Ablation Long-Term Issues?

Hi,

I'm a otherwise healthy 33 year old male that was diagnosed with SVT.  I have an ablation that is scheduled for about a week from now and of course now I'm starting to freak out a little.  Obviously, I've read a lot about the pros and cons but haven't read basically anything about the long term issues of the procedure.  I realize that the procedure hasn't been around for 50 years which makes it a bit scary to know if there will be some long term issues with my heart.  I've seen a couple of posts of people that did it 20 years ago but most people don't seem too concerned with any long term issues.

I guess I'm trying to decide whether I should be more concerned with being on beta blockers for the next 50 years OR the unknown long-term issues with ablation (does it increase chance for congestive heart failure, weaken your heart muscle, aneurysms, etc.).  Does anybody have any knowledge about long term beta blockers vs ablation?

Thanks!

[ireneo]

What little I know about heart meds is they seem to lose their effectiveness over time and you have to be switched to something different.

As for ablations, I've had 3, the earliest was in 2000 so it hasn't been decades yet. But after 3 ablations I'm not noticing any changes in my heart function that I know of.

[sparkyr]

Thanks ireneo.... I guess I'm worried that by killing off part of the heart that there could be some long term ramifications after 20, 30, 40 years of your heart beating.

[Bromley]

Hi. I had one ablation in 2004.  It significantly reduced the severity of my SVT.  In my case there were long term issues. I would not forego an ablation if that is what is being recommended. However, I would make darn sure you pick very qualified people to perform the procedure. Best of luck.

[cindy707]

Hi i read your post too...had my ablation 4 years ago for a super severe case of SVT and Atrial Fib among other things.  I had a single ablation and it was success and alot easier than a root canal to me or a no brainer procedure.  The ablation was developed by Drs. Natale and Schienmann and they were the leaders of the procedure altho i don't know exactly when they were first done.  All i know is that i feel the procedure saved my life.  For me the SVT began to get super progressive on me, the meds became less effective as Ireneo said and i doubly agree w. Bromley that make sure you have chosen well in the choosing of your doc.  I had a certain criteria that the doc had to meet after doing lots of research and he met it all and i am glad i chose as i did because i had sort of a rough time of it during the procedure which was not the norm but i wanted to make sure whomever i chose could hand anything that might pop up and WHEW did it ever.  I got my life back on a golden platter was back at work within a week and aside from very rare issues that i usually cause myself i got the green light.  As far as long term effects go i would not think that there are any if the doc is either using the RF's or Cryo procedures because there is no scarring or after effects.  The heart is a muscle just like the muscles in your legs or arms and is a pretty resiliant organ and a tough little bugger structurally and it would take alot to physically damage it thru a catheter.....however choose well w. your doc because it isn;t the ablation that is usually the issue in the end it ends up to be the ablater and their ablilities and experience....i think alot of us were like you a couple of weeks before the procedure when we second guessed ourselves and probably half of us almost backed out of the procedure which could have been very very bad for us...if you start getting super spooky message me at any time w. any of your questions about the what ifs or simply just re post...so many on this site have had the procedure done....good luck w. it and let us know how it all works out for you...i know tomH just had one done recently and can offer up alot as a "newbie" (sorry Tom).....we're here for you...

[Darlingorla]

I had an ablation procedure for PSVT 6 months ago and I am so glad that I found the courage to go through with it.  I took a beta blocker for 15 years and eventually it stopped controlling the episodes which put me in the ER by ambulance 3 times in the last year.  The final straw came when I had to be chemically converted by EMT in my kitchen (Adenisone).  All meds have the potential for unwanted side effects when taken long term.  If this procedure had been around 28 years ago when my arrhythmia surfaced, I would have seriously considered the procedure.  As it was it was only brought to my attention by the doctors in the ER last year;  my own cardiologist never mentioned it,  I had to practically force him to refer me to an EP specialist.  I have still to ask him why he waited so long ... perhaps it is because of the cost as healthcare is publicly funded here in Canada.

[PikaPika88]

I would comment in ablation vs open heart surgery.  It is definately ablation better than open heart surgery.  

Normally, if the medication can control the palp then the doctor would like to avoid the ablation.  Unless it is the dangerous arrhythmia.

[tom_h]

"Ablation technology has reached a point where the procedure is considered much safer than trying different medications to find out which one MAY work for you."  This is a direct quote from cardiologist.  I was/am on a common betablocker, Metoprolol for five years and it did little to stop my SVT episodes; 3-5 per month.  It did help to convert them more easily than before. Now 5 weeks out from ablation, I've just had my first month with zero episodes for the first time in a couple of years.  

