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Ablation or No Ablation???
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Ablation or No Ablation???

My health history is way too complicated to outline here.  Enough to say that since 2007 I have fought bladder cancer, BCG treatments, a stint, syncope, stress induced v-tach and constant blood pressure and heart rate issues (usually nonresponsive to meds). It really is much more detailed and significant - but, those are the major points.
Things were so sketchy in 2009 that my cardiologist brought in an EP and they agreed an AICD was necessary.
Since the implant, I have not been "zapped" and no v-tach events have recorded.  This has everyone scratching heads since my resting (and I mean resting) heart rate hovers at 95-110.  The result is I am frequently exhausted, weak and lethargic.  Additionally, I often experience chest pain radiating to my left arm and jaw.  However, EKGs show only a slight arrhythmia – nothing significant.  In other words, my heart muscle is fine – maybe even normal!  In fact, at times I can have periods of normalcy where life is good and symptoms are nonexistent.  These periods last anywhere from a few days to a few weeks then it is back to sixteen hours of sleep and not enough energy to even walk up the few stairs leading to my front door.  So far I have not been able to pin down a pattern or trend.  Just kind of happens that way.
The latest theory is my fatigue results from the increased heart rate and that the increased heart rate is a result of a defect in the sinus node.  Since I already have an AICD implanted – the logic for the EP seems to flow toward ablation of the sinus node and – by default - dependence on the device.  This scares me a bit but I am hopeful of an upside.
I am really hoping to regain quality of life.  I am mostly housebound without energy most of the time and lately (very recent) I have noticed a deterioration in memory, ability to speak without a slur, irritability and general sense of foreboding.  So, I think whatever is happening might be getting a little worse.
Anyone had similar experience?  Diagnosis?  Result?
Apologize for the long post – believe me, this is the abridged version!
9 Comments Post a Comment
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Avatar_f_tn
I'm sorry you are going through this.

If I understand you correctly,  your cardiologist wants to do an ablation which would make you 100% dependent on your device but is not  100% sure of your diagnosis?  If that is the case, you definitely need to seek another opinion (s),  preferably from a  Dr (EP) at major medical center.  Devices like ICDs are life lines for people who's Hearts go into lethal arrhythmia's or are incapable of beating appropriately but to be put in a situation where you are made to be reliant on one seems like an extreme option that should be considered when there are no other options.

Can you go into more detail on the syncope and v-tach episodes?  Eg how frequently they happened, what you were doing at the time, medications you may have been on, preceding symptoms etc?   How was it determined that v-tach was "stress induced"?  This is a very rare and potentially dangerous rhythm.  There are some rare syndromes in which stress is actually a trigger for v-tach but I have not ever heard of stress itself (in the absence of these particular syndromes ) to cause v-tach.

Have you had hormone levels (testosterone, thyroid etc), blood sugar, etc tested recently?  Have you seen a neurologist for the speech slurring and memory loss?

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1516034_tn?1298600949
Thank you for your response..
As I mentioned, the history s broad and varied.  For the last 18 months or so I have been poked, prodded and tested for everything from low testosterone to thyroid and everything is in normal range except the testosterone which was very low.
During two treadmill stress tests I went into vTach within 3 minutes and rapid heart rate occurs with even minor stress (stairs short walk).  On the other side of the coin, I hit bradycardia at times without explanation.  During those episodes my O2 sats are very low – 85-90.  Its seems I “pass out” before I can really discover what is happening.  Fortunately – my Electro Physiologist was able to replicate and document such an episode while I was in the hospital for testing and that is why he placed the AICD over a year ago.
Meds are Metroprolol, Lisinopril, Asprin, Simvastatin, Amedorone(sp), Plavix and AndroGel (Testosterone).
Neurology tests were all normal and performed before I was allowed to renew my driver’s license.
At this point my Electro Physiologist has no explanation for my symptoms and is very concerned about the long term consequence of such a rapid heart rate and feels the SA Node is the culprit.  The plan is to ablate the Sinus Node and if the process leads to a complete ablation then I already have the device so I would just be dependent upon the device to set the rhythm.  Apparently in most cases this is done before the device is inserted.   In my case I was in vTach so often my cardiologist was afraid I wouldn’t make it to the hospital during an event and the lights would go out permanently. – therefore the defibrillator was essential.
In any event - I am writing this I am being monitored and they surgery was just moved up to tomorrow.  So, I guess research is over and away we go.

I will certainly watch this site and offer any insights and advice I am able to come away with.

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Avatar_f_tn
Oh wow.  Well best of luck for your surgery tomorrow and please update us as soon as you can!

Take care.
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1516034_tn?1298600949
What a difference... four hour procedure and a follow up visit to “fine tune” the AICD and I feel much better.  In the interest of full disclosure – the procedure was NOT painless.  In fact they had to stop because the pain was escalating my monitored heart rate making accurate assessment impossible.  Still, after 34 “burns” they apparently got lucky and ablated what needed to be ablated.  I am now paced at 60 and 150 and – for the first time in years – I am able to walk and take stairs without dizziness, shortness of breath and – sometimes – syncope.

Time will tell – so far, so good and I am slowly weaning off the medications like metroprolol and lisinopril and other statins and betas.

Life is good.  Awesome!
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1569985_tn?1328251082
Congratulations on your successful ablation.  It is always good to hear a success story.
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1807132_tn?1318747197
It sounds like the ablation was a success.  Congratulations.  Take it slow for a while as your heart has been through a lot and needs time to rest and recover but this is indeed good news.  Take care.
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1516034_tn?1298600949
Need a little reassurance...
Was doing fine first few days after the procedure - in fact I still feel better than before.  However, yesterday began to experience occasional sharp, stabbing pain in the center of my chest.  Additionally - today I would say my breathing is "labored".  Not short of breath - just a little tough to catch a breath now and then.
I've been told there could be a healing period and I am wondering if this is just part of it. I find it strange the symptoms took a few days to manifest.
Anyone else has similar experience?

(tried to post this a couple of times - hopefully 3rd time charm)
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3588335_tn?1351884463
I had ablation just over three months ago for wpw, I didn't get the sharp pain but my chest was definitely sore and I got tired and had to rest to catch my breath for just a trip from the living room to the kitchen. Before the procedure I was pregnant but able to walk for 40 min for exercise right now I feel comfortable with only 20min a day some days a little more but I feel it is getting better, my surgeon did say he was really aggressive with my ablation to make sure he got rid of the extra connection because it was a bad one . The majority of my symptoms the soreness and stuff from the ablation did start a few days after it was done and I do still get the occasional pvc but not as much as before.
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1516034_tn?1298600949
MayDayRebel.. thank you.  I am sorry you had the troubles. However you have helped ease my mind.
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