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622511 tn?1373571503

My first dreaded EP-Study/Ablation I finnaly decided to do.

TO All IN THE FORUM. ANY FEEDBACK IS APPRECIATED.


Sorry to repost, in the incorrect forum if I did, I just want to make sure I reach the many people in the forum that can advise me on waht to expect. I also  just happen to do a search on interpolated PVC's and a link lead me to this forum, which I am a member of already, so I decided to post. Anyway, although I have a two-fold problem (that many of you already know through my previous posts)which began with PSVT/IST in 1992 "followed a few years later by a "2nd curse" PVC's which were ONLY single-form uni-focal PVC's in roughly 2000 my 1st episode of both Multiform/complex PVC's started.  I have been getting interpolated PVC's pretty regular "when they start up" since about 2001. Now getting these pretty frequent "runs" if you will, of Interpolated PVC's, I am able to tolerate and endure single form and the occasionally garden variety PVC's alike, as they are "now" nothing compared to the feeling of ongoing runs and clusters I get.  I would like to post this at the forum, as I haven't posted recently since I am coincidentally going through with the EP study after being on the fence with abaltion for these arrhythmias for almost 16+ years now. I just can't deal with these interpolated PVC's and the "occasional breakthrough of SVT as well, ANYMORE. I have already seen a Dr. Frances Marchlinski at the University of Penn. who is supposedly one of the best at PVC ablation. According to my EKG's, he has a good idea where they me be coming from. The drawback, is I may have a focus on the left and right side of my heart. I was told by another EP doctor that you can have only a single focus causing these types of PVC's. I guess he was wrong? My understanding of Multi-Form PVC's is more than likely the result of Multi Foci (lesions) present. Where remains to be determined by the EP study itself, although as I stated he has a good idea of where they are emanating from. I just hope that the "majority" of these PVC's can be  successfully ablated and that the SVT, if sampled or induced during the study, can be as well. Killing to birds with one stone, in my case,  would be ideal. He primary goal is to go after the PVC's "first". Then if he can find a bypass tract that is rarely ( only less common because of the BB) still causing my PSVT while he's up there and can ablate that too, it will be the greatest gift and most ideal outcome one can expect. I go in April..Quite "scared" I will admit as a 53 year male, as it will be my 1st invasive procedure and ALL I dwell on, and I shouldn't so much, are the possible WORST complications such, as MI, Stroke, Artery Perforation, Valve Damage. After those, worrying about coming out with a worse life threatening arrhythmias that were termed "benign" but truly bothersome arrhythmia's that are affecting the quality of my life. Only thing I can say is that if the ablation is successful for even on of these arrhythmias, I will only wish that I would have done this sooner and maybe I could have avoided the 16 years I suffered from this problem. Conclusively, do you think I am expecting too much from this procedure or is it possible to get the "ideal" outcome? Just to point out Dr Marchlinksi, told me if he were to rid me of 95% of my problem, especially the PVC's, would I be happy with that.. I said of course! Are my expectations too high or is it possible to kill two birds with one stone during what I hope to be a "single" ablation.
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Avatar universal
I agree with you.  I have had 3 ablations- with varying degrees of success and failure, but no reall major complications.  I would easily go back if they could fix it.  It is way preferrable to go a bit more invasive to escape years of meds with lots of side effects.  I hope it goes very well and you find a way out.  I have wondered about getting on a plane and going to one of these world reknown folks to see if their skills make any difference.  I'd say my ep mds were excellent too though.  Experience is everything when it comes to a procedure like this.  I'm happy for you that you get to be with the ep elite.  Good luck.
Helpful - 0
622511 tn?1373571503
hank You all and I truly believe it comes down to being inn the "Right" hands for this procedure. I read of failed ablations and totally successful ones or just ones that have significantly reduced the majority of the BAD episodes. So, yes, I know as Heart2 has said, that the doctor wants to do the ablation but again it was I who sought out this doctor and made my decision to finally do it. Yes, I know there are risks but if I don't do it I will always wondered would it have helped me. Oh, and heart 2, I appreciate your concern and don't know what went wrong with your procedure and I'm sorry to hear that but I tried many meds, including every beta blocker there is, and even a Calcium Channel Blocker, which worsened my PVC's. I have been on Tenormin for many years, a specific1 Beta Blocker , and intrinsically one of the safest according to my Cardiologist of those 16 years, here in NJ.  I know at worst I could even die from the procedure or get a stroke, etc.. but I have to take those accept those odds, as a better or near 95%  outcome is in my favor...I hope and pray, as I am not ready to go 6ft under and if I am going to come out of this with a life threatening arrhythmia I NEVER had to begin with, the truth  is I'd rather be dead, as harsh as that sounds. Also, I want OFF the beta blocker, as the side effects of the BB I have taken so long has taken it's toll on me in many ways as well. So it's a double edged sword in a way. It's either Meds and the horrific side effects, or just maybe a new lease on life, even at 53. You say try ALL meds first..No way.. There is a higher mortality rate using anti-arrhythmics than NOT doing anything at all (in my case) for the "benign" yet very bothersome frequent multiform PVC episodes I suffered from for many years. This doesn't include the SVT which is pretty stable but as I said in the 1st post, I do get 1 or 2 breakthrough episodes of SVT. So that is my story and I thank you all who replied and wished me luck. Hopefully, I will make it through without any "major" complications, even if the focus is on the surface of the heart or "concealed". They then have to make an incision under the rib cage and attempt to get it that way, only of course, if it is in fact concealed. I'm saying my prayers and have faith in this doctor, as he was recommended to me by many other experts as well.
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Avatar universal
Hi, I'm so sorry you have been suffering for 16+ years.  I waited only 5yrs to have my EP study done.  You don't mention meds...have you tried anything?  I would say that an ablation should be a last resort after all the standard meds are exhausted.  My EP study and ablation was successful for ST and I had many spots on the one side ablated.  However, I had a complication that could easily have killed me.  It is by the prayers of all my friends & family and the grace of God that I am able to share my opinion with you.  I can't disclose the particulars for legal reasons, but I will tell you that NO procedure is SIMPLE.  Especially when it's done to YOU.  Be sure you have tried every med they can throw at you, and keep in mind that the EP doc wants you to have this procedure.  I wish you well and I'll say a prayer for you.
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Avatar universal
Dr. Marchlinski is known around the world for A-fib & PVC ablations.
Helpful - 0
267401 tn?1251852496
I don't know about that particular doctor, but I know from the research I've done that in general, because PVC's can be so hard to induce when a patient is sedated, the general success rate for ablation of PVC's is quite a bit lower than for other ablations, such as SVT's.  There may be less risk involved because of the area of the heart where the PVC's originate, but as I understand it they are harder to pin down than say a WPW or A-fib, AVNRT, AVRT, etc.  So the remote chance of complications of ablations in general are even less with your type of ablation.

That being said, success rates around the world vary for even the most successful types of ablations, so your EP doc might be brilliant with PVC ablation (and if so, you may want to tell missalisa ;)  ).

Good luck with your procedure.  Please let us know how it turns out.
Helpful - 0
Avatar universal
I think everybody goes into an ablation with their expectations high. You do have one thing going for you and that is the EP. Dr Marchlinski is considered one of the top EP's for ablations. He did mine in January 07 for a-fib and flutter. He had to ablate both sides and the procedure lasted almost 8 hours. I was told that I might need another ablation but so far that has not happened. I am still in NSR and the pvc's and pac's I had before the ablation have 95% gone away also. Good Luck!
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