Ablation vs. Medication

[pg1949]

I've had SVT for several years, but ended up in the ER this week and had to be converted.  My doctor has offered the choice of medication or the ablation procedure.  I'm 58, active and don't want to take medicine the rest of my life.  I am going to the Cleveland Clinic for a consultation regarding catheter ablation.  My family is against this.  I've been having an SVT episode about once a month now for 2 years.  I'm always able to convert, until now.  I just want to be rid of it, but I don't want to do anything foolish either.  I'm just confused and would like to hear anyone who also had to make this choice and how it turned out for them.

[Michael J. McWilliams, M.D.]

That is a very logical concern.  I trained at the Cleveland Clinic.  I trust them.  They will present you with options and risks and you will be able to make an informed decision.  There may be medications that will can permanantly suppress the arrhythmia--it depends on what type of arrhythmia it is. If it is AVNRT (the most common in your age group), this is usually a very simple and safe procedure.  One episode a month is pretty frequent, especially if you require shocks to get you out of it.  This all comes down to a risks/benefits decision.  After they talk to you about the risks/benefits/alternatives to the procedure, youcan make a more informed decision.  I would tell you the options myself but I cannot do it without knowing what type of SVT it is.

If your arrhythmia is atrial fibrillation, you will need a trial of medications before ablation to be compliant with the current guidelines for atrial fib ablations -- but I think you would know the name of the SVT if it was atrial fib.

I hope this answers your question.  Please let us know what you decide to do and why after you visit the Cleveland Clinic.

Who is your appointment with?

Good luck!

[ireneo]

I've had 3 ablations to improve my heart arrhythmias. It's not a terrible procedure. They use light sedation to keep you comfortable and there's usually a bit of bruising in the groin afterwards. That's about it. You didn't specify what type of SVT you have - PSVT, atrial flutter or fib? An ablation for a-fib is more complex than the average PSVT like I have. I agree with you that having the ablation sounds much better than taking meds with possible side effects the rest of your life. I'm sure your family is worried about the procedure but it sounds scarier than it really is. For me, the ablation was the way to go. I don't take any meds and my heart, although not perfect, is greatly improved. I'm happy with that.

[js33710]

I had an ablation for AVNRT about 3 weeks ago.  The procedure itself was not a problem.  I had some slight chest discomfort for a few hours, lying still was probably the worst part it.  My heart rate was in the low 90's for about a week, and with minor exertion it would be 130 which was unexpected.  Resting heart rate is now 60 and I am having minor palpitations frequently.  My EP says this will settle down and he will consider the procedure successful if original symptoms don't return in 6 months.  I think the bottom line is, everyone is different.  If I had a choice, I would try medication first.

[rosetoes]

When you decided to have your ablation, how ofter were you experiencing your AVNRT?  I'm not sure that I want to go that route yet.  I have had two episodes in the last two years.  I have just started taking a beta blocker in hopes that it will take care of the AVNRT.  Did you cardio doc give you any alternatives outside of the ablation?  I read in a a magazine re: SVT, that there is a "pill in the pocket" that would stop SVT....was that shared with you?    

How are you doing now?  Hopefully much better.  Have you ever tried medication, if not why?

Thank you

[js33710]

Episodes of AVNRT are scary and unpleasant to say the least.  I started having them in my twenties, and have had episodes as often as once a month.  I have found that while I can drink coffee, the combination of caffeine, OTC cold medications containing pseudoephedrine, and major stress increases the odds of AVNRT.  My GP told me that although episodes are annoying and unpleasant, they are not dangerous (yeah, I know this is hard to believe).  I learned to stop them using the valsalva maneuver...not always on the first try, but I never went to the ER.

I decided that at fifty, I would see an EP.  He said AVNRT is the most common cause of tacycardia, and that it was nothing to worry about at my age, but twenty years from now it was likely that an episode would caue fainting spells.  He thought that ablation was the treatment of choice and did not even suggest a trial of medication since ablation often cures AVNRT.  He is welll respected in the medical community and I know other patients have been very pleased with the results of their ablations.  If things settle down, and he says they will, then its a good thing.  

I would definately take a wait and see approach if your episodes are infrequent, especially if a pill in the pocket is an option.  If things get progressively worse, you might reconsider.  It is a relatively safe procedure, but your EP will not know the exact location of the problem until he does the EP study.  

