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Heart Disease (Expert Forum)
more about arrythmia solutions
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more about arrythmia solutions
by Lyn2, Jun 29, 2001 12:00AM
Hi,
Sorry just one more confusing situation to throw at you. You've probably been asked every conceivable heart question through this forum.
Anyway, my questions relate to taking amiodarone vs. AV node ablation. I am getting such confusing messages about amiodarone, and hearing alot of horror stories.
I am 33 and have been taking amiodarone for about 6 months for various arrythmias. I have ventricular rates up to 300bpm. It is likely afib with abberancy. I also have a number of other atrial arrythmias. I have already had 2 ablations and a dual chamber pacemaker.
Since I began taking the amiodarone I have developed peripheral neuropathy in both arms, significant tremors (diagnosed by neurologist) and severe sun reaction. I can't go out in the sun even with 45 spf. I burn badly and develop blisters, and other problems everytime I am exposed to the sun.
I truly have tried all other antiarrythmics, including the new tykison, all of which either caused worsening of arrythmias or just ineffective. The dilemna I have is the amiodarone is working to control the rhythms better than any of the others, but I am having these side effects.
I was told when they put me on the amiodarone that if this didn't work they would likely have to ablate my AV node. There are too many focusses to try to ablate. And the fear is they may move to a different part of the heart. I have episodes of pitting edema, which is controlled by diuretics. But the EP doctor believes the edema is caused by AV dissasociation, and that my body doesn't tolerate it well.
BOTTOM LINE.....
What is your feeling about amiodarone use in a young person vs. ablation of the AV node? Wouldn't an AV node ablation compound the dissasociation problem? I have been avoiding my EP doctor, because I just don't want to have to make yet another choice about treatment. But I would like your opinion to think about.
Will the neurological problems get progressively worse if I remain on the medication? That would be a weighing factor.
Thankyou so much for reading through this. Any input would be more than great.
Sorry just one more confusing situation to throw at you. You've probably been asked every conceivable heart question through this forum.
Anyway, my questions relate to taking amiodarone vs. AV node ablation. I am getting such confusing messages about amiodarone, and hearing alot of horror stories.
I am 33 and have been taking amiodarone for about 6 months for various arrythmias. I have ventricular rates up to 300bpm. It is likely afib with abberancy. I also have a number of other atrial arrythmias. I have already had 2 ablations and a dual chamber pacemaker.
Since I began taking the amiodarone I have developed peripheral neuropathy in both arms, significant tremors (diagnosed by neurologist) and severe sun reaction. I can't go out in the sun even with 45 spf. I burn badly and develop blisters, and other problems everytime I am exposed to the sun.
I truly have tried all other antiarrythmics, including the new tykison, all of which either caused worsening of arrythmias or just ineffective. The dilemna I have is the amiodarone is working to control the rhythms better than any of the others, but I am having these side effects.
I was told when they put me on the amiodarone that if this didn't work they would likely have to ablate my AV node. There are too many focusses to try to ablate. And the fear is they may move to a different part of the heart. I have episodes of pitting edema, which is controlled by diuretics. But the EP doctor believes the edema is caused by AV dissasociation, and that my body doesn't tolerate it well.
BOTTOM LINE.....
What is your feeling about amiodarone use in a young person vs. ablation of the AV node? Wouldn't an AV node ablation compound the dissasociation problem? I have been avoiding my EP doctor, because I just don't want to have to make yet another choice about treatment. But I would like your opinion to think about.
Will the neurological problems get progressively worse if I remain on the medication? That would be a weighing factor.
Thankyou so much for reading through this. Any input would be more than great.
Doctor's Answer
by CCF-M.D.-CRC, Jun 29, 2001 12:00AM
Dear cn,
My answer would depend upon what type of arrhythmias you were having and what type of ablations you have already had. If possible I would first try to ablate the underlying arrhythmia. A complex ablation like this should be attempted at a specialized cardiac center such as the Cleveland Clinic. If this was not an option for whatever reason and you were intolerant of medications I would probably proceed with an AV node ablation. This is a last resort procedure but it does control ventricular rate and relieves some symptoms. It will not worsen AV syncrony. Hope this helps. If you would like to be seen at the Cleveland Clinic I would recommend Dr. Natale or Dr. Saliba. You can make an appointment with either of them by calling the number below.
My answer would depend upon what type of arrhythmias you were having and what type of ablations you have already had. If possible I would first try to ablate the underlying arrhythmia. A complex ablation like this should be attempted at a specialized cardiac center such as the Cleveland Clinic. If this was not an option for whatever reason and you were intolerant of medications I would probably proceed with an AV node ablation. This is a last resort procedure but it does control ventricular rate and relieves some symptoms. It will not worsen AV syncrony. Hope this helps. If you would like to be seen at the Cleveland Clinic I would recommend Dr. Natale or Dr. Saliba. You can make an appointment with either of them by calling the number below.
