lingering questions re ablation and more

[LynnSB]

I realize during an EP study the electrical system of the heart is "mapped".Is the heart othewise imaged?What else does an EP study reveal,if anything,about heart structure/function?

I had my ablation Sept. 15 (av node reentry tachycardia)and still have skipped beats,usually isolated, but sometimes I have runs of fast beats lasting 10 to 30 seconds. Can that be my old reentry area trying to act up again?

are rapid beats like that sometimes ectopic tachycardia? my ep doc said something about not thinking it paid to go after every pac.

PAC/PVC question: the ones that bother me the most, except for the rapid ones, are the palps that leave me momentarily feeling weak. When I say momentary, I mean just for a second or so.. it's an " all out " feeling.. sort of like having the breath knocked out of you but just for an instant. Do you hear people describe something like this ? I assume it is because the heart doesn't have a chance to fill up with blood in between beats or something... that produces the awful feeling. Would that be more likely with a PVC or PAC? not that it matters.. just curious. it is such a dreadful feeling.. happened for 20 years so I guess it won't do me in.

Still hoping the ablation worked!
Thanks for your time -- and patience -- with me!

Lynn

[CCF-M.D.-RCJ]

Lynn,

Thanks for the post.

Q1:"What else does an EP study reveal,if anything,about heart structure/function"

An EP study is not an EP study is not an EP study.  Each one is different.  For example, some EPs use intracardiac echo (ICE)during afib ablation while others do not.  If ICE is used, then a lot of structural information can be obtained.

Q2:"Can that be my old reentry area trying to act up again?"

It could indeed, either from recovery/healing or from ongoing inflammation.

Q3:"are rapid beats like that sometimes ectopic tachycardia?"

Yes.

Q4:"Do you hear people describe something like this ?"

Yes, over and over.  You have been on this site enough to have heard/read it as well.  I think that the explanation you gave for this sensation is probably right, but no one knows for sure why some people are bothered by extra beats and others are not.  In general PVCs are more likely to cause symptoms, but PACs cause the same symptoms in some people.

Good luck Lynn.  

[KarenSA]

Hi Lynne
I am interested in your post ablation experience as I am considering having an ablation.  I had an EP study done 6 months ago and opted to only have the investigation done in order to get a diagnosis and then decide on whether to ablate or not.  I was diagnosed with atypical AVNRT which has been recommended for ablation.  I also suffer from ectopic beats including couplets which they have got down on ECG.  Sometimes it seems the two things 'run' together which is not a very pleasant experience.  Perhaps similar to what you have experienced too?  My EP has advised that it could be some time after the ablation once the inflammation has settled and healing has taken place before the actual success will be felt.  My concern is that the problems continue and maye even worsen.  I would really appreciate it if you could give me your email address so that I could correspond with you directly as you recover over the coming weeks, or alternatively if you could keep posting updates on this forum as to how you are doing!  It is hard to know what is the right thing to do.  Getting a firm diagnosis has eased the fear though of not knowing what was wrong with my heart.  Many thanks.

[Ryman]

Hi Lynn.  I'm sorry your still struggling with this.  I think if you are concerned about your general heart structure and function it would be good to try to get an "echo" (ultrasound) done.  This will determine many things such as: thickness of heart muscle, size of the chambers (they can tell if anything has become enlarge), valve function, regurgitation, the pericardium, and from what I'm told many more things.  It's a very comprehensive study and best of all it's completely  painless.
    BTW if you get a chance check out the Glassheart thread that we were communicating on.  It describes my latest experience with a cardiologist.  Hang in there.

[LynnSB]

Karen -- I can certainly say that I am STILL GLAD I had the ablation and, in fact, my symptoms are better. I just thought they'd be virtually GONE. My EP nor my cardiologist (both nationally known,extremely experienced, etc.) told me NOTHING about what to expect in the recovery period. In fact,my cardiologist seemed to think (saw him about 4 weeks post ablation) that the palps were just palps, couldn't be related to the ablation.In my only brief (phone) conversation with the EP doc, he said to ignore any "transient" skips and flutters.I'm trying. I've tried. I just wish I could believe this would truly get even better. But, as I said, my symptoms are better than pre-ablation. If you want to post your address, i'd be happy to correspond

Ryman -- I have had echos. the last was about a decade ago. My cardiologist sees no reason to do another one . He can tell a lot by just listening to my heart, looking at my ekgs, my multiple event monitors ( for a total of 2 months this year alone). Sure, another echo would make me feel better but he's a very experienced, wonderful cardiologist, chairman of the dept. of medicine, former chairman of cardiologist and he has always taken me seriously and listened carefully to both my heart and my worries ( he is, however, hard to get on the phone.). I want to just believe him -- i trust he knows a tiny bit more about cardiology than I do.. hahahahahaha! He's never thought I was in any danger. but when it's MY heart skipping and flipping, it is so hard to think anyone knows what's really going on. I'm trying. I've been meditating lately, back into yoga. I think it is helping a bit.

[KarenSA]

Hi Lynne
Thanks so much for the reply.  My email: ***@****.  I live in Johannesburg South Africa.  I hope that what I have learnt may make you feel somewhat more at ease (I know what it is like though with the constant arrythmias playing havoc with one's psyche!). It seems that AVNRT is one of the arrythmias which responds very positively to ablation.  My EP discussed the recovery with me and this in fact helped to scare me off the ablation procedure as I did not feel I was ready to cope with the increase in frequency and severity of ventricular ectopic symptoms which he warned me of post-ablation (my PVC's can get quite hectic without any help! - usually couplets and what I think could have been three episodes of NSVT earlier this year).  But, I wanted a diagnosis, so, they just 'mapped' the electrics in the EPS for me and found atypical 'slow' AVNRT.  It is so 'healthy' that it ran without stopping itself and they had to 'switch it off' in the lab.  It was masking any attempt to find an origin for the ventricular ectopies which unfortunately did not present themselves in the lab.  I was advised that my PVC's will remain after the ablation as they are caused by a different problem, however they might well decrease in frequency and severity (after the recovery period)as they and the AVNRT are possibly complicating each other. He did advise that they have two assessment periods for post-ablation evaluation - 6 weeks and 6 months.  What I feel is important too is to remember that when they quoted you 6-8 weeks for healing time, this will be the average.  That means that there will be those of us who fall outside of this range, quicker and slower - allow yourself much more time and don't be swayed by average statistics.  I think those who have only the AVNRT may have much smoother recoveries than those who have the ectopic problem as well.  My understanding is that you have the problem with PVC's too like I do?  Good luck with your recovery, I am thinking of you and wishing you well.  Stay positive and please email me if you would like to chat off this forum. Regards Karen

[Ryman]

Hi Lynn. I have an email address that you are welcome to contact me at. It's '***@****'. Anyone else who would like to correspond is welcome to mail me as well. I created it for this purpose and may not be able to respond very quickly, but would like share my experience.
   I hope you are doing well. This week has been very good for me so far. I started taking aspirin again(maybe Hank was right about it, or maybe it coincidence). I've also started going to the gym and doing light exercise. Maybe the combination of these things as well as having many of my questions answered have payed off(knock on wood).

[Vuce]

I too would like to post some success stories.  I am going to have an ablation in a month or so for Atrial Flutter.  EP said that they can cure it in my case with a good chance of success (90%+).  In talking to several people I work with I came upon two people (one of which went to the same doctor I am with) who have had successful ablations and no problems since.  I am sort of anxious to get this over with and get on with life.  Since I have been on Toprol I have had no symptoms but at 34 years old I don't want to be on beta blockers for the next 50 years. I exercise every day or so and am in great shape so I want this over and done with.