[416340]

I'm a 24 year old female who has been diagnosed with RVOT VT with about 25,000 PVC's a day. Over the past year, I tried living with this, but my episodes started becoming more frequent and more intolerable (dizzyness, extreme fatigue, palpitations, chest pain).  For the past few weeks, i have been taking a beta blocker (Sotolol) and so far it's been very effective.  However, i am concerned about the long term side effects of beta blockers and am debating if i should get ablation done.  Has anyone here choosen ablation even when the beta blockers were working? Thanks!

[rosetoes]

First let me say thank you so much for sharing your experiences with me.  This disorder weighs heavy on my mind and it's so nice to talk to people who actually can relate to AVNRT.

When you would have an episode, how fast would your heart rate go and for how long before you could stop it?  Also, what manuver worked best for you?  If this should occur again, I'd like to try to stop it myself, if possible. Boy I just can't imagine experiencing an episode monthly.  I sincerely hope that the ablation works for you.

It is hard to say if the beta blocker is working.  Since I have only had two episodes in the last 21 months, I will have to wait and see.  I am going to visit an EP specialist and ask about the pill in the pocket.  I will keep posting to update and hopefully learn more about your progress as well as others.  Thanks again

[js33710]

My heart rate was between 160 and 200, maybe higher...but its hard to count when you're in that condition.  During the first episodes, it would stop on its own, just as suddenly as it started.  I read about the valsalva maneuver, and found that by laying on the floor, holding my breath and bearing down, the heart rhythm would convert.  I often had to try it more than once.  The quicker I caught it, the easier it was to stop. I once had an episode that lasted for two days, it converted spontaneously.  My GP said it was nerves (and my husband was in NICU at the time so I believed him).

When I realized this wasn't life threatening, I learned to live with it.  That said, there's something about turning fifty that makes this kind of thing a little more frightening.  You mentioned that you enjoy travelling.  I have never let this keep me from travelling, and never had an episode during a flight.  I admit to a overdoing the cafe con leche in Madrid last year and paying for it...but, it was worth it!  Wait and see, and try not to worry too much.

Thanks for your concern.  I'm pretty optimistic that the ablation will work and all will be well.   I'll check back and see how you're doing!

[myjeepbeepbeep]

HI PG,
I just had an ablation done two days ago and it wasnt that bad...feel free to email me if you want to chat about it!  ***@****

[rosetoes]

Hi,
Glad to hear that you are doing well.  What made you have the ablation?  Please tell me about your condition and how long you lived with it before having the ablation.  I recently had a second episode with AVNRT after 20 months of freedom and now it has hit me hard.  I'm on beta blockers now, but am giving some thought to ablation.  Like many, I worry about the procedure and results.  Please share...Thank you.
Rose

[rosetoes]

I surely understand how one can't count their bpm when experiencing an episode, we can only count so fast....You sharing your experience really helps. I am 51 and very healthy outside of AVNRT.  I will take my beta blocker now and continue to explore my options.  If and when I have another episode, i will try to convert myself.  It hard to keep your head when you have a heart rate of 225, but I did better this last time  then the first time  I experienced an episode.  Thanks you and best wishes!

[pg1949]

I have my appt. for the Cleveland Clinic this Thursday.  You asked who my appt. was with and they say it's with Dr. Dressing.  I tried looking him up on the CC list of docs and they say there's no such Dr.  This makes me nervous.  He's too new to list??  That's a scary thought for me.  At any rate, I plan on listening to all the information provided and making an informed decision.  Thanks to you and all who have listened.  PG1949

[myjeepbeepbeep]

PG,
It is Thomas Dresing.  Only one s.   He did my ablation last week.  He is very good and very compassionate.  You will like him!
S

[myjeepbeepbeep]

forgot to add this link that may help you !http://www.clevelandclinic.org/heartcenter/pub/staff/searchdetail.asp?staffid=7187&name=&keyword1=&keyword2=&specialty=Cardiovascular+Medicine&cnt=2!

[Michael J. McWilliams, M.D.]

Tom Dresing is a great guy.  He has been at the Clinic for about two years and trained at the clinic before that.  He was out in private practice for a few years but his desire to stay on top brought him back to the clinic.  He is very honest, easy to talk and technically skilled.  You will like him.

When you see  him, don't forget to compliment him on his bow tie -- it's his trademark.

good luck an let us know how  it goes.