I believe my GP is going to leep me on the betablocker even though I no longer have SVT.  I'm 60 y/o, and over the years my BP has begun to creep up a little.  Metoprolol is easily tolerated by me and it keep my BP like a 20 year old. He believes it also helps greatly in heart attack survival.

Good luck with your ablation.

[patjd]

I had an ablation for SVT 15 years ago " age 27.   I didn`t want to go on medications for life, and thought it was the best option.  It worked on the first try , and they got rid of 7 extra electrical pathways an have had no svt since.  Unfortunately I have started to suffer from sinus tach, for the past 2 years.  I had to go on beta blockers to control it, any probably will be for life.  I don`t know if this is caused by a long term effect from the ablation or not.  But I still think  that being SVT free for 13 years was even worth it.

[sparkyr]

Thanks everyone for their input.  While my SVT is fairly frequent (especially when I exercise regularly), it isn't extremely severe.  It will almost always be induced if I'm playing a sport.  If not doing a sport, it will happen maybe once a week.  It will generally last only 5-10 mins (~180 bpm) and will go away if i sit down and let it run its course (i.e. I don't ever have to go to the ER).

My doctor (Dr. Badhwar) has worked with Schienmann (someone mentioned him earlier) who pioneered the procedure and now does the majority of the ablations at UCSF.  He is considered one of the best at this so I feel safe that way.

However, I guess the lack of severity of my SVT (although frequent) makes me question whether it is worth the risks associated with the procedure.  I haven't tried any beta blockers.  In my case I feel like any complication and I would be worse of then when I started.  Infection scares the hell out of me.  And the people that say they get it more often or worse after the procedure scares me too.  Not to mention having weird palpitations and chest pain.

[tom_h]

While infection is always possible, the procedure in minimally invasive.  There's no "cutting" involved.  The entry site is punctured with a rather large needle-like device.  I had mine done at UMass in Worcester, MA.  Great care was taken to insure that I was as clean as possible for the procedure.  I had even been given two germicidal sponges that I used the night before and the morning of the procedure.  I believe it was a Phisohex type of cleanser.  By the way.  You might be stressing about the entry point.  I've said this before to another fellow who had his done last last week.  The entry point is often referred to as the "groin", and that usually congers up all kinds of awful thoughts for the typical male.  So I was surprised to see that the groin was actually the leg crease.  Lay on your back, pull your leg up a little, and the crease that's formed is where they enter the femoral vein.

Ablation success I think depends a lot on the kind of tachycardia you have and its source.  I was wondering if they've determined the source of yours; AVNRT,AVRT,WPW, etc?

Afterwards, you probably will get some short runs or occasional PVC's for up to several months afterwards until scar tissue forms a secure break in the pathway(s) that was causing the problem.  I've had some short runs, and one the other night that went on for nearly 10 seconds until it dropped out.  But all are feeble and don't have the aggressive pounding of what I'll call "the real thing".

Have you discussed the type of sedation you will receive during the procedure?  I had general anesthesia, and barely remember the cath lab after being first mainlined with a big hit of vallium!  The guy here last week had a twilight sedation and recalls the experience as a "highlight tape" and doesn't clearly remember anything in between.  You're going to do fine!

[sparkyr]

These posts make me feel a lot better about the procedure but I am still unsure whether or not it is the right call because of my pre-hypertension.  I can't decide whether I should try beta blockers and maybe knock out both things or do the ablation and be able to exercise more.  

They do not know what type of SVT other than it is not wpw.  I also don't know the type of sedation but I'm looking forward to finding out!

[sparkyr]

So I had my ablation the day before yesterday and it was sooo easy.  They didn't sedate me at all so that they could easily induce my SVT which I thought would freak me out but it actually wasn't bad at all!  It was a little weird laying their while they are making my heart fire in weird patterns, taking it up to 300bmp then back down to 50bmp, and shooting me up with isuprel (kind of an adrenaline boost).  Most of their burns I couldn't feel except for the last one but even that one was just barely uncomfortable.  But really the worst part was how uncomfortable it was laying down with my head turned the whole time.  The numbing shots at the entry wounds feel like the novacaine shots the dentist gives you prior to a filling.  Not really pleasant but they only last a couple seconds.

