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Ablation Success?
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Ablation Success?

Hi - I'm a 53 yo male with a history of heart disease.  I had a stent placed in my circumflex artery 18 months ago.  Since then, I've experienced several sessions of PACs (with a few PVCs too).  I've tried several medicines with little success.  I've tried Flecainide, and I'm currently taking 75mg of Metoprolol twice a day.  For the last three weeks, I've been experiencing 20-25 PAC's per minute with a slight break upon waking up in the morning.  I know they aren't dangerous, but they are problematic.  When I get runs of 4 to 5 ectopic beats in a row, I'll get nauseous and dizzy.  

My EP was able to catch a half dozen of them on a short EKG strip.  The good news is that they all appear to be coming from the same location and have the same waveform.  My EP wants to schedule me for an ablation within the next week to try and get this under control.  This is a quality of life issue.

Question - What are the risks of ablation?  
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21 Comments Post a Comment
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Avatar_f_tn
Hi Jim! I too am having an ablation done (on 4/22).  In my research I have read that the risks of complication are less than 1%!!! That sounds good to me! My EP guy did say that there is always a risk that something could go wrong but  it so very rare.

Did you ask your doc about it? What did he say?
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110220_tn?1309310461
I had an ablation for SVT almost two months ago and I did wonderfully.  I must admit outside of the SVT, I had no other heart issues....a structurely normal heart.  I am 52.  I was told that I had one of the easiest  forms of SVT and the cure rate was between 95 to 98%.  

The procedure itself...I don't remember...the injection of Versed and I woke up in recovery wondering if they did the procedure.  No problems afterwards, no beta blockers, nothing and I feel great. Actually I go for a two month checkup tommorow.

Best Wishes to you.
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Avatar_m_tn
She didn't say yet.  I've had an ablation done before for SVT, but was just curious if the ablation for PAC's was any different.  IE, same risk, less risky or more risky.  Since PAC's are not life threatening and just a quality of life issue, I want to make sure I'm making an informed choice.  My holter just registered 22,000 PAC's in 24 hours.  So they are certainly impacting my quality of life.
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21064_tn?1309312333
Hi Arizona Jim,

I had two ablations for PVCs (2003) and I am nearly PVC-free after 4 1/2 years!  It was truly like a miracle for me!!  I did have to sign a release about understanding the risks, but they were very, very minimal (percentage wise).  I'd do it again if I had to.

Before the first ablation, my most recent holter also registered 22,000 PVCs, no PACs.  I hear ya!  The twilight sleep is great : )

Please feel free to ask about the procedure, post, whatever.  We'll do our best, and then as we say, we'll see you on this side of the mountain.  The view is beautiful : )

connie
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Avatar_n_tn
   My ablation for a a fib was in December 06.  My thinking was similar to yours in that it was a quality of life issue and not a medical necessity.  Sotolol kept me under reasonable control, but I felt tired a lot.  And I certainly did not want to have another a fib episode when hiking in a Wyoming wilderness area and four hours away from medical attention.  That did occur the summer before my ablation.  
   My doctors described ablation as a "low risk" procedure, but not a "no risk" one.   They also use the word "cure" when talking about the potential of ablation.  That is a word not often used by medical professionals.  
  Now after almost a year and a half, my answer is clear.  I did the right thing--no medication other than a statin and an aspirin.  I will be 65 in three weeks and I am hoping to do a four day backpack in the Wind River mountains this summer.  I have no concerns about another episode.
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Avatar_m_tn
If your EP is saying ablate you should consider it.  Do you trust your EP?  That is probably the biggest question.

As for risks, my EP says that the real mortality rate is MUCH less than 1% - in fact he's never lost a patient after an ablation.  Since he is quite well regarded in this area I consider that significant.

As the EP puts it, 60% of all patients undergoing ablation are essentially cured.  Of the remaining 40%, 20% get better after a 2nd ablation.  If all else fails and you are like me - i.e. in persistent, continuous a-fib (6 months now) - and a 2nd ablation fails to bring your atria into line, the final step is to ablate the AV node and install a pacemaker to make the ventricles beat regularly.  It won't give you normal sinus but it will give you a regular beat - somehting I haven't had since early last November.  

The 60%, 20% thing sounds nice but here is how it works in simple odds.  Your odds are 3 to 2 that one ablation will correct the problem.  After that it's a toss-up.  Even odds you'll need a pacemaker.  For me it is a simple matter of trying to get my life back.  My Dad's mother had a pacemaker in her chest when she died and his younger sister has one now.  I have done all I can to get my affairs in order.  My wife has a medical power-of-attorney for me and knows my wishes.  I have already spoken to the man I want to say words over me if the procedure goes south.  I'm gonna go visit my folks' grave (they're bunking at the National Cemetary at Ft. Sam Houston, Tx) Saturday or Sunday.

They say there are three things a man should do in his lifetime; build a house, plant a tree and raise a son.  My house is 11 years old.  My son is 39 and has given me 3 grandchildren.  The tiny 1 gallon oak tree I planted in my back yard 10 years ago is taller than my house.  Guess I've done what I'm supposed to.  

Good luck either way you choose to go.  Ultimately you have to decide if the cure is worse than the disease or vice-versa.  