[wmac]

So my question is that you said having one episode of svt once a month is considered quiet often then what about having nsvt at least once a month sometimes I get three or even four episodes a month. Although I have had two attemtped ablations with no sucess. They say dont worry. So im kinda confused here, nsvt is more serious than svt isnt it??
wmac

[pg1949]

Certainly glad to clear up the name thing and to hear good things.  Just wondering...how long did your procedure take and did you stay overnight?  Once you had your original appt., how many times did you return to the Clinic for tests, etc., before your procedure?  Anything you can add would be appreciated.  

[Michael J. McWilliams, M.D.]

Neither one will hurt you if you have a structurally normal heart.  SVTs tend to be relatively easy to fix, NSVT can be quite difficult to fix.

[myjeepbeepbeep]

Hi,
I think I made 2 trips to see the Dr. before my procedure.  Once for the initial consult and the second a follow to a few tests, one being a treadmill test immediately followed by an echocardiogram.  After I decided to do the procedure, I think I had to wait around 5 weeks for an opening.  
My procedure took just shortly over 3 hours.  I did have to stay overnite in the hospital.  However, since I am very afraid, almost phobic, of hospitals, they were very lenient about letting my husband  stay with me.  The care was excellent and I didnt mind being there at all.  
The nurses and staff in the procedure room were very calming and reassuring.  I was most afraid of the anethesia as I really do not like being out of control, however,  honestly, if I could bottle that stuff up for everyday use, I surely would!  It was very relaxing and I could not believe I was on that table for 3 hours.  I remember nothing unpleasant about the whole thing.  
I think the worst things for me was 1) the boredom of laying still for 4 hours after the procedure and 2) finding out I had a latex allergy when I got home and dealing with the itchy rash where the adhesive tape touched me.
The best part---I am now 6 days post procedure and have not felt ONE missed/flipped heartbeat.  YAY!!!
Let me know if I can answer anymore questions for ya!

[hopeful 5]

I had an ablation 10 days ago for SVT.  I had been on beta blockers for 20 years but in the last year  would still get several episodes a week.  I finally decided to have the ablation done.  I have palpitations for most of the day now.  This is not comfortable and I hope it gets better as time goes by.  The doctor advises me not to think about it but I am finding this very difficult.  I am not sure how to deal with this and am having some anxiety over the fact that these symptoms I am experiencing now will not go away.  I have heard many success stories about ablations and hope to be one eventually.  
I would try beta blockers first for a while and then consider ablation if the meds don't work.  Good luck with your decision.

[myjeepbeepbeep]

HI,
I had my ablation a week ago.  I dont seem to have any skipped beats anymore but having slight discomfort in my chest....almost feels like i am out of breath.....just a couple of times a day.  Heres hoping we are both success stories!

[hopeful 5]

I am happy to hear you are doing well.  I think I am an exception to the rule and I have heard of so many success stories about ablation that I would recomend to others that they go ahead worry free.  I am hoping that my heart settles soon and resumes a normal beat.  

[bama jane]

I have short episodes of svt almost daily lasting just a few beats, less than a minute, in the past Ive had them longer, am on beta blocker so I think that blunts episodes.  Lots of misbeats daily, a couple of hundred or more, going on 8 years with this,  My question is, to those having ablation, how often were your episodes and how long did they last?  Had an attempt 8 years ago and they could  only induce sinus tach eventhough they had seen the atrial tachycardia on holter monitors. Also how frequent are the misbeats after ablation? A few or in the hundreds or thousands?
Thanks

[pg1949]

OK, you two....I have been to the Clinic and had my evaluation, exam, etc.  I am now trying to decide what to do and I can't decide.  You two have both recently had this done.  Would you do anything differently?  I am just so scared to go through with it.  Did you feel this way too?

[myjeepbeepbeep]

I can relate to your apprehension.  I WAS SCARED TO DEATH.   i will say that I am without doubt the worlds biggist wimp and I found this procedure to be not that bad.  The worst part is the anticipation in the waiting period.  
I have felt so good since the ablation--heartbeat wise-- that I would not hesitate to do it again.  

Good Luck with your decision!
S

[tired of my heart!]

