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Son scheduled for Ablation procedure
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Son scheduled for Ablation procedure

My son is scheduled to have an ablation procedure to correct his artyhmia.  But I am sort of confused on why the doctor is recommending the procedure.  My son is 15 years old; he has had only two seperate cases of arythmia that sent us to the ER.  The episodes were about 3 weeks apart.  the first case happened out of the blue; one he came up stairs and said "dad my heart is not beating normal".  To make a long story short we spent the night in the ER and the arythmia converted on it's own before day break.  So they sent him home and told us to follow up with a cardiologist.  I forgot to mention my son plays high school football so after he left the ER, the doctor said he was safe to resume all activities, which he did and continued to practice high school football.  No afib at all during football practice.

He sw the cardiologist 2 weeks after leaving the ER; they did the routine test and everything was normal but the cardiologist suggested that my son stop playing football and wear the holt montor for 30 days to be safe all is okay.  So that's what we did and within 1 week of wearing the holt it happened again about the same time in the evening; while running up stairs he felt his heart kick into an arractic beat. This one really scared my son.

So this is the second episode; we saw the cardiologist the very next morning.  He said, "your son is going on medication and no football is allowed unless he get's it fixed.  He was still in afib during the testing that morning; the cardiologist showed us his abormal rythym on the EKG and ekocardiogram.  So we followed his advice and my son started taking the med that same day; within 20 minutes of taking the med his heart returned to a normal rythm.

But here are my questions; we got a second opionion from Emory in Atlanta.  The new cardiologist has recommended my son have the ablation procedure.  However I don't understand why; he has only had 2 events which were 3 weeks apart.  The medication appears to be working just fine.  I asked her could he continue to play sports on the medication; she says that she would not feel comfortbale without additional medication adjustment.  She said the procedure would be best so that he would no longer be on meds and he would feel better.  But my son feels perfectly normal on the little 50mg. pill he takes each day.  He is having no side effects however I realize the meds are really designed for adults and may have consequences for him down the road.

I'm just confused if ablation is the best thing considering he is perfectly fine on the meds and it seems possible for him to continue to follow his dream of going to college and play football.  How do they know that he will ever have it happen again? I just don't want to have this procedure; then we find out that it didn't work or there is some other complication as a result.

Help; confused parent!
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Avatar_m_tn
I'm sorry to hear your son is suffering from afib. The ablation has been recommended because it is curative. Ideally, he would not want to be on medication. Firstly, it doesn't tend to work all that well and secondly, it has side effects.
The episodes have only happened a few times but they will get worse, I can assure you of that. And as they do, quality of life suffers. He will stop playing sports and as a consequence, fitness levels go down potentially cutting a few years from the later end of his lifespan. The condition will become mentally taxing and affect quality of life. And during an ablation procedure, they do an electrophysiology test (shocking different areas of the heart to see if they can induce any other scary arrhythmia) which is good to do so they can largely rule out other problems. My uncle only had one episode of arrhythmia but unfortunately it killed him at 21 years old. Your son almost certainly doesn't have anything serious beyond Afib but wouldn't it be good to have it cured and not have to worry?
The procedure is not especially fun. It's between painful and uncomfortable but well worth it if it fixes you. Talk to your doctor about the potential complications. I suspect they can't make him worse. The complication rate from these procedures is very low, especially if you normalize them by stripping out all the high risk patients that would have had a complication anyway if they did not undergo the procedure.
It is not without cost though, so check with your insurance company about your co pay. Mine was over $100,000 and I was stuck with a $10,000 bill to pay on my own at a very difficult time in my career.
Best of luck,
A
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Avatar_f_tn
Hello there , sorry about  your son's heart problem .  I  sympathize  with him , for  I  used to  suffer  immensely  from  DX Paroxysmal Supraventricular  Tachycardia .
I  had my  first  rapid  heart beat  at the age of 19 . Than for  many  years  these very unpleasant  attacks  seem to  come like  once or  twice a year .
At  the  age  of  43 ( in  2000 ) when  the attacks became  more frequent  and  longer with   heart beat  up  to  260 bpm , I  have  had   " Radiofrequency Ablation .
I live and  work  in  Phoenix  Arizona  , and  I have  it  done  locally  by  dr S. Shridar .
The  whole  procedure  took  about  6 hours , I was semi sleeping  , it  was not painful
but  rather  uncomfortable . After  it  was done  , I  have had to lay flat  for  about  6 hours .
One month  after I went  abroad  to  Egypt  , and  was  able  without any problem  
to get  on  the top  of  Mount Sinai .
I  am  free  from  tachycardia  since , but  currently  under  medical investigation  for
autonomic dysfunction ( my tachycardia was a part of this ) as a result of  Multiple Sclerosis .
Hope this would  help , good  luck  to you  and  your son .
Vanda
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187666_tn?1331176945
A-fib can be dangerous if the episodes last very long. The upper part of the heart is quivering and blood clots can form. That means he would have to be on life long medications to manage the arrhythmia and the clot formation. An ablation could take care of it all if successful.

I've had 3 ablations done (for atrial flutter - a close cousin of a-fib and PSVT). My experiences were pretty mild. I didn't enjoy getting an IV put in but the actual ablation was a fog and what few memories I had immediately after faded away over the next couple days.

Do think about it. Get as much information as you can until you feel comfortable with your decision either way.
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Avatar_f_tn
Sorry to hear you have had some moments of concern with your son. I always find it much more difficult to deal with my child/s health concerns than my own!

As noted by other members, ablations are commonly done these days for all sorts of arrhythmias and can actually cure many, many people. However, research into the long term success rates and complications of this procedure suggests that the type of arrhythmia the patient has, the skill and experience of the person and the facility performing the procedure, and the specific techniques used (there are many types of ablative procedures) are all important variables. I have had arrhythmia and tachycardia (WPW) since I was a child and would have LOVED to have had it ablated at age 15 had it been possible then -- especially with todays techniques and equipment, which have improved so much.

