no doc....but i say if it's affecting your quality of life that badly and its gotten that serious, i'd go with your doc's recommendation and have the procedure.  have a good appt with the EP doc...let them explain every little detail to you, that's what they are there for and a good one won't mind a bit!

[danicalifornia]

Does anyone know if anxiety-related tachycardia responds the same way that straight-up SVT does.  By that I mean, that my tachycardia jumps from 80 bmp to 220 bmp in one beat and returns the same way...I wondered if the tachycardia that is stimulated by anxiety reacts the same way or rather increases more slowly.  

I do appreciate both of your comments so far...they have been helpful.  I too, am at the point where I am getting the ambulance called on me all the time when I collapse in public...have to ride the senior citizen handicapped carts at Walmart and the grocery store and occasionally have to use a cane when I am weak and dizzy from bouts of tachycardia (which ***** because I look young and healthy), so it would seem that the ablation might be worth a try....I was just considering trying anxiety medication first to make sure that I couldn't rectify the problem by reducing the very bad anxiety that I have been experiencing lately.  I have had to totally stop excercising lately, and abbreviate my social life...ie...no dancing....so I am not sure whether I should just go ahead with the ablation regardless of whether or not I try the anxiety meds.  

Any other comments/insights are very welcome.

Thanks,
Dani

[JKJ]

Hi...I've had 2 ablation procedures for SVT and had no complications from either one.  The first one was an out-pt procedures and the 2nd one I had to stay overnight in the hospital (different doc; his preference).  My SVT has slightly returned now years later and I now take a calcium channel blocker.

They were able to trigger mine while I was on the table....it did take awhile, but they did it.  (I have a stubborn heart I guess...LOL!)

My SVT was causing serious problems, several trips to the ER for passing out, heart rates well over 200bpm, etc.  So it comes down to what you are willing to live with.  I couldn't live with my SVT anymore, literally.

But I was knocked out for both procedures in a very deep la-la land.

Good luck with whatever you decide!

[ireneo]

It's true - if anxiety is the cause of your fast heart rate, then there won't be a "bad" spot in your heart to ablate. Any anxiety or stress can increase our heart rate. Just think of times when you've had a near miss while driving a car. Your heart rate pops up and that's a normal reaction to the stress.

They do have to trigger the arrhythmia during the study to see what's causing it. If they can't do that, then they pull out and you're done. I think most times if a person has some type of SVT, they can trigger it. The single things like PVC's are more difficult to track down. All you can do is go in, let the cardio try. If he finds a spot and can fix it, that's one less thing you have to deal with.