I am a 26 year old female with lone a fib.  I was put on toprol and did not tolerate well (too tired).  I did not try any other medications because of their potential side effects and because they were a pregnancy class D.  I am going to have an ablation in Sept.  My decision was for the ablation because I want to get pregnant and the risks to a pregnancy from the medications were scary.  I am very nervous about the ablation, but I am trying to stay optimistic.  An ablation seems like my best chance to have a safe pregnancy without drugs to control my heart rhythm.  I hope that this helps!  

[hopeful 5]

I have spoken to so many that had a very successful experience.  I would encourage you to try this.  I have had some complications so I would say to be aware of the small percentage that something would go wrong.  I would not be nervous about the actual procedure, while it was not pleasant, I only remember the beginning and the doctors can give you enough meds to make you comfortable, that is, alseep or nearly.  Good luck with your decision.  This is a chance to improve the quality of your life, we need to take chances sometimes.  

[pg1949]

I have decided on the ablation procedure to be done this month at the Cleveland Clinic.  I was again in the ER yesterday with a heart rate or 202 and had to be converted with Adenocard.  I can't wait to have the ablation.  Here's my question.  I had them give me my ECG's from the ER with heart rates recorded at 186, 121 & 102...also showing the conversion.  Would these chartings be something the EP Doc at CC would want to see?  The Dr. thinks I have AVNRT...could he tell for sure by looking at these ECG'S that actually show the SVT happening?  I have never been so upset about anything before in my life and it's really starting to get to me.  Thanks for your help.  I need it!!  

[pg1949]

Weeks ago you asked me to keep you posted.  I had my ablation on Tuesday, with Dr. Dresing at the Cleveland Clinic.  It was indeed AVNRT, but with currents circling in both directions. They said my situation was a challenge and it took 7 hours.  I feel great and have not one skip, flip or flutter.  You are right.  They are great there.  It could not have gone any better.  I am off my Cardizem, hopefully for good.  I want to thank you for being at this forum for all us of who suffer from all types of arrythmias.  I feel like a new person.  Thanks again.

[Pumped]

Hi All,
Nearly 50 years old, male, living in Perth, Western Australia.
I've been reading your comments with interest. I'm booked in for a study/ablation on Thursday after having episodes of SVT since I was about 14. I've done the beta blockers and all sorts of other things bt the last two months has been horrible. I've suddenly gone from a hospital episode (I'll go after two hours) about every three years to several in the last few weeks. Adenosine converts the rythm but it's horrible feeling, isn't it?
Good to read your experiences of ablation - pg1949 is helping me feel less frightened about someone fiddling about with my ticker! Thank you!
It's nice to find a forum that tells me I'm not alone and that the anxiety I'm feeling isn't just because I'm a wimp (I am, but it's good to know that's not the cause!). I'm feeling much less anxious after reading your stories.
My doctor hasn't explianed to me the different types of SVT. When I asked him he informed me that part of the procedure will be to confirm the type and (hopefully) treat it on the spot. That would, for me, be the ideal outcome.
SInce the last adenosine conversion I've also been getting what I describe as an 'internal shiver' that feels like my heart is quivering. It only happens as I'm drifting off to sleep, never any other time. Anyone have any clues? I've asked my doc. He put me on the treadmill and, after abot 10 mins at 170bpm nothing showed apart from a few ectopics. I'm a bit concerned, despite his assurances that all looks well.
Am I just suffering from acute hypocondria?
Cheers,
Frank

[tired of my heart!]

I had an EP study and ablation two weeks ago for a fib.  Since then I have not had any trouble with my rhythm...The 1st few days following my procedure I had some flip flop feelings, but they did not amount to anything.  I was always afraid of my next episode and started to live around my arrhythmia.  I was just scared all of the time.  Now, I feel 100% better than before my ablation.  I don't think that I realized how abnormal my rhythm was on a daily basis...I feel great!  I have an eerie quiet in my chest now.  The 1st few days following my ablation, I felt like I got hit by a truck...I was sore from laying still and I was sick following general anesthesia.  From what I have read, it seems that people have an easier bounce back following conscious sedation.  Any aches and pains following would never make me change my mind about having an ablation.   I really feel like a different person.  Good luck to you for your ablation!!!

[Momto3]

What terrific news!!  Congrats on the successful ablation.  

I had 2 ablations (RVOT and LVOT) a few years ago.  Like some of the others here, I was very nervous, but decided to give it a try.  It turned out to be a great decision!  Hope you have continued great days!

