Problems after Ablation

I was hoping that maybe you might be able to give me some answers. I have been through 3 ablations for AVNRT in the past year. I am now suffering, severely I might add, with what My cardio has referred to as "pacemaker like syndrome" I also have daily runs of accelerated junctional rhythm that cause me to feel as though I'm going to pass out. This rhythm has been present since my first ablation procedure last Oct. I have had multiple event monitors and have also shown many other rhythm disturbances(Afib, Aflutter, LAFB, NSVT, IST, PVC's that were multiformed, 2nd Degree AV block, type 1)

My first question is, what can be done to bring my heart back into synch? Once you loose AV synchrony, can anything be done to bring it back?

Second question, I have had this accelerated Junctional issue since Oct. This is affecting my quality of life on a day to day basis. Although I do understand that it is not a life threatening condition, I just can't stand to feel so sluggish, or feeling like I'm going to pass out multiple times in the course of 1 day. What can be done for this, since it looks like this is here to stay with me?

Thanks in advance!
--Brooke

[Michael J. McWilliams, M.D.]

Hello,

My first question is, what can be done to bring my heart back into synch? Once you loose AV synchrony, can anything be done to bring it back?



It needs to kick back in on its own.  There isn’t anything we can do to make the junctional rhythm stop.  In theory, a pacemaker could return AV synchrony by pacing over the junctional rhythm.  This is not a standard indication for a pacemaker.



Second question, I have had this accelerated Junctional issue since Oct. This is affecting my quality of life on a day to day basis. Although I do understand that it is not a life threatening condition, I just can't stand to feel so sluggish, or feeling like I'm going to pass out multiple times in the course of 1 day. What can be done for this, since it looks like this is here to stay with me?





A pacemaker is the only option that I know of.  I have never seen a pacemaker placed for this indication.  If the atrium is paced at a rate faster than the junctional rhythm, you will have AV synchrony.  Pacemakers come with their own set of risks though.  Talk to your doctor to see if they have additional thoughts.

I hope this helps.  I am sorry to hear about your symptoms.  Good luck.

[frenchie47]

Hi Brooke
what is accelerated junctional rhythm and what does it feel like?

[Brooke_38]

The junctional rhythm initiates within the AV nodal tissue. Accelerated junctional rhythm is a result of enhanced automaticity of the AVN that supersedes the sinus node rate. During this rhythm, the AVN is firing faster than the sinus node, resulting in a regular narrow complex rhythm

During a predominant junctional rhythm, the pulse usually is regular and the heart rate may be within reference range. Frequently, the junctional rhythm is 40-60 beats per minute.
Prominent jugular venous pulsations (ie, cannon a waves) may be present due to the right atrium contracting with a closed tricuspid valve. It also causes me to feel extremely fatigued and feelings of lightheadedness and presyncope. I have also had 2 syncopal episodes due to this.