That being said, if it was my son, I would attempt to obtain a second or even third opinion on his condition and recommended treatment and compare the specialists and procedures to see what is the best route for your son to take. Luckily, he is old enough to have some say in this. Did they suggest an immediate ablation because they are concerned about a potentially life threatening critical arrhythmia event? Or because he is an athlete? Or because of something else? Do you have the luxury of putting this off until you can get another opinion? I'm not suggesting there is anything wrong with the first opinion, but the success and safety of these now common procedures is really dependent on the variables listed above. Also, there are some places that specialize in children and while your son is nearly a grown man, as a teenager whose body is still growing, you want to make sure you are getting a qualified specialist who will take that into account. Often they will use cryoablation, rather than RF ablation in children and your son is at the in between point right now. Also, the techniques will vary by doctor training and facility preference (some docs and some facilities only know how to do "one kind" of procedure), so ideally you want to look into a facility and specialist who has training and experience in various techniques so they can choose the best one for your son's individual situation.

Over all, blation, when performed by qualified specialists in experienced facilities on appropriately selected patients have revolutionized the treatment of arrhythmia and dramatically changed lives for the better -- just remember that you and your son have a right and responsibility to understand ALL the WHATs, WHENs and WHYs of this procedure so make sure you have all the information you need to feel comfortable before making your decision to have it done now or try to wait until your son is ready to make the decision all on his own.

Good Luck with this and do keep us posted!
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Avatar_f_tn
Thanks for your response.  I am still not comfortable but this was our second opinion.  The first cardiologist put my son on meds and suggest he could only have this fixed by an ablation procedure.  He would not even give my son a stress test because he said he went into afib while running up the stairs in our home so that was a form of stress test.  The second cardiologist immediatly recommended an ablation, I think primarily so that he would not have to remain on meds the rest of his life.  So here we are...his procedure is scheduled tomorrow at Emory Children's in Atlanta; they're suppose to be one of the best.  However I will have a talk with his doctor prior to the procedure and if she does not make me feel comfortable I am not sure I will proceed with the procedure.  I still have some more questions.
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Avatar_f_tn
One thing that you need to know is that if the electrical tracts that are causing the problem cannot be found because they are not electrically active tomorrow, no matter how hard they try they may not be able to ablate your son. make sure you ask them about that. Many people live out their lives with A-Fib and A-Flutter. The doctors seem to be really pushing this and that makes me question why? Does he have ANY other heart problems that are going on that maybe you are not aware of? I would want someone to explain to me why they are SO adamant about this..
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Avatar_f_tn
My son had the procedure with no complications; thank God! However I am still a little concerned because they could not get him to go into afib; this had to be the longest 6 hours of my life.  The doctors spent the first 3.5 hrs attempting to get him to go into afib, which they were not able to do; not sure if this a postive or not..????  But they were able to detect atrial flutter, which did doctor came out and asked did we want her to fix the atrial flutter; which I don't understand why she felt she need ed to ask us that question.  We are depending on her to make those types of decsions; well we decided to have her ablate the atrial flutter, which she explained could be my son's reason for going into afib.  She said prior to returning to the operating room that if it was her son; she would have it done; so we gave her the go head; so the next 2.5 hours they spent abalting atrial flutter.  She explained it's more challenging to ablate than afib. Did he really need this flutter ablated? he never had any flutters

But here is my question; I've read that afib and atrial flutter can be connected but also they may not be connected so if this is the case; how do we know we are in any better shape now than we were be fore the procedure?  The doctor said that my son can resume football and all activities after resting for 5 days.  

Well, it's been 3 weeks and he has not had any problems; he is longer on meds either however I have not let him return to football until I get some more answers.  He has a follow up next week and I am going to ask the doctor how can his afib be fixed if atrial flutter is independent of afib.  it just does not make sense, I assume she knows what she is doing but I am not yet comfortable.  Part of me wonders if my son needed this procedure in the first place; he only had 2 episodes of afib and she recommends abalation.  We followed her advice; also he never had atrail flutter until they were working on him during the ablation.  I just need more answers before I turn him loose on football. I just seems I should feel more comfortable after this procedure but I am just wondering since they did not find afib if this procedure was needed and is he truly fixed.
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187666_tn?1331176945
Your son probably would not be able to feel the difference between a-flutter and a-fib. It's a matter of rate and uniformity. How can we possibly tell the difference between a rate of 350 or 450 bpm? And some folks with a-fib don't feel much of anything while others are quite affected depending on the ratio of atrial beats to ventricular beats.

I do hope that fixing the a-flutter in your son will help him in the long run. Only time will tell. Don't be discouraged if he has to have another ablation. It's not that unusual. Once they ablate one area, another jumpy area may reveal itself and the cardio will have to go in and zap it as well. So far it sounds like he's doing quite well though. Keep a good thought.
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Avatar_f_tn
Storm, just a quick note to say that A-Flutter is usually the starting point; from there it turns into A-Fib. A-Fib is a much higher rate. I don't understand at all why the doctor came out and asked about ablating your son's tract???? That makes no sense to me at all.
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Avatar_m_tn
Im going thru the same with my 21 year old son. How is yours doing? Any after affects? Was he ever put on a 2 week cardio net monitor to see if he has small A-fibs as he sleeps? Is he on any meds?  My sons a fib was first discovered after a night of binge drinking at college. Thats has stopped but he still goes into it every other month or more just by gagging on a pill, vomiting, or coughing hard. I dont know what to do. His cardiologist is totally against an ablation. He has seen deaths with this routine procedure even at the best known hospital for it. I dont know what to do.
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