Connie

[pg1949]

I wish you luck on Thursday.  I know exactly how you've been living and it's not fun.  I never knew when my next ambulance ride would be.  Twice in one month was more than enough for me.  Honestly, my ablation experience was far better than what I had in my mind.  I experienced no pain at all.  I could definitely feel my heart racing off and on during the procedure.  Afterwards, I had no pain, no tiredness and I felt great immediately...I'm 58.  I've also have had a couple of flip flop feelings since then, but nothing to be concerned about.  Oh yeah, laying still for several hours afterwards was a drag.  Good luck.  Check in when you're back home.   PG1949

[2003katt]

is it possible after you've had an ablation procedure done for it to come back?

[pg1949]

I guess so.  I'm only a week out from mine and surely hoping and praying that it doesn't return.  They told me there's a 10 to 20% chance of it returning, in my case.   I guess I'd like to know, from anyone with the knowledge, how soon they had another spell after their ablation.  I should have asked these questions last week, but I was just so glad to be alive, that I didn't think to ask.  

[Pumped]

Hi All,
I've bumped my EP study out to October 25. I wanted another consultation with my cardiologist. After reading through a lot of posts on this site and info on others I felt I wasn't a informed as I should be - I'll be pumping my doc for more information. I want to make sure the procedure is needed, not just a convenience thing.
I started taking magnesium supplements and getting a little more rest - I've been going on about 4 hours sleep a day for the past 12 months or so. My ticker i behaving itself sooo much better. No 'wobblies', no skips and no flubs for a few days now. Feeling good!
I'll probably still go ahead with the EP study, largely for peace of mind, but I wanted to send out a thank you to you all for sharing your experiences nd making me feel less alone and helping me get over my fear of someone fiddling about with my heart. I'll keep you posted as things progress...
Cheers,
Frank

[hopeful 5]

I am seven weeks out from my ablation and am still struglling with lots of odd rythms.  The docs are not sur eif or when it will get better.  what steered you toward magnesium? and what does are you taking?  I am trying several alternate therapies.   i am wondering if anyone out there has had success with acupuncture.  I am at the end of my rope and am desperate to try anything. I have skips, flutters, junctional rythms and racing beats.

my case is very rare so I would not let it disuade you but getting as much info as possible is really smart.  

[Pumped]

Hi Hpopeful,
Sorry to read that your ablation hasn't worked out yet (note the 'yet' - keep hoping!)
I'm not sure what, if anything, is actually working for me. Typically, I feel fine between episodes of SVT. It takes me a couple of days to recover from a serious bout, but the last couple of times I've had the rhythm problems I described earlier. It could well be that I've simply gone back to normal - it just took longer this time.
My doctor has been nagging me for years to slow down. I have a habit of driving myself too hard. These last episodes of SVT shook me enough to listen and get some more rest - I think that's doing me so much good. The magnesium thing I picked up somewhere (perhaps around this site) and it resonated with talks I've had with my doctor about my electrolytes over the years. I take just one 750mg capsule per day.
I'm very active - I cycle a lot, run a bicycle shop, have a full-time job in project management (very stressful!) and I'm studying for my PhD. No wonder I occasionally fall over! It looks like fatigue can be a significant trigger for SVT. I'm trying to address each potential trigger. Fatigue and electrolytes this week. I stopped coffee two weeks ago (hate that!). I still smoke a bit but I'm nearly off the cigarettes too.  
Judging by people's comments here I'm a relatively mild case, with SVT rhythms around 230bpm and stable but have difficulty reverting, hence the consideration of ablation. I know that ablation or not I MUST make some lifestyle changes. My worry (which I suspect is shard by many people here) is that I just don't know when the next wobbly will hit and the constant feeling of being on guard is particularly wearing. That's the peace of mind I'm looking for from the ablation.
I do hope things settle for you, Hopeful. Keep posting :)

[richtemp]

