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Avatar universal

SVT Ablation, should I get it?

I'm a 28y/o female that's pretty active. I've had what I assumed was SVT on and off for the past 9yrs, up until a few months ago it was never caught on a monitor. It mainly came out with exercise, I would feel a PAC then feel my HR increase to very high rate. I finally had a 30 day holter monitor to wear and caught an episode, my HR went up to 260bpm! I got light headed and just sat down and let it ride out, lasted about 5 mins or so. I usually vagal out of the episodes but I let that one go since I had the monitor on. My Dr. referred me to a cardiologist and he wants to do an ablation. I work as a cardiac RN so I've taken care of many patient with this procedure but never thought I would need one. My question is, is it worth it? I get occasional PACs with anxiety or exercise but that's about it. I've read that many ppl suffer PACs and PVCs pretty extensively after the ablation. I understand that these are benign but ppl end up on meds to control them, which I don't want and was the main appeal to getting the ablation. I'm a very active person and love to run so having SVT has definitely stopped me from doing this. Anyone have any advice??
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Avatar universal
Hi.  Just wondering what you've decided.  I have a very similar case to yours I think.  unfortunately I haven't caught the rhythm.  My ep cardio suggested ep study as well.  My biggest fear is that they can't make it happen and it's all for naught.  I have exhausted every other test though and done some of them multiple times.  My frequency is about 1-4 a year and it last about 15 minutes.  I really just want to get this monkey off my back.  I'm afraid to go on rafting trips because I'm worried about it happening far from a hospital and what if I can't self convert.  Frustrating.
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Avatar universal
Thanks for the replies, I was concerned with having PACs again, especially during exercise because that's what would start my SVT. However, these feel different don't seem to be increase my heart rate at all, just a flutter feeling. I've been having them on and off but as you said it takes a while for them to go away and I'm fortunate to just now start having them again.
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1807132 tn?1318743597
How bad are they while you are working out?  I sometimes notice a few but not many but if I get them it is during cool down.  Likely nothing to worry about and exercise is definitely good for your heart but you may want to speak with your doctor about it just to be sure.  like Tom said, it can take up to a year for things to settle down.  Mine it took almost 2 years and I still get them, may never be totally rid of them but they aren't as bad as they were the first year following the ablation.  
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1423357 tn?1511085442
Expect all kinds of skips, and short runs of SVT for a year and beyond.  It takes a long while for things to settle down.  4 months?... Go for it!
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Avatar universal
Four months after my procedure and I've been SVT free, however
I started having PACs this week, both resting or while working out. No other symptoms and it doesn't shoot my heart rate up but it didn't seem to start until I started really exercising. Is it possible I'm doing too much too soon? Thanks!
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1423357 tn?1511085442
I had mine done one week before Thanksgiving.  I went back to work on Tuesday, and then drove 250 Thanksgiving morning to our kids houses.  On Friday, my son paced me as I did some easy laps at the rink; 8 days later.  I'd say it took about 6 to 8 weeks until I felt really 100%, but I felt that I was holding back a little and really not giving it "full smoke" again.  In March, my cardiologist responding to my skepticism that was my heart was really fixed decided that it was time to prove it.  Wired up in a full lead EKG, he put me on the treadmill, The Pain Train he called it, and urged me on until I punched out, exhausted at 13 minutes into the standard Bruce Protocol test. "Not bad for an old man!", I remember him saying.  After that,  I think I started giving everything an old man could give without fear of going into SVT.
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Avatar universal
Two days post op and I'm feeling pretty good. Had one tachy episode this am but it wasn't SVT so I'm ok with that. I also have some chest pains on and off but it's more like a sore achey feeling. I am finding that I tire easily, how long til you felt like you could go back to doing normal activites and not be exhausted? How long til healing is done and the ablation is considered a success? Since my SVT was with exercise, I guess I won't know until I start working out again if it was successful. I was planning on giving it three months before I get back to the gym.
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1423357 tn?1511085442
You're going to be a little limpy for a week or two perhaps.  I found that a stroll around a mall after a day of resting helped a lot.  Yes, I had jumpiness too!  Expect that for up to a year or longer.  You're young, and still have a full life ahead of you now free of SVT.  Live it!
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1807132 tn?1318743597
I am so glad to hear it went well.  your odds of a cure are super high so you are likely free from this for good.  I had the same response realizing I got myself all worked up over nothing but until you do it you just can't know.  I was in and out in a couple of hours as well which I am sure helped our experience.  Well rest up.  Your heart may run a bit fast and be jumpy for a time but it will get slowly better and soon be a distant memory.  Congratulations.
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Avatar universal
Thanks, its such a relief to have it done and over with!
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1423357 tn?1511085442
Sorry, I directed my comment to you!
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1423357 tn?1511085442
Great!  I knew you could do it!  Now take it easy for a couple of days, then slowly pour it on.  Enjoy you life and don't look back!
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Avatar universal
Congratulations!  Glad it was easy peasy for you!
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Avatar universal
Had the ablation today and I can honestly say I worried way too much about this procedure. I went in at 9am and now home by 5pm! Other than a sore groin and some lightheadedness I feel way better than I ever expected! My Dr was able to induce my SVT with adrenaline and brun the spot that caused it and couldn't get it to go back into SVT so he feels like it was successful. My procedure took only 2hrs, and the staff was wonderful! I encourage anuone living with SVT to get the ablation done. I know it'll be a while before I'll know if it was a 100% successful but the procedure itself was totally worth it. Get
It, you'll be glad you did!
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Avatar universal
Hi there,