Post-op is easy.  It's kind of boring waiting around for 4 hours while the entry wounds close up.  The day of the procedure it kind of felt like my heart and been put through the ringer which i guess it kinda had.  No pain but it felt a little weird like after I've had a bad SVT spell which makes sense.  By the next day there was no issues at all.

Hopefully there are no complications but all in all this was so MUCH easier than taking meds everyday (and any side effects).  I still don't know for sure that I'm fixed yet but it really was so much easier than expected even without any sedation. (They did give me a hit of fentanyl after that procedure was over to lower my blood pressure and pulse from the isopryl).

If anyone is having an arrhythmia and in the Nor Cal area I highly recommend going to UCSF.  Their doctors and nurses are amazing and they do several of these each day so they are really, really efficient and know exactly what they should be searching for and where they should be looking at.  Dr. Badhwar was amazing.  The ablation Badhwar was doing before me was taking longer than expected so they preped me in their other room and called up Schiennman (they guy who developed the procedure) in case Badhwar didn't finish in time.  It's pretty amazing to have a fall-back doctor that is equally as talented.  

Now it's time to keep my fingers crossed that it worked!

[tom_h]

Great!  I told you you'd do fine.  Congratulations,  now take it easy for a couple of days.  The leg(s) will probably be sore for up to a few weeks, and will look like hell for a week or so. Take care now and get better!

[karin76]

I was diagnosed with SVT in high school. My episodes always landed me in the ER. I was put on beta blockers right away and was on them for years. The problem I had with the beta blockers is that they really seamed to drag me down. It was hard for me to get and keep any good amount of energy. This problem really became aggravating trying to raise my daughter. I continued taking the meds because if I didn't I ended back in the ER. When my first daughter was two I met a new cardiologist who recommended the ablation. I was scared out of my mind to be honest, but it was the best decision I ever made. My daughter is now fifteen and I have not had one episode since I had it done and there is no need for medication . Good question on your post though. I’ve often wondered to if there have ever been any study’s on long term affects if any.

[livingintheOC]

Hi Cindy!  Hi Tom!  I was diagnosed with WPW Sept. 2009.  Have been on Flecanide since.  Scheduled my cryoablation for Feb 7th today.  I can't even begin to tell you how nervous and scared I am.  Your comments and information has really helped so so much.  Thank you.  I live in Orange County, Ca and I agree that you need to really ask your doctor alot of questions.  I asked my doctor how may times she has done the procedure.  She had to do 75 before she could sit before a medical board.  She has done over 1000 since then.  She is only one of three doctors in Orange County that do them.  I am glad to hear that you both are doing well.  I'll keep you posted on how mine turns out.

[tom_h]

You'll come through it fine!  Let us know how it goes. If you'd like to read a little more detail of my experience, please check my journal entries under my user name.  Good luck.....but you won't need it, trust me!

[midgetchris174]

I had a radio frequency ablation yesterday, 3/9/12 for 20,000+ PVCs a day.  It took 5 and  half hours and I was awake, non sedated during the whole thing. First they numbed the groin(the crease between leg & genital where ur underwear usually rest) up real good, which really didnt feel any worse than getting the iv put in my arm. The next thing, the doctor was saying they had access, and was I was watching the wires being threaded to my heart...I couldn't feel them moving inside me, only the doctor's movement around the groin area, which didnt hurt.  Once the wires were in my heart (3 of them) for about 30 min they just kinda watched what my heart was doing on its own since it was beating abnormally without their help.  Then they used the wires that were in my heart to pace my heart, making it speed up, slow down, and they were able to get the wires positioned just right to reproduce the PVCs that i was having.  So then they inserted another wire, the ablation catheter.  And burned a spot.  Yes it did burn...sort of like eating something really hot and you get that burning feeling in your stomach. But the anesthesiologist very quickly gave me some pain meds which relieve the burning sensation completely.. Today, 24 hours later, I feel pretty good aside my my right groin area being a little sore and my muscles a little achy from the adrenaline they gave to speed my heart a little bit after they made the first burn and the pain med slowed my heart. All together they made 4 burns and so far I am very happy that I chose to had the ablation done.  The reason I am posting is because before I had the procedure done, I had read alot of these forums about having it done, and it seems not many people post what their result was afterwards, after all, most never have any reason to come back here...cause they had the procedure done successfully. My heart is calm with no thumps, skips, or flops. I would definitely have a 2nd ablation if the PVCs ever come back! Best of luck to anyone who is planning to have this done.