I just got out of the hospital and was looking up proxysmal superventricular tachacardia in which i had (hopefully i'm cured lol) But i was told 3 hour procedure it took 6 hours fro what i understand i had to have 18 to 20 ablations in which the doctor had told my mother and wife i still havn't talked to him to be sure. They were on the right side of the heart and had to poke through the septum to get to the left side of the heart to do some there and guess on the outside of the heart for some. (now with saying this my wife and mother told me this and the doctor told them) I hope this is over for me because he also told them i might have more he is not sure on the last one my heart came out of a tachacardia attack and he tried to induce again but wouldn't tachacardia again in which is good! He did state however we would know in about a year from now. This started when i was 13 years old mildly. They were never quite sure which form of tachacardia it was till about 22 when the cases started getting worse. Now every one with this might agree that it is hard to really know which one it is unless they actually catch it in the act. This also is hard because by the time you get to the hospital you usually can convert yourself and by then EKG thinks everthing is normal which made me feel like an idiot as you might expect. Well 2 weeks ago i had to call a ambulance out to my home because after 20 minutes i couldn't convert myself and they had me try in the ambulance and i still couldn't my heart rate was 255 beats per minute so they gave me adenisine which there was a delayed reaction but it stopped thank GOD. After being observed in the E.R. for about 3 hours i was released went home went to bed woke up maybe 30 minutes later with another full blown attack i waited for a long time to call this time lol i felt kind of imbarrased but i called the E.R. nurse and they told me to call 911 again well this time they got it on EKG only this time it was 247 beats per minute so once again they administered the medicine and it was another delayed reaction. Back to the E.R. 3 hours released saw cardiology or Electrophysiology and set up the procedure. Now to tell you the truth they really don't know which tachacardia it is until they actually go in because i was diagnosed with SVT and ended up being PSVT and they really don't know how serious it is until they go in in my opinion! Now the procedure was painful for me and i can stand pain by the way i'm a healthy 28 year old male. But i would never want this procedure done ever again. Maybe the reason why it was difficult to diagnose me was because i showed signs of alot of the different tachacardias. I only remember 20 minutes of the 6 hour procedure! If you are only having a mild case of tachacardia then i suggest not the ablation unless your doctor ensures you this is the right thing to do in your case especially if you are young. But the downfall of the medication is that you will have side affects and the medication is only 50 to 60 percent effective. Now the way i got my arrythmias to stop was by laying on the floor breathing in for 10 seconds then holding my breath and baring done as hard as i could for 10 secounds this usually got rid of the problem within 5 minutes of doing this. When you come to a point when you a passing out from this then its time for the ablation! But this is just me so i say good luck to all you ablation patients because it wasn't that great for me and i would never want it again but on the other hand i can hopefully say that i will never have another attack so pick your evil lol!

[richtemp]

it sounds like to me then didn't get everything while they were in the first time this i might talk to my doctor about but if you read your discharge paper work from the hospital it does say you might expect arrythmias for a spurt of 2 to 3 beats occasionally and you heart might flutter alittle these are common in some people but if the arrythmias are coming back full blown and you are passing out or can't get them to stop i might tell my EP this or if your not getting the answers from the EP consult another hospital it sounds like to me they didn't get everything if the episodes are the same and no better good luck to you!! I probably wouldn't try any other kind of therapy for this so early in this stage and taking things the doctor hasn't recommended. If you dont trust your EP find a new one don't take matters into your own hands whatever you do you never know the risk or the outcome if you do. Also do they have you on any medicines like metropolol as needed if not ask your doctor about this. they have me on this as needed because they do expect that i might have another attack and if so i need to take the med so just an example for you best of luck!!!

[richtemp]

Also sorry about the spelling i have paroxysmal supraventricular tachycardia
For those wanting to know these are the forms
Premature beats
Supraventricular Arrhythmias
Atrial Fibrillation
Atrial flutter
Ventricular Arrhythmias
Ventricular Tachycardia
Ventricular Fibrillation
Bradyarrhythmias
Triggers: Stress, Smoking, heavy alcohol use, heavy ecercise, use of certain drugs (cocaine or amphetamines) use of certain perscription or over the counter medicines, and too much caffeine or nicotine so there you have it probably already metioned but just a reminder also metropolol should not be used if you have asthma in which i do thats why they tell me to take as needed there i will leave everyone alone for now lol!

[mommyf2]

Hi,
I have recently had two RFA procedures.  Neither successful in getting rid of my SVT.  I am currently on Calan 240 and HCTZ .  I have a history of high blood pressure (really high). I recently was pregnant and had severe eclampsia (seizures and all). In an episode of SVT my heart rate will hit 240-260.  I have passed out many times.  During both of my RFA procedures I went into Atrial Fib. I was awake for my second one (over 6 and 1/2 hours and still didn't show the rythm that was needed).  He did ablate two areas the first time.  It didn't help though. I have what my Dr. says is an Automatic SVT. He says I don't have a trigger to get the rythm that they need to perform the ablation.  However, as soon as I'm in the recovery room, I  start to have the fast heart rate.  Other than medication, and ablation are there any other options?  I am finding it hard to cope with this problem.  I can't seem to be sure that I won't pass out.  It is scary with having two young children.  

