SVT, Lithotripsy

I am a 44 year old female with a history of 20+ kidney stones discovered in my 6th month of pregnancy 8 years ago.  In Sept 2009 I went for a routine check up with a urologist.  I had no symptoms of any kind.  I went to a new doctor because my old urologist had left the practice). The new doctor reported that one of my stones was large (8mm) and encouraged me to have a lithotripsy procedure.  He said that if I did not the stones could cause permanent kidney damage, etc.  I was weary of the procedure and even canceled it days before but was encouraged by the staff that I was worrying over nothing and that it was a simple procedure, so I decided to go through with it.

I was told that the procedure should take under an hour.  When I woke up hours later I had people standing around me.  I had chest pain and felt dizzy.  I did not think much of it because I did not expect to feel 100% after surgery.  But the look on their faces and concern said more.  Apparently my heart rate was bouncing from 30 to 140 throughout the procedure.  They admitted me overnight for testing and were not able to find anything.

After I was released and moving around, my heart rate soared to over 200+, on and off daily.  After seeing numerous cardiologists, I was told that I had two options, either take medication for the rest of my life to control the SVT, or have a cardiac ablation.

I have no prior SVT or heart related issues.  Before this lithotripsy, I was a normal healthy active woman.

The experience was overwhelming and perplexing.  Can anyone tell me what had gone wrong.  The urologist denied that anything happened; however when I was in the hospital for observation, a nurse (that was apparently in the room at the time of the lithotripsy) came in to see me the following morning and told me "I was so worried about you.  I asked him, what organ are you near."  The doctor denied the incident and in fact told me that it was "The best lithotripsy procedure he ever performed!"  He then went on to say that it was probably the anestasia because they are use to "working on big guys."

Can anyone tell me what may have went wrong?

Thank you!

[Brooke_38]

Hello...

ESWL (Extracorporeal Lithotripsy) procedures deliver shock waves from outside the body to break the stones. There have been instances where these shock waves stir up arrhythmias and can exacerbate ones that were there prior to the procedure. Have you asked for the operative report to see what was happening when you first went into SVT?

I just went through an ESWL 2 weeks ago. I do know that my Urologist was concerned about my underlying arrhythmia and the potential for it to run "wild" inta-operatively as well as post-operatively.

I am attaching a link here from a medical journal titled "Unintended SVT Induced by ESWL:Anesthesiolgy"    

http://journals.lww.com/anesthesiology/Fulltext/1998/03000/Unintended_Supraventricular_Tachycardia_Induced_by.38.aspx

Hope this helps you in your search for answers. Best of luck to you!

[Durk21]

Thanks for your reply.  I can't help it, but I am so angry over the entire situation.  It was overwhelming, especially for my two children.  

The doctor was so aloof about the whole thing.  Like I said above, I had no pain, no symptoms and probably did not even have to have the lithotripsy to begin with.  I was never told any risks related to the heart.  The only risks I was told is that he may not be able to get all the stones and would have to do it again, or that something may get caught and a stent would have to be put in.

Out of curiosity, who writes the operative report?  If it is the doctor, I am sure it says only good things.  But there was a woman who came to see me the next morning and expresses concern.  I am assuming she was a nurse.  Are there any other people in the room who would have to write what went on during the surgery.  I have a stack of "reports" from this incident.  But they are sooooo vague.  It only says that patients rate went below 50.  It does not say how low or how high.

Thanks again.

[Brooke_38]

Hello...

I can appreciate your feelings of anger relating to what you have been through. Being a mom, I know how children are affected by things that they don't understand, especially when they are happening to their mother.

The operative report is produced by the surgeon or other physician(s) who participated in the procedure. It contains a detailed account of the findings, the procedure used, the specimens removed, the preoperative and postoperative diagnoses, and names of the primary performing surgeon and any assistants (including nurses) You should also inquire about the post-operative care nurses notes from the recovery room. During your recovery, vital signs are taken every 15 minutes for the first hour post-op.

The stone you mentioned being (8cm) in size, would not have passed on its own. I'm sorry that you are having to deal with all of this. Are you now taking medication to treat the SVT?

[Durk21]

Thanks for your reply!  It is very much appreciated!!!!!

I am definately going to get those reports.

As far as my stone(s) - I have many.  My prior doctor said, "If they don't bother you, leave them alone."  This doctor originally told me they were almost 10mm and later reports said 7-8mm - which means that they have not changed in size in years.  Because I "thought" it was getting bigger - I had the procedure.  I am wondering if there were other means I could have treated the stones.  I was never one to drink a lot and I guess that is why I got it in the 1st place.  But now I am much more conscious about it and drink often.

In any event....., I had the cardiac ablation in November and that stopped the SVT.  However, I totally feel a heart change.  I definately feel a lot more breathy and am always tired.  I don't have the same stamina.  I know it is not in my head because they  did a 24-hr monitor after the ablation and it stated that I have almost 900 skipped beats in the 24 hour period.  So I don't know if that is why I am not feeling the same.  I am usually the type that can move forward and put things in the past, but because I am not "myself" it haunts me. They wanted me on a small dose of Toporol because they think it may help me to not feel the heart changes, but the whole reason I had the ablation was to avoid taking medications.  I prefer not to take it because it gave me dry mouth and I'm guess it has its own side effects, so I figure I'lll just deal with it.

I really appreciate the time you are giving me.  It is very kind of you!!  I am going to get the reports.  I am interested in seeing what it says (or as I suspect - what it does not say.  I'm guessing that it will be very evasive.)

[Brooke_38]

Hello...

I've been dealing with kidney stones since 2007. According to my Urologist, stones that are >4-5cm usually require intervention eg. Lithotripsy which of the procedures is the least invasive. I've passed stones before, and having had 2 children naturally, I'd go through that again before enduring the pain that I experienced from the passing! I'm sure that you can relate to the pain I'm refering to...

I highly recommend increasing your water consumption in an effort at decreasing stone formation and flushing out any toxins that can build up in the renal system.

Following your ablation procedure, did the EP tell you what type of SVT was ablated? Just curious :) It was my pleasure to help you out! I wish you the best of luck!

[Durk21]

The way I knew I had stones was that I had passed one when I was 6 months pregnant.  I was in the hospital for 5 days before it passed.  Yes, I totally agree.....I would go through labor 10 times in a row before wanting to pass a stone again!!!!!  And i did not have easy labors.  I was told I had over 20+ stones....totally crazy number.  I guess the lithotripsy wiped out most of the ones in my left kidney, but now I still have a ton in my right kidney.  But after my ordeal with the lithotripsy, followed by a cardiac ablation, it is obvious that I would not be going through that again.  I definately have ones left that are bigger than 4cm.  

As far as what type of SVT I had, I could not even tell you.  I know it originated in the least concerning part of the heart (not atrial fib, or atrial flutter).

Thank you again.  Your an angel!  I see you reach out to a lot of people on this site.  God Bless You!!!!  Christa