Aa
Can an extra pathway disappear on its own?
When I was 20 they discovered my tachycardia was due to an extra pathway in the heart.Since it was close to the heart's natrual pacemaker they decided against intervention but later, as the techniques advanced, they advised an ablation.Should something go wrong with the ablation, they would have a pacemaker ready to be inserted. However I was still hesitant, given the slight risk that I would end up with a pacemaker and never got round to doing the procedure. 25 years on I have realised my heart beat has slowed immensely, from being constantly over 100 bpm down to 60+ bpm.I am wondering whether the pathway could have disappeared on its own or whether it's at all possible that a secodnary problem has made my heart rate slow down and it is only within the 'normal' range because of the extra beats from the pathway.
My ablation was SVT which is entirely different than sinus tachycardia. Sinus tachycardia is the body's physiological response when a reasonable stimulus, such as the catecholamine surge associated with fright, stress, or physical activity, provokes the tachycardia. It is distinguished by a presentation identical to a normal sinus rhythm except for its fast rate (>100 beats per minute in adults).
Supraventricular tachycardias typically have a narrow QRS complex on ECG. When experiencing SVT, the EKG waveform looks is entirely different than sinus rhythm. I suffered from Atrioventricular reentrant tachycardia (AVRT), also known as circus movement tachycardia (CMT). It results from a large, wide reentry circuit. One portion of the circuit is usually the AV node, and the other, an abnormal accessory pathway from the atria to the ventricle. The accessory circuit forms a conductive loop which when activated basically causes the heart to fire before it's supose to.
My SVT heart rates ranged from slightly over 300 when I was a child to around 200 at 60 y/o, and at normal respiration levels. SVT brought on by physical activity would be in the neighborhood of 250, and I had plenty of them. What finally prompted my EP study and ablation was I had been experiencing 3 to 5 episodes per month. I finally caught two by wearing a 30 day monitor. This caused my cardiologist immediate concern as he had never actually seen me in SVT, and when he saw, he believed. My SVT HR was much higher than he typically sees in a sixty year old, and he wondered how my aging heart would tolerate rates like that as I move into the next decade and (hopefully) beyond.
The EP took one look at the EKG, shook his head, looked at me and said "You should have come to me ten years ago". That started the process. Everything went great, and I've been SVT free for 9 months now. I've had some hicups along the way in the form of PVC's and PAC's, but those have disappeared and I feel perfectly normal again.
There are many active members of the forum that have had ablation therapy. In fact, we have one scheduled for next week. The process has become very routine. There's really no need to fear the process, and EP's will stop if they determine that the area of concern is too close to the AV node. Accidents can happen of course, but anyone that you'd want to be there in an emergency are in the lab with you and that was reassuring.
Supraventricular tachycardias typically have a narrow QRS complex on ECG. When experiencing SVT, the EKG waveform looks is entirely different than sinus rhythm. I suffered from Atrioventricular reentrant tachycardia (AVRT), also known as circus movement tachycardia (CMT). It results from a large, wide reentry circuit. One portion of the circuit is usually the AV node, and the other, an abnormal accessory pathway from the atria to the ventricle. The accessory circuit forms a conductive loop which when activated basically causes the heart to fire before it's supose to.
My SVT heart rates ranged from slightly over 300 when I was a child to around 200 at 60 y/o, and at normal respiration levels. SVT brought on by physical activity would be in the neighborhood of 250, and I had plenty of them. What finally prompted my EP study and ablation was I had been experiencing 3 to 5 episodes per month. I finally caught two by wearing a 30 day monitor. This caused my cardiologist immediate concern as he had never actually seen me in SVT, and when he saw, he believed. My SVT HR was much higher than he typically sees in a sixty year old, and he wondered how my aging heart would tolerate rates like that as I move into the next decade and (hopefully) beyond.
The EP took one look at the EKG, shook his head, looked at me and said "You should have come to me ten years ago". That started the process. Everything went great, and I've been SVT free for 9 months now. I've had some hicups along the way in the form of PVC's and PAC's, but those have disappeared and I feel perfectly normal again.
There are many active members of the forum that have had ablation therapy. In fact, we have one scheduled for next week. The process has become very routine. There's really no need to fear the process, and EP's will stop if they determine that the area of concern is too close to the AV node. Accidents can happen of course, but anyone that you'd want to be there in an emergency are in the lab with you and that was reassuring.
May I ask you what you will probably consider a silly question? If your HR wasn't affected, why did you go for the ablation eventually? (I trust all went well with it?)
Wow... thank you both! I've lived with this for so long but I'm still hazy about the details... I never got my head round the technicalities... or even what the condition is called! Doctors have always sounded a bit vague... or maybe my brain is not scientifically inclined :)
But thanks again... I had never psoted on a medical forum and have never actually spoken to anyone who has the same condition... this is very refreshing indeed!
All the best :)
But thanks again... I had never psoted on a medical forum and have never actually spoken to anyone who has the same condition... this is very refreshing indeed!
All the best :)
I had SVT for 54 years, first starting when I was six. All of the cardiologists that examined me thought that my condition would eventually clear on its own. So yes, accessory pathways can activate and deactivate over time. Whether they still exist, but are dormant are unknown to me.
I've always had a high average heart rate. Even in superb physical condition, my resting pulse was only in the high 60's. My cardiologist explained that the hearts pacemaker sets itself shortly after birth, and is difficult to alter without the aid of drugs. Age can have a bearing on heart rate, and at 60, my HR has diminished somewhat. Ablation therapy which I finally had last year (for similar hesitations as you) did not affect my HR in any way. Finally, although a just a layman, I seriously doubt that an accessory pathway would influence sinus heart rates, instead serving as a conductive pathway for non-sinus rhythms like SVT, where rates can be 2 to 3 times normal.
I've always had a high average heart rate. Even in superb physical condition, my resting pulse was only in the high 60's. My cardiologist explained that the hearts pacemaker sets itself shortly after birth, and is difficult to alter without the aid of drugs. Age can have a bearing on heart rate, and at 60, my HR has diminished somewhat. Ablation therapy which I finally had last year (for similar hesitations as you) did not affect my HR in any way. Finally, although a just a layman, I seriously doubt that an accessory pathway would influence sinus heart rates, instead serving as a conductive pathway for non-sinus rhythms like SVT, where rates can be 2 to 3 times normal.
The heart is an amazing thing and who knows what can happen. I've never read about anyone who had an extra pathway go away.Many extra pathways people have are there because they are born with them as in dual pathways in the AV node or the extra pathway in Wolf Parkinson White Syndrome.
I don't think your hr going down would have anything to do with the extra pathway. I also doubt that extra beats from the pathway would slow the heart down. It might be that your heart is doing what it's supposed to do by using the correct pathways. That's only a guess. I would discuss those questions with a cardio but from all appearances this is a good thing. Many of us who have had extra pathways have found the condition usually worsens as we get older.
I don't think your hr going down would have anything to do with the extra pathway. I also doubt that extra beats from the pathway would slow the heart down. It might be that your heart is doing what it's supposed to do by using the correct pathways. That's only a guess. I would discuss those questions with a cardio but from all appearances this is a good thing. Many of us who have had extra pathways have found the condition usually worsens as we get older.
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