Good luck with the procedure.  It was a piece of cake for me.  I sent you a message, hope to hear from you.
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1423357 tn?1511085442
Well I wish you the best!  I think we all go in the lab with some degree of fear and dread.  If you haven't done so already, speak to the electrophysiologist and ask if he can give you something to make you comfortable.  The day of your procedure IS NOT the time to ask for this.  They have everything "mapped out" by that time.  Inquirer now!  Let us know how you do, and we're always here for any last minute questions.  BTW, forum user "Jannie411" has an excellent journal on her procedure.  She was completely awake for the entire process (I don't know how she did it!)  Good luck!
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Avatar universal
I've decided to go on with the ablation next week just because it will never go away otherwise. As much as I am terrified of the procedure, if I want a chance at being able to run again and start a family SVT needs to be taken care of. I'm hoping everything works out ok and will keep everyone updated. Thanks for all the replies!
Helpful - 0
1807132 tn?1318743597
There is a type of svt that happens in older folks and really active folks called afib.  I would try and find out if this is the type of svt you have.  It is a bit trickier to fix so you will want to read up on it to know what you are dealing with.  But first question your ep on whether or not they suspect afib.  If so then the flutters may actually just be some ectopic activity.  I had svt my whole life but it didn't get active until my late 30s.  By my early 40s I was starting to get a lot of the flutters every day from my heart being irritated by the svt.  They are a separate issue from the svt.  I got the svt cleared up and the flutters have just about gone way.  When you were in the ER were you there for a super fast beat or these flutters you mention.  Meaning do you feel different symptoms or is this all just a flutter feeling for you?  It is important to know what you are dealing with so you can make the best most informed decision on whether to try ablation or not.  Take care and keep us posted on how you are doing.
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Avatar universal
You mention the key is finding it.  I assume you are talking about the particular area of defective tissue?

I'm 52 and have been experiencing palpitations for years.  I'm fairly active for my age and do a few half-marathons or marathons each year.  This summer I had a big episode while finishing a run.  Got to the ER and they ended up doing a heart cath but found no blockages.  Everything checked out great.  30-days on an event monitor lead to a finding of SVT.  I've been on a beta-blocker for about a month. I resumed running shortly after that. I believe the palpitations abated for about a week and have steadily resumed.  I currently experience approx 20-30 "episodes" of fluttering per day.  Can't seem to pinpoint a food/supplement/medicinal cause. However, I haven't had another situation similar to that which sent me to the ER.  My EP has suggested an ablation and we are considering it simply in hopes that my heart will go back to feeling normal and I can quit thinking about it all the time.