Bill
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Avatar_m_tn
Thanks everyone.  I've talked to my EP this afternoon, and I've decided that the risks are small and the chance for feeling better is quite high.  I'll post again after the ablation on the 29th and let you know how it went.
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Avatar_m_tn
maby its something in the az water.. im going in for mine on the 30th... going to baywood?  dave
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Avatar_m_tn
Good luck.  I'm sure hopeful that they can get these darn things stopped or at least slow down the frequency of them.
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Avatar_m_tn
Thanks for all your responses.  I had an EP study yesterday morning and wound up with an ablation of a "Dual AV Node Path".  It was causing tachycardia.  As for my PAC's, I'm still having 2-3 a minute, but that beats the heck out of 20-30 a minute.  My EP thinks they may subside a little more over time because the heart is still irritated from the EP study and ablation.

The EP and ablation took five hours from the time I was wheeled into the lab until I was rolled out and saw my wife again.  I was awake several times during the procedure and I was able to see five separate catheters on the monitor.  There was no pain or worry involved in the procedure.  I was sedated with some good drugs and I slept off and on during the entire thing.  I was admitted to the hospital overnight for observation and got to come home this morning.  I took a four hour nap this afternoon, and I'm ready to return to work tomorrow.  The only discomfort is very little pain and swelling in the groin area from the two places they installed the catheter.

If you're having problems with various arrythmias, I'd really recommend you consider an EP and possible ablation to resolve the issues.

Jim
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Avatar_f_tn
So glad you are feeling well!
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Avatar_m_tn
i also had mine done wed the 30th.. i also remember waking on and off.they ablated 5 and i was out in 2 hrs.. feel very relaxed. also woud highly recomend this to all that need it. the hardest part is getting to the lab... nervous!  i am so glad i found this site ...GREAT HELP..
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21064_tn?1309312333
Oh yeah, the nerves can play real tricks on us!  So glad to hear that you both had a good experience!  I agree a few ectopics a minutes is WAY better than 20-30!!  Here's to continued good days!!

Have a great weekend!  

connie
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Avatar_m_tn
Wow.  I haven't felt an extra beat since Wednesday.  48 hours with a normal heart beat.  YIPEE!
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Avatar_m_tn
Good for you Dave!  Are you back to work yet?
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Avatar_m_tn
naw... im kicking back untill monday .. i feel good enough to but my doctor said to relax for 5 days... think i will take advantage of it!  how about you?
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Avatar_m_tn
Jim,
Just for grins and giggles, ask your EP what your atrial dimension is.  The reason I suggest this is that for some reason that number is an indicator of sorts about the likelyhood of ablation cleaning up A-fib.  For the record mine is 5.7cm and the chances of ablation fixing my rhythm problem are extremely remote.  Actually the chances WERE remote.  Since no sane betting man would put money on my getting a regular rhythm without a pacemaker, I decided Friday before last (4/25/08) to go ahead and get a pacemaker implanted and have my AV node disconnected from my atria.  I have a nice STEADY 80 beats/minute now.  My device even has accellerometers in it and can ramp up my heartrate as needed.  It actually feels strange not to feel strange any more.  I keep taking my blood pressure to reassure myself that I'm still running regular.

Oh, well, 7 days on the pulse generator and counting.  Here's hoping for another 519 weeks before they have to swap out the device for a new one.

Regards,
Bionic Bill
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Avatar_n_tn
I'm having this procedure done on 12/9/08 (tommorrow)   I am nervous, but I'm assuming I'll be knocked out for the entire procedure.  I've been living with this a-fib for two years, and I am tired of being tired all of the time.  Sounds like most of you have no regrets.  Thanks
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21064_tn?1309312333
Hey ptbsjb!

Welcome!  No regrets from me.  It's been 5 years and the difference is remarkable.  My ablations were for PVCs.  GOOD LUCK!!

I'll send the limo for you so you can ride in style to your appointment.  It will be fully (cyber) stocked with all of your favorites : )

Keep us posted!
connie
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Avatar_f_tn
Hello! I'm new here and have been having terrible pvc for years now. They have gotten much worse in the past 8 months to the point that I have them allllll the time. Sleep is something that I rarely get as they keep me up at night. I am so discouraged! I will be seeing a cardiologist and ablation will be offered. I am so scared! Should I have this procedure done? I just had half of my thyroid out last January and had surgeries. I am so discouraged. Any words of encouragement? Thanks so much!
Wendy
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1553240_tn?1294255610
I am at the cosidering stage. I've an appt. with my cardiologist today and will be discussing the Ablation procedure. I've been on flecainide acetate for almost 4 yrs and have noticed a gradual decline in its ability to control the afibs, thus the consideration of the ablation procedure. I am apprehensive about it needless to say but apparently there is no real alternative if I want a quality of life that is satisfying. I will say that the research I have conducted gives a very broad spectrum of success stories and one or two real horror stories. The one thing that concerns me most now is that there is apparently a degradation of effectiveness as time progresses. Because it is a realtively new process there is not a lot of long term results available. Stress seems to add to the likelihood of the onset of the afibs so there is some work for me in how I deal with it. Much to be discussed today and considered before making the decision to ahve the procedure but it looks like my alternatives are almost none.
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