I spent much time on this forum since being diagnosed with SVT last year and while thinking about an ablation. Well, just yesterday I had my long awaited ablation and thought I would share my experience in hope it helps anyone else considering it. Here is my experience:
I had an ablation yesterday for SVT/AVNRT. I am in my early fifties, female, otherwise healthy and active. Like many others, I was quite terrified to undergo a procedure where wires are inserted into my heart, having my heart stimulated to go into a rapid rhythm, having my heart tissue burned, and all the unknowns of it being successful or not and what recovery would entail. It took 3 bad SVT attacks over the course of the last year to push me to the decision to have an ablation. Heart medication was not something I wanted - I did not even try it. My SVTs were sudden, exceeding 200-220 bpm, requiring injections of adenosine to reset my out of control heart rate with multiple trips to the ER. I was relieved in a way when they finally caught the rhythm via ECG and diagnosed it to be SVT - negating a prior diagnose by my ex-PCP who brushed it off as me just suffering from anxiety/panic attacks (which I firmly did not believe, and glad I didn't take any of the anti-anxiety and anti-depressant pills the PCP tried to push on me).
Some of the ER doctors and EMTs I encountered along the way suggested I see a "EP doctor" and look into an "ablation" (huh?). Like many others, I am sure, I knew not one person who had undergone this procedure, nor did I know who the "good" EP doctors are in my area (if any). But with research and persistence, I located a highly regarded EP cardiologist not far from me and who was kind enough to arrange contact with prior ablation patients with similar profile as mine with whom I could discuss "what it was like". I was lucky, but only because I asked.
Though I was very nervous about the procedure, I tried not to dwell on it and just looked forward to it being over, holding on to hope that it would take the SVT burden away. After all, it is said to be a possible cure with a high success rate. If I didn't try, then I would never know. I arrived early at the hospital and proceeded directly to the pre-op where I changed in to my ablation attire (standard hospital gown with special shoulder snaps), had my vitals taken, a baseline EKG, and was hooked up with IV gear in my arm. Much to my surprise, I was also treated to a foot massage by the resident hospital masseuse while covered in warmed blankets. For just a moment, I let myself imagine I was at a spa and felt a tiny bit of the stress melt away.
Someone from the "ablation team" came to pre-op to fetch me/bring me back to the cath lab for my procedure. She was going to be the one to give me the sedation during the procedure and explained how that part works: I would be made sleepy for the initial catheter insertion sites in both groin areas (which I would not feel, and sure enough I didn't). I would from time to time be made somewhat conscious during the procedure so my heart would not "get to sleepy" as the aim is to get the heart to beat (pacing) so they can find the problem spot(s). I was a bit apprehensive about being awake, but she assured me that even though I would be aware I would not be anxious. I later found this to be absolutely true.
There were at least 4 people assisting the EP cardiologist during the procedure who helped get me set up in the cath lab. I was covered in "sticky patches" all over so they could get the 3D imaging of my heart and other monitors established. It was cold in the cath lab (as the equipment needs to stay cool) but more heated blankets took the edge off. They informed me how patients need to stay still and keep their arms from moving during the procedure, and to help assure this they put loosely bound wraps around my wrists which was not a problem. Next thing I knew they were starting the sedation, I drifted off, and my procedure began.
I remember asking questions (though I don't recall what I asked), feeling rapid beats a few times, but nothing that scared me. At some point I recall them saying they were nearly done and at this point they made me come out of the sedation more fully so they could stress my heart rate to ensure the spot they ablated was blocking the bad pathway which caused the SVT. I spared no time telling them my heart was beating really fast (as if they did not know) and they said the doctor was doing that - not my heart (which I understood later is a good thing). What seemed only moments later, they said I was done and all went very well. My procedure took less than two hours, but it seemed like only 15 minutes to me. They had to spend some time applying pressure to the sites in the groin to stop bleeding, which I don't recall feeling any pain - just pressure. They took me back to the recovery area where my EP cardiologist explained via a drawing where in my heart he found the bad circuit and ablated it (just one spot) - and it was AVNRT. He was very confident he got it and said I was an easy case.
When I arrived in my recovery room, I recall my heart rate going up a bit - nearly 100 bpm from 65, but it settled down quickly. Recovery took about 5 hours where I was to lay flat without moving my legs or lifting my head. The bed was tilted a bit which made it more comfortable. Having family there, some food/something to drink, a TV, and more warm blankets helped make the recovery phase easy and it felt good to just rest and take a nap. Consider not drinking too much as if you need to use the bathroom you won't be able to get up and thus have to resort to other means. The doctor came by to discharge me and reminded me to rest for a good day or two before resuming most of my normal routine except for exercise which could be resumed in a week. I am feeling fine today except for a few odd squeezy type palpitations and short runs of subtle rapid beats if I move around too much. The doctor said this sort of thing is normal and could go on for a good month as the heart recovers (it is a bit angry right now). The sites where the catheters went in are a bit sore and require some careful attention to not disturb to ensure they heal. But other than that, I am feeling fine.
In hindsight this procedure was NOT a big deal for me considering how anxious beforehand I was. The worse part was the anticipation by far. As far as pain goes, the most painful part was the IV needled stuck in my arm, which was minor discomfort. My SVT problem was not too complex I am told, and only time will tell if I am cured of SVT. But if for some reason I needed to have another ablation, I now know what the procedure is like and would not fear it as I did before. I hope my experience helps reassure anyone facing cardiac ablation for SVT.
Good for you, and an excellent report! The EP doc I went to uses general anesthesia whenever possible, and that's what I got. I remember nothing past scooting onto the table and getting my arms comfy and "propped up". The only thing I wanted to do after the initial hypo of Vallium was sleep.
So expect the groin tobe tender for a few days and to walk with a noticible limp for perhaps a couple of weeks. Also expect some jumpiness from your heart for manymonths to come. It usually takes a while for everything to return to normal. Congratulations on getting your life back!
Thanks tom_h for your reply! I recall reading many of your posts in the last year which have been helpful to me. I hope you are doing well. I am looking forward to getting my life back for sure - but will take it easy for now and not get too worried with the expected jumpiness in my heart as it heals/adjusts. I mainly wanted to reassure others that the procedure itself really is not that bad at all. I was so scared that I cancelled the procedure the first time I scheduled it. Another SVT attack later put me back on the phone to schedule it again, and so glad I did.
Good, and that's exactly what we need here. People naturally come to this site to research the procedure, but also if they encounter a problem after the procedure has been done and are looking for answers. Consequently, the electrophysiology procedure and ablation may appear to be weighted towards failure. The successes may never come to this site. So your story, and others I think help to reassure people that this is a good alternative to drug therapy.
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