Does this sound familiar to anyone?
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1807132 tn?1318743597
If your svt has a history of stopping on its own within a certain amount of time you can feel pretty comfortable doing just about anything or going just about anywhere.  Atrial issues are rarely life threatening.  I understand a certain amount of caution being out in the wilderness but in general svt is not rated by the medical community as a health threat and as such ablations are considered optional.  I rather wish this wasn't the case but the point is svts are rarely if ever the cause of sudden death.  I respect the idea of not straying out to where help cannot be found but I would not stop living your life because of your svt.  It isn't anything to fear but rather just to be managed.  If your body is stopping it on its own odds are it will continue to do that.  There is usually a progression to the syndrome as opposed to a sudden change.  I would highly suggest consulting on this with the EP finding out if there is any activity you should restrict yourself from but I suspect they would tell you to continue to live your life.  As well learn vasovagal maneuvers to help you manage your svt on your own.  If you can take control of your svt instead of it controlling you then there isn't a thing you can't do.   Stay strong and fear not.  
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1423357 tn?1511085442
Your comment could have been written by me prior to my EP procedure.  I too would never do anything that put me out of reach of a hospital, even while knowing that in the 54 years that I had it, I never set foot in one as I was able to slow it with Valsalva maneuvers.  Still it was always back in my mind, and I took up sports that kept me closely to where I started,  Yes, something like rafting in the Colorado would be out.  That would put me in a remote area.  Instead I took up speed skating, and track cycling.  I was never far from where I started.  My family had a big sailboat, and I'd often sailed with them offshore or in the Chesapeake Bay.  But when they sailed to Bermuda, I declined to go much to the disappointment of my late dad,  That was out of the question for me. This was long before they had the technology that they do today. So while I definitely challenged my SVT, daring it to happen participating in sports that required every ounce of whatever I had in me, there was this particular limit that I had that I wouldn't cross.

We've had a few people here in the 4 years that I've been associated with the forum that had failed procedures due to the inability to get their heart to go into SVT.  That is key to finding it.  Unfortunately, the hospital bill is nearly the same as a successful procedure.  So unless you have a very low co-pay, or have money to burn, it['s good to make your procedure count.  Being somewhat of a cynic, I would imagine that an electrophysiologist doesn't think about that when he's encouraging a prospective patient to commit to the procedure.  It's another payday for him regardless of success or failure.
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Avatar universal
That is also another concern for me, what if they can't make SVT happen and fix it the day of?! Mine seems trigger by stress and high HR so I'm hoping the adrenaline they give will set it off. While I'm worried about the procedure, I'm also nervous to do any exercise that requires my HR to get too high. I used to run a lot and haven't been able to this year. I know someone that had that the procedure done but they couldn't get it to go in SVT so they stopped it. Can't do anything if they can't find the area. She was disappointed so she's back on metoprolol at this time. I've read how a lot of ppl feel so much knowing their SVT is fixed afterwards so I understand having to worry about going on trips. Like tom_h said he has a much better life without it. Our situation isn't as severe most so in that case we are lucky. I'm leaning towards getting it done just so I won't have to worry about it getting worse... Still gonna read more about it tho before I make my final decision.
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1423357 tn?1511085442
Michelle and I had it most of our lives.  For me, it was always manageable.  That technique you are using is called a Valsalva.  It was what I used for 54 years until I got it fixed.

Again, speaking from my experience I was back to normal within a month.  My heart was not immediately still.  But it was a lot less than what I was experiencing prior.  Over the next year, the short runs of SVT I was experiencing after the procedure began to diminish.

An electrophysiology procedure while safe does carry some risk.  Again, it is my opinion that 2 episodes per year does not warrant this procedure, especially since you can control it with what you're doing.  Regardless of your decision, best of luck to you!
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Avatar universal
Thanks for your input guys, as far as cost, I was told my insurance is covering the procedure, thank goodness! When I was saying i vagal, I just bare down like I'm trying to have a bowel movement. That usually kicks my SVT back into normal rhythm. I have PACs while working out and that is what usually kicks my SVT in, I'll start feeling them then one hits just right and my HR takes off. I've never had this happen at rest though. Like I said my Dr is concerned it will progress and become unmanageable. I just read how most ppl don't feel normal for about yr which is really discouraging. My main concern is starting a family, I'm sure pregnancy will cause my SVT to become worse. But I being able to workout with out the fear of SVT would be nice to have...
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