Recurrent SVT after RF Ablation

I have had 2 prior ablations, and am now scheduled for my 3rd. My first ablation was last february. Two weeks after that procedure, I was back in the ER with a heart rate of 280. My second ablation was then 1 month after the first. Both ablations were performed on the left side of my heart. I did not begin having SVT symptoms again until about 11 months after my second procedure. I was on a heart monitor and an EKG was performed at the ER during my 40 min episode with a HR of 260. Adenosine was successful in converting and the readings showed that the error is now on the right side. I was told by my cardiologist that a third EP study with possible RF ablation is necessary and then if RF ablation cannot be performed, a cryoablation will be needed.

My question is, How common is it to have recurrent SVT after "successful" RF ablations, especially having 3 within a 1 year time period?
Also, Is it possible to have new faulty pathways become active over time?? Should I expect more of this?

Thank you!!!

[michellepetkus]

It is actually not that common for accessory pathway svts to reoccur after an ablation as ablations are generally pretty successful but it is not unheard of for people to have multiple extra pathways.  Sometimes it is hard to get a pathway to become active in an EP study so I would surmise that you have had a couple of trouble spots your whole life and depending on your heart's mood one or the other will act up and obviously did not show up during the previous studies.  The extra pathway after all is really just extra muscle fiber your being a muscle.  I do hope though that this third ablation does the trick for you.  Please let us know when it is and I will send good thoughts your way as well do keep us posted.  Take care.

[tom_h]

Think of the accessory path a ribbon of conductive muscle tissue.  The entire width of the ribbon must be scarred by heat to deactivate the path.  After the physician bridges the path, they antagonize the suspected path in an attempt to get it to conduct.  In your case, it's possible that the path wasn't completely bridged,and after your heart heals and the inflammation goes away, a small thread remains and begins supporting SVT again.

[MaryLL]

Hi, I'm sorry you're going through the recurrent issues after your 2nd ablation. In my experience, having had 3 catheter ablations, it is possible for them to miss aberrant electrical pathways and some areas do grow back. Between my 2nd ablation in Feb/12 and in June/12, some of the pathways reattached. My last 2 ablations were cryoablations.
My first ablation was not completed, about 95%, due to a common heart malformation they weren't expecting. After both my 2nd and 3rd, my EP pronounced the procedures "successful." Clearly not as my afib actually got worse. My EP says that about 2% of people with afib are resistant to treatment. This is a time when one doesn't want to be in the 2%!
Five weeks ago I had a surgical ablation (bilateral thoracoscopic mini-maze/ablation. We will see in the next 2 months how successful it has been. It's been a tough recovery as it is more painful, I got fluid in my lungs and am still recovering from pneumonia.
The surgeon who performed the surgery said he has done hundred's and no one has gotten worse. Because he is going in through incisions in the sides of the chest, he gets a more thorough view of the heart. I also went into afib during the procedure, so they were able to see what was happening on that front. I think the success rate is about 88-90% but even when episodes still occur, apparently they are less frequent. The jury is out on mine.
I hope they will be successful in ablating your right side. Please keep us posted to know how you are. I will also let people know how I am after 3 months. Your heart rate really goes fast, that must be scary. This whole thing is scary in my opinion. But, we keep going forward because that's what afib is about. Wishing you the best!