[mommyf2]

I forgot to mention that I have psvt.  I tend to have atrial tachycardia and if it doesn't stop after a while I go into atrial fib. I have been hospitalized several times for this.  The scary part is that if my heart rate continues for a long time, my heart shows signs of wear.  The first really bad episode, I was put in ICU and told I had tachycardia induced cardiomyopathy.  Since being on the medication, I have what appears to be a normal looking heart and normal sinus (unless i'm in SVT).  My EF dropped below 40% the first time.  By the way I'm 28.

[richtemp]

I could be wrong but according to the documentation given to me psvt is sudden onset arrhythmias doesn't necessarily have a trigger like my case i could be sleeping, shopping, relaxing on the couch, taking a bath, working so really don't let that worry you!
Now to answer your question on the in the ep study they can't trigger your heart don't worry my ep doc told me it is not rare to not get the heart to trigger it happens alot and not to be discourage in my case they had no problem but in alot of cases they can't trigger the heart. This just means they will keep a close eye on it. Now if you do have it happen maybe try calling 911 so they can document it either way if you are having an arrhythmia you should not drive to the hospital because if your not passing out now you will start and that is where the concern comes so call an ambulance this helps in 2 ways. One they can document the case with a EKG and two your spared from a major accident even if it quits before they get to your house you should still go and be checked out.  As far as the meds go maybe your doc should put you on a lower dose of meds? I don't know i'm not a doc but that sounds reasonable in that case just dont do it without your doc's permission first though! Now if you read above what i wrote you would see that some medications can trigger an arrhythmia so any other meds you are taking check with your EP or PCP to see if they do always ask the pharmacy to if they can e a side affect because you have psvt.  Also there's nothing wrong with a second opinion (another hospital or EP) My EP told my family that he thinks he got them all but i might have another EP study to make sure because he did see more. But he couldn't trigger my heart to that rate again so this is something if you have psvt your probably going to live with for a long time and its good that your looking into it and getting knowledge on the information. I experienced jaw numbness and dizziness which is also a huge sign of a problem with psvt. I didn't know this until the procedure lol. They told me if that ever happens go immediately to the hospital! It took 15 years of my life of pain and discomfort, two hospitals and alot of E.R. visits for them to finally give me 20 ablations on the same day and them to finally take me serious that i had a huge problem going on! Keep your head up and don't give up or be embarrased about going in they will get to the problem. good luck to you!!!

[moe6668]

I have had atrial tachycardia attacks for the past 3 years.  They have progressively gotten worse in the last 3-6 mos.  I recently attempted an ablation this past 14-sep=07.  It was unsuccessful as I went into the arrythmia with no drug s given and then broke in 30 sec.  They tried Isuprel drip, pacing at 300bpm and eventually used adenosine... it was the only drug to push me into the arrythmia, but it wouldn't last for longer than 15-30 sec intervals.So, no ablation after 5hrs in the lab.  I have felt like **** since the procedure.  I usually get these attacks when I'm sleeping...it wakes me up from a sound sleep.  They have since left me on Cardizen CD 240mg/day and added Norpace 300mg/bid and I take Inderal 40 mg prn for the attacks.  Are there any other options available to me at this point?  Furthermore, these attacks seem to be hormonally related to my monthly cycle:  worst time is from date of ovulation through my period.  I'm 39 yrs old, never been pregnant.. would like to be but really scared given these attacks knowing they could worsen during pregnancy.  I'm a recovery room RN and eventhough I have worked in critical care for years, I still get scared with these attacks.  I had one episode when I was in college where my hr was 220+ and I went to the ER.  Told me I had MVP and panic attacks.  Was worked up by cardiology and heart function was ok.  Shortly after that episode, I went on the bith control pill.  Never had another problem with it until I went off it 5 yrs ago... progressively getting worse along with my periods.  I'm not a candidate for the pill anylonger, due to age, high BP etc.  Could this be a real cause of these attacks?  Any suggestions would be greatly appreciated!  I'm in the Phila area and I love my DOC.  Just disappointed and frustrated!

