Flecainide vs. epicardial ablation

[cmish]

I had an EP study 5 days ago that showed the problem area either inside the muscle or on the outside.  Dr. tried for 2 hours, but couldn't ablate from the inside.  Very disappointing day.  He started me on Flecainide-I had vision problems and migraines for the first few days, but better now (I'm keeping my fingers crossed!). He also has me on 25mg atenolol.  The Dr. mentioned another procedure that's more invasive.  I looked it up & it's Epicardial Ablation.  Has anyone ever been on Fecainide or had this procedure?  I don't like taking meds, and would like to have more energy.  I'm 44 and have been beyond fatigued for the past few months-don't know if perimenopausal hormone changes kicked the PVCs & VT into high gear, but I'm tired & short -of-breath walking across the room.  I almost laugh when Drs/nurses ask me if I feel thePVCs & VT.  How about all-day, every-day!

Anyway, I'd like to know how others fared on Flecainide/Atenolol and if they had more energy and less PVCs/VTs.  I'd also like to hear from anyone who's had the epicardial ablation(the more invasive procedure).  I'm not an athlete and am diabetic (taking Metformin).  I'd like to have more info before I push for the procedure.

Thanks!

[Mom2four85]

sorry to be brief with this, but I've tried to post 3 times today and something happened but I wanted to respond

please be cautious with sustained VT; it can be very dangerous and I hope you find the answers you need with your dr...I would really consider the ICD as a preventative against another episode even after ablation or meds

I have a Boston Scientific Teligen 100 which is small and was a relatively easy procedure after the recovery process; you really don't even notice it's there unless you have VT's or an event.

[cmish]

The ICD was mentioned briefly - and again by my PCP a couple weeks ago.    

The sustained VT just happened out of the blue as I was driving to Easter brunch - I'm guessing it originated from the same spot causing the shorter runs and PVCs.  EP was disappointed that he wasn't able to ablate.  I would be ecstatic if the PVCs and nonsustained VTs were reduced.  The Flecainide seems to help, but vision disturbances pop up (sometimes followed by a migraine )when I least expect it.  I'm not cleared to drive, work, or exercise yet, so I'm not sure how the vision problems and headaches will impact that.  

I met with my dietitian last week and she suggested I see someone who specializes in metabolic imbalances, or perhaps an endocrinologist.  I also got vitamin D level tested a couple weeks ago - highly deficient.  Haven't talked to anyone about HRT.

Thanks for the well wishes for my follow-up.  I have a feeling I'll need all the luck I can get!  

[Mom2four85]

just curious, did they say what caused the sustained VT? that can be a very serious thing and hopefully they'll find what caused it if they haven't yet.  have they mentioned an ICD (implanted cardio defibrillator)? vt can be very difficult to ablate, so it may be difficult to fully cure you

the only thing that's helped me in 2 years is Inderal, mild-moderate pvc reduction and no bp/hr problems - I went from roughly 50,000 pvc's & VT runs to around 10,000 pvc's, VT; pac's & PSVT after my ablation

if hormones are a contributing factor and they know this, have they talked about HRT? I know my gyn wrote a script to my EP asking if it was ok to treat with hormones because I have alot of female problems and I do notice a small difference monthly since he placed me on meds

good luck on Friday

[cmish]

The doctor's name I was given is Dr. Bogun.  If you search "Epicardial Ablation & Univ of Mich Hospital", there's a list of Drs under the article.  His is listed last and there's an e-mail for him as well.

I started on the Flecainide 50 mg twice/day after the EP study showed they couldn't do the ablation from the inside.  The flecainide has caused some weird vision problems that are usually followed by a migraine and nausea.  I do notice a difference in my heart rhythm, just not sure it's worth the side effects I've been having.

I've had arrhythmia issues for years, but my doctor didn't seem to pay any attention to  them.  Last fall, I started getting them all the time and the rhythm changed.  I was short of breath walking across the room(possibly hormonal change).  I changed PCPs and when the dr. heard it, he immediately ordered an ECG, Holter, & Echo Stress Test.  After all those, he referred me to a cardiologist who put me on a 30-day monitor.  On the 7th day wearing the monitor, I had a sustained v-tach that landed me in the ER, followed by several other tests and several days in the hospital.  The original Holter monitor had picked up a lot of PACs and some PVCs,but that was a good day!  Apparently I have a lot of PVCs and non-sustained v-tachs during a typical day.  They seem to be worse during PMS.  In the ER, I had Amiodarone.  I was switched to Metaprolol and was on that for almost 3 weeks.  It caused some daily stomach problems, so after the EP study, I was put on Flecainide and Atenolol.  

I have an appt with my cardiologist this Friday, so I plan on asking about the other procedure.  I just may e-mail Dr. Bogun directly.  I'll let you know what happens.

[DeltaDawn23]

I live in Ann Arbor and saw Dr. Morady for a consultation for persistent Afib.  He was spoken of very highly on this message board.  He said the Norpace my current cardio suggested was a reasonable choice and I have had a few side effects, but it seems to be working.  Just curious about who the doctor is you were told about at U of M.  I need all the information I can get and we are lucky to have such a good hospital with excellent physicians and resources here.

I am taking Norpace, Atenolol, and coumadin and seem to be staying out of Afib so far (6-1/2 weeks since last episode.)  I take the Atenolol in divided doses (1/4 of a 25 mg. tablet at a time, and depending on my hr and bp, take between 1 and 2 tablets a day) and it worked for me for about 7 years before I started having more frequent episodes.  I don't have personal information on the Flecainide, but several on this message board have mentioned taking it.  I think all the anti-arrthymics have side effects.

[cmish]

Just did another search for epicardial ablation & Univ of Mich Hospital.  Came up with an article that had an e-mail address for the Dr. I was told about on Tuesday.  I have an appt with my cardiologist on Friday - I'll see what his gameplan is & maybe I'll try to e-mail the other Dr.  Doesn't hurt to try, right?

Thanks for your help.

[curmudgen]

sorry ...checked that listing I gave you and it doesn't work....  I searched yahoo..typed in
epicardial ablation and found many vert interesting sites....interesting way to do external ablation.

[curmudgen]

strange ... here is the yahoo search page I got....
http://search.yahoo.com/search;_ylt=Aiw9j_BR1GNT0kxRzgNLa1JG2vAI?p=epicardal+ablation&fr=my-myy&toggle=1&cop=&ei=UTF-8

[cmish]

I've spent hours combing the internet.  Can't find much on epicardial ablation.  I've found that it's a less common procedure and more invasive.  Most of what I've read is about experiences with the standard endocardial ablation-which I would've had done this past Tuesday had it been possible.  Unfortunately, it wasn't.  

Flecainide hasn't gotten very good reviews from the blogs that I've read and I'm not happy about taking meds for the rest of my life.

[curmudgen]

I assume you have searched the internet for articles and blogs of those that have experienced the procedure?