Ablation for frequnt PVCs and NSVT

Hi

I am a healthy 22 year old female, strong heart. I had an successful ablation done for svt 2 years ago. Ive had PVCs all my life and they just seem to be getting worse. In fact Ive been having runs of NSVT 4-7.


I am really considering ablation for this; I dont want to be on medication for the rest of my life.

My question being is ablation that risky for a female my age and why? What are the chances of this procedure eliminating these crazy PVCs and what documentation is out there about successful ablations.

I have an appointment with my EP though I would like a second opinion on this option.

[Bromley]

HI. I have an appointment with my EP ~ 1-2 weeks from now for very similar reasons. NSVT 10 --- and SVT 10. I had an ablation 4 years ago for lasting svt and that is gone.  

I read that ablation of idiopathic VT has high success rate depending on what it is, and whether it is inducible during the procedure. The risks are very serious, but the rates of occurrence are not high --- compared to other medical procedures.  The specific numbers are subject to interpretation, and of course there might have to be different numbers depending on who you are, the type of VT you have, and so on. However, after skimming through a recent book on RF ablation, I dont see a lot of consistency or standardization in the published numbers.

This only makes philosophical challenge --- to decide what risks make sense to take, and what risks are actually ethical to take even when you are talking about your own life being at risk --- that much more difficult, especially if your existing situation is such that you are not in great danger.

My opinion is that it is a good idea to do the research on this in case the situation becomes worse over time and you are forced into the ablation. I have found it a difficult call to decide whether or not it makes sense to ablate NSVT 10.  My EP previously recommended ablating the remaining svt, and EP studying the remaining NSVT to determine whether it is a good candidate for ablation, whether there is a safety issue, etc. He felt that there would be a good chance that an ablation for NSVT 10 could just make matters worse. So since my svt 10 is not a safety issue, I left it alone and take the drugs (in my case a little goes a long way, and i dont really get much out of the side effects).

I would follow through on getting the second opinion from a well qualified doc. I plan to do the same.

kind regards, Bromley.

[Momto3]

I've had two successful ablations for PVCs (bigeminy, trigeminy, couplets, NSVT).  However, the doctors were not really interested in ablating until I experienced a decrease in ventricular function.  Up until then, I was more on a course of "accept" and "live with 'em".  I was used to them, so I was not afraid or worried about the "what if's".  

I have mitral regurgitation and when I developed cardiomyopathy, the ablations were on the table (literally...lol).

Let us know what the doctors have to say.  

Oh, as for the risks, there are risks, but they are relatively low.  The ablation for the left foci carried a little higher risk, but all turned out fine.  

[Bromley]

Hi.  Just to clarify, some of the risks include stroke and death. These are serious outcomes. The rate of occurrence for these outcomes is something different. Some consider the rate of occurrence low enough that they feel comfortable choosing the treatment.

As you can see, not everybody sees it the same way. If you are used to rates of occurrance needing to be less than 1 in a billion hours for instance, you might find ablation statistics not to your liking.  We are looking at more like 1 to 5 in 100 for some of the most serious risks associated with ablation, depending on who you talk to. Of course, I like your idea of seeing documentation with some research behind it.

As I tried to explain above, but not very well, there are some ethics involved in the choices. For instance we all know it is not ethical to play Russian Roulette. I know this is a bad comparison because there isn't a medical cure in that. But how much different is it if you dont need what ablation has to offer?  This might even be borderline for some people's religion (mine for instance, assuming I don't convert to some new religion)!!  This is the  problem with ablating PVC 1 or NSVT 10.  Different than ablating PVC 10000 which leads to HCM?     ....Yes.....

Brom.

[empressofq13]

Just my experience....I had an ablation while sedated because of anxiety issues and all went well.  I had it about 2 yrs. ago and no more SVT's.  Still have MVP racing and flutters occasionally.  This didn't change that of course, but so glad to not have to worry about my heart going 215 bpm for 45min at a time anymore!  Was sore after and the hardest part is lying still on your back for so long after, so as not to disrupt groin clot, I have total spine DDD and much pain, so this was hard on me.  Everything else was great!  Good Luck in your decision.
Cindy

[upbeat633]

I have high frequency pvcs which varies between 20,000 to 30,000/day. I have a structually normal heart and good ejection fraction. Three cardiologists have said no to ablation, and recently an electrophysiologist said *absolutely* no to an ablation, even if I asked for one!

[rach6060]

What type of PVCs are you having? any in a row, any NSVT?
How are you staying so positive during these time I must ask? I have such a hard time copeing when they get really bad.
Are you on any type of medication? And how often do you feel them?

[julesluvsdrew]

My electrothesiologist is the one who suggested the ablation.ON the ablation table he was able to induce my nsvt..actually it was V tach there...but prior to that all he saw were lots of pvcs...I knew i was having nsvt a lot and explained that..a lot of people on here said their doctors wouldnt perform an ablation for only pvcs...You said you are having nsvt so theres a good chance yours will be able to help you.My ablation helped for about 3 years!!!!!!Unfortunatly they will discuss with you that the areas can come back,even in different places later...Not everyone is the same though!Good luck with everything..

[rach6060]

Hello
Did the NSVT and the PVCs come back ? And how severe is it now even after ablation?

[upbeat633]

My pvcs are thought to be unifocal, lots of couplets and triplets, lots of bigeminy. I have had several episodes of NSVT too. Most were in the range of 6 beats, a few 10 beats episodes. I did have one stretch that was 62 pvcs, but since my heart rate was below 100bpm, I was told this was not considered tachycardia. And surprisingly, I felt no different, no symptoms with the 62 beat string, it actually felt very regular.

I have tried 3 different beta-blockers, but with so many side-effects and no benefit to the pvcs, I thought nothing would work.

I then saw an electrophysiologist who recommended Sectral (acebutolol) which is considered an "older" beta-blocker. I tried it at the lowest dose available of 200mg, but it left me very sluggish, so I halved the recommended dose, and it has stopped the long strings. No more!!! That was 4 months ago. I now take 100mg on an as needed basis if I feel like I'm going to have a bad day, or if I've already had a bad day and think it will prevent another.

It even seems to lower the high frequency pvcs "a bit" if you can consider 20,000 to appox.15,000 is lower :-). I haven't tried increasing the dose as the EP suggests because now my BP is in the 100/60 range and I just feel too tired and dizzy. But no more strings (I'm especially thankful for that), and even a few less pvcs is ok by me.

Again, every doctor I've asked has said no to ablation for pvcs, but ablation for VT is different. Also, if you search this forum regarding ablation you may discover many people who have positive life changing experiences, and you will find people who experience pvcs post-ablation that they never had before. It is a decision you need to research fully.

[emt2rescue]

I started having issues about 7 years ago. With several episodes or SVT  lasting for hours. At 1 time i had received "Adenosine"  by paramedics.

I had an EP study done 2 years after the first epsiode, i dont remember if any ablations were dont at that time.

About 6 months later i began getting single PVCs and then it grew to coupling PVCs then 3 then 4...  Non-Sustained Ventricular Tachycardia

http://www.youtube.com/user/emt2rescue?feature=mhum#p/a/u/1/xYRnbVV122M

So about 2 months ago i had another EP study done and ablations were done, they did about 40 burns which was pretty uncomfortable. I currently take 80mg twice a day. My EP DR. wants to wing me off soon!!

BUT i am still having episodes coupling PVCs and NSVT even after the ablations.They occur very frequently and last for a very long time.

I hoping that something can be done real soon!

[emt2rescue]

http://www.youtube.com/user/emt2rescue?feature=mhum#p/a/u/0/3bpGZZzzfTs