[kellebelle4]

All I can say is wow...after reading all these posts. I like you suffer with nocturnal tach. I am scheduled for an ep studay/ablation on October 9th. Of course the last couple of nights have been quiet. 2 weeks ago the paramedics caught svt while I was hooked up to the 12 lead montior. I spent a couple of hours in the er was sent home an told to check with my cardio. I waited a few days called the nurse at my cardiologist didn't hear back.

Finally after another horrible night I walked in with the ekg strip the paramedics left at my house. In a nutshell I finally saw the ep specialist he was very informative and decided it is time to try an ep study...... I am praying for an answer. I have been having these epsiodes since 1995, would eat dirt to make it stop. My hearts and hugs go out to all of you.......Kelly

[heartysue]

Have found the posts here very touching to read..

I had an AF ablation in May of this year - all was well, apart from the odd missed beat, for about  10 weeks, and then the AF attacks returned, for 1 hour, 3, 4,6 and unfortunately I have had several now, lasting 20-22 hours :( - the ECG shows that as well as AF, I now have Atrial Tachycardia.

I return to my hospital early December for a touch-up ablation (which has an extremely high success rate) so am praying I will get fixed then.

Like someone said earlier, I too want my life back, having these attacks every 36 hours at the moment is no fun and quite exhausting.

Have been offered Flecanide as a pill in the pocket - that strategy hasnt worked yet, and I can, if I want to, start to take 2 x 50mg of Flecanide daily up to the operation date - I am not sure what to do, as at least the days between the attacks are good and I can carry on doing my walking to get fitter..

FYI I have had different arrythmias for about 12 years now, I am now 46, and am looking forward to my next 'go' at being fixed :)

[Momto3]

Good luck in December!!!  You've got a great attitude and seem like you're gonna knock the AF outta the park!!    

I also ended up with 2 ablations...I thought the 1st one worked well enough, but the doctor didn't agree.  So, it was back to the "table" and I must say, she was right!!  It has been about 4 years and I'm still just getting occasional blips. Hope you have great results with the upcoming ablation (an early holiday gift perhaps...)

[heartysue]

Thank you for your good wishes, I just love your expression "you're gonna knock the AF outta the park!!  "

I will hold on to that thought lol!

[Smitty150]

My situation was this: bothersome Paroxsysmal AF for 15 years getting progressively more annoying and with more-frequent episodes. PIP did OK but it took 4 hours and the meds wiped me out. My local EP told me I was moving toward Chronic AF. I then failed suppressive meds and decided to go for the PVI BECAUSE the success rates are high when one is still in Paroxsysmal AF but much less so when one has progressed to Chronic.

I had the procedure at CC with Dr. Walid Saliba. He asked to use the robotic options (for positioning the catheters) and I agreed. The procedure itself was a breeze and boy does it feel good to be in a "production line" of patients being prepped for the EP Labs!

Yes, my local EP offered to do the procedure, but he's the Lone Ranger in my town. How well does the hospital staff assist him when they do relatively few procedures? What does he do if he gets in deep doo-doo and can't page Andrea Natale for help?

I am 2+ months down the road and have no symptoms and am taking no meds. I send the CC an EKG FROM MY HOME PHONE every week. I go back in November for an Echo, an EKG, and a CAT plus a meeting with Dr. Saliba. Yes, all these are very common tests but I think the technicians giving tham at CC and the doctors interpreting them will be tops.

The PVI procedure is "mature" in the sense that many local and regional centers can perform it. On the other hand, it is by no means an institutionalized one.

If I need a suit I may go to The Ajax Discount Men's Store, but if I am going to meet the Pope (and not Saint Peter), I'll go to Brooks Brothers!

[sophie2005]

I have been diag with atrial tack - Had an attempted ablation & the doc told me he could not get my heart to go into tack. I have tried inderal, toporal, arithymal - nothing works. Does anyone have a problem when you are taking a nap or falling alseep for that matter with your body jerking & waking you up? I am so depressed about these attacks - as one person said their attacks come on at anytime as mine do. This has affected my life. I hate that it has this kind of control over me.

[dlhirschpc]

A related discussion, ablation was started.

[mitchiethekid]

A related discussion, I don't know what I have was started.