pvcs

[scooter01]

Is an ablation a safe alternative for pvcs?

[TGM86]

Hello Dawn...how is your daughter doing the past week. I didn't hear any comments after mine so I was just curious. What Dr. did her ablation this past summer?

[TGM86]

I'm sure the doctors will throughly examine her and exercise all of their options before going on to the open heart ablation. Did she have an Electropyhsiology study before the other ablations? The docs can determine a lot by what they find during their investigative work prior to any procedures.
The type of pathway I had ablated was not one they could reach via catheter, hence the open heart route. I have to say it was very stressful and a long recovery. I was out of work for 4 1/2 months afterwards. Anytime they crack your chest open it's going to take awhile for the sternum to heal. I also had some post op complications like pericarditus, which is not uncommon after this type of surgery. This is when you get an inflammation around the sack of the heart and it's very painful and hard to breath. I also experienced several episodes of atrial fib immediately after I came back to Mi. from Duke...that was scary as I hadn't anticipated more problems. Good luck, ask a lot of questions of the docs before you decide to do anything. Ask how many of these procedures the doc has done and what his/her success rate is. Going in fully educated you will feel better in whatever decision you make.

[ddavey]

hi there,  i found your post interesting as my daughter is seeing drs at the U of M.   i read that you underwent open heart for ablation, and i am wondering what that entailed.   my daughter has dilated cardiomyopathy (she is 22yrs old and mentally impaired) and there is a possibility that this condition is caused by very frequent pac's (30,000 on 48hr holter)  she underwent an unsuccessful ablation in july, she has a defect near her mitral valve and they were unable to ablate on the left side due to this defect.   her condition had been stable, but is becoming tenuous again, and i know that there is a possiblity of an open heart ablation or removal of the defect in her future and i am wondering what that type of surgery entails    thank you  dawn

[TGM86]

None of the meds I tried worked. Like Inderal, Atenolol, Verapamil. The only other one they suggested was Rythmol and they thought that might be too aggressive for me. These were all cardiologist I've been dealing with.
My intitial diagnosis was WPW with PAT. That would go on for 6-8 hours at 300+. Spent 3 months in hospital after I returned from Vietnam to try various heart meds to try and control this arrythmia, I was 19 at the time. Inderal was new then and it worked, just kept taking higher doses to keep it under control. Was taking 4, 40mg per day back in 86 when I had episode that didn't end. Flew to Duke Univ. for EP eval and subsequent open heart for ablation. Even after the surgery I still have the PVC's and short runs of atrial fib and pac's. Docs are cautious to do any more ablations at U of M because of my history.
I appreciate your suggestion as to looking into another ablation. Are you a Cleveland Clinic Doc. How do I get a referral if I choose to come there?....thanks. TGM

[Cleveland Clinic]

For that many PVC's, assuming that they all come from the same origin, I would recommend an ablation procedure.  I take it that none of the meds you are on are helping you.

[TGM86]

Hello. Will an ablation be considered if I also have Atrial Fib and PAC's along with the 20 some thousand pvc's per day. I feel them all it is all very frustrating, raising my anxiety and worrying if I'm heading into a atrial run or somethingl else. I've had these since I was diagnosed in Vietnam back in 1968.
Had open heart to ablate pathways in 1986. One worked one didn't. What would you recommend?

[Cleveland Clinic]

Medications should always be the first approach to most arrhythmias.  Intolerance or lack of effect should be what makes one move on to the next step which might be an ablation procedure.  Only The ablation procedure and its risks depend on where the PVC's come from.  If them come from the right side of the heart than the risk to ablation is low.  When they come from the left the risk may be higher.  The argument to have an ablation is based on the incidence of PVC induced cardiomyopathy (heart failure).  If you take that into consideration, then the benefits of ablation definitely outweigh the alternative (not ablating when the medications arent't effective).