pericarditis after ablation for SVT treatment

[jenny197241]

Tylenolsy had an ablation after having SVT for 10 years which was happening frequently and I was unable to vagal myself out of the arrhythmia which led me to the ER twice in one week with needing IV adenosine. I went to see my cardiologists which I see at least every three years for a stress test and Echo.  My last stress test & echo was in December of 2012, the results were normal Ejection fraction 70%. Since I was unable to Vagal myself out and having SVT more frequently he suggested I have an ablation performed. He said it would be easy, an in-n-out procedure and I would never have to deal with SVT again. He said that the ER EKG strips looked as if it was a RIGHT  Sided extra pathway. I had the ablation on 10/10/13. It took along time 7 hours. I ended up with a new diagnosis of WPW and a small heart. The EP Dr had to use my right and left groin, and my right neck vein. He said it was difficult to get to the pathway. During recovery I had chest pain and shortness of breath and periods  palpitations. I had neck,  back, right shoulder and occipital pain. Severe the only tthing that would relieve it was morphine and that would only knock me out. When I was knocked out I did not feel the pain. I had runs of vtach a few times per RN, I stayed in hospital less than 24 hours and the doctor came in and told me I was ready to go home even though I told him about my symptoms. He said my symptoms were  all expected because of the left sided ablation that my heart was probably irritated and I would have all of those symptoms because I had been on a ventilator for 5 hours and on a hard table for seven hours.  He ordered me hydrocodone 5/325mg 1 tab q6h for muscular pain prn.  I went home less than 24 hours after my Ablation, with all these other symptoms,  thinking it was the usual thing after an ablation.  I arrived home at 2 p.m, then slept until 6pm awakening with excruciating occipital , neck, right shoulder  & chest pain.  My husband was very agitated with me because nothing he did was right.  So he called the EP Dr and left a message with his answering service to have the doctor call Us back. the EP doctor called us back and wanted to talk to me. I told him my symptoms and he asked me my vital signs which were 103/43, 59,  36, O2 sats on room air 98%. Temp was 99.9.  He asked me if I had any morphine to take. I told him No. He said then take two Tylenols and don't lay on your back or the back of your head and call me at 0700 in the morning if the symptoms worsen. I did what he told me to do and by 5 a.m. I could not bear it any longer.
my story will continue on the next comment Section.

[tom_h]

Jenny, as you may alraedy know, cardiac catheterization and ablation therapy makes you more prone to pericarditis.  Severe pain in the neck is a classic symptom of pericarditis.  Speaking of your neck, did he tell you why he used your neck as an entry point?  Was it for left side access?  The reason I ask is access to the left side of theheart is generally achieved by a transseptal puncture, literally piercing partition between the atria with the catheter.  I had a left side ablation 3 years ago for a form of SVT similar to yours, except mine conducted in the opposite direction from WPW.  Like you, I had a large hematoma which broke the day after the procedure and drained down my thigh to my knee over a period of two weeks.  This is a common occurance as the patient is often given Heparin which reduces clotting. My hematoma looked like a half an orange just after the procedure.  I limped around a little for about two weeks as tje pain slowly subsided.  Lets assume that your  pericarditis was due to a black cloud that follows you around and not the fault of the physician.  If that's the case, I would't give up on him quite yet.  Sometimes, recovery form pericarditis may take quite some time.

By now, the punctures in your thighs should have completely healed.  How has your heart been since the ablation?  Expect some skips, and short runs of SVT for months.  It takes time.  I hope your curremt condition improves so you can try out your heart HOPEFULLY free of SVT.

[jenny197241]

So I  was d/c'd home on prednisone 40MG X3 DAYS, THEN 30MG X 3DAYS THEN 20mg x3 days then 10mg x3 days, colchicine 0.6mg daily, iron tab every day, nexium one capsule daily , hydrocodone 5/325mg 1tab q6h prn. He did not want me to take indocin because my hgb levels. So on d/ c day all the tests looked better,  but still having sob and cp, both are better then when it all started that lead me back to hospital,  but still there.  I had a 14 day follow up ablation appointment to have ekg and echo performed. He said at d/c date that almost all the symptoms would Be resolved.  He said my ekg would be back to normal without ST elevation and my echo would show no fluid he suspected with the current drug regimen.  I went home and was scheduled to see the doctor in 10 days.  the first couple of days were hard with shortness of breath with minimal exertion just going to the bathroom would cause me to have shortness of breath.I had to take many rest Periods to catch my breath. But it did get better where I could do things and get out of the house but still having chest pain and shortness of breath but not as bad as it was. I had been having diaphoresis so my husband took my temp and it was a 102.4, i. Felt really tired and fatigued with muscular aches,  but symptoms would go away with tylenol,  the temps started 3DAYS after d/c from last hospital stay and normally would not go above 101.0 and again it was manageable with tylenol.  The14 day follow up was here and I went to see the EP Dr.  Told him about my persistent symptoms and my temps. He performed ekg which read NSR.  No ST elevation was on the ekg strip. The echo was also performed by the EP Dr,  it read increased amount of fluid In the pericardium.  I told him I was now on prednisone 20mg for 1 more day.  He increased my prednisone back to the start of d/c date regimen. So back to prednisone 40 mg X 3DAYS THEN 30MG X 3DAYS THEN 20mg x2wks then 10mg x 2 weeks.  He wanted me to go get cbc drawn to check hgb level.  I was ok with this because I wanted to know my WBC count. And my right upper extremity was still tender and I was guarding it with ambulation. He Palpated my Right groin and RUE to see if I had any hematoma but did not feel anything, he never looked at it visibly. But I can say it is getting better because it is now not dark purple but yellowish purple and I can ambulate a little better each day.  The major concern with me and the EP Dr is the fluid build up in my pericardium. He said to see him in a week and we would discuss options of a periocentesis. I told him no way, hopefully the medicine will work.  I do not want anything more invasive done to me. It seems like complications follow me. I went to lab,  to get my cbc count drawn.  The next day the EP Dr called back while i was sleeping , and said my hgb level was 11. 7, didn't say anything about the wbc count.  So I called when the office was opened on Monday and asked what my wbc count was. I was told by the nurse that it was still high at 17,  I reminded her of d/c wbc was 16.  I asked her what is the EP Dr going to do about the wbc count. She said she would have to talk with the EP Dr and would get back with me. She called me at The end of her day saying the EP Dr says it is probably because of the steroids im taking. No need to worry about the wbc count.  He has said at the beginning of this pericarditis episode that it is not bacterial,  but what if he introduced something into my heart through the insertion sites? I don't remember ever getting blood cultures drawn?  I am worried I want to know if there is anything else that can be done that this EP dr is not thought of.? Should I get another opinion from my primary Md,  I don't know if  my primary Md would even step on a cardiologist toes. Should I go see another cardiac Dr ? I don't know if I could wait that long to see another one. My follow up appointment is tomorrow and I am having severe sob,   respirations 42, bp 131/91,  hr 103.  I have not slept since yesterady at 12pm and it is now 2: 50pm. My O2 sats on room air 95% to 98%. If I do need the periocentesis I don't think I want him performing it, because he is the reason I am in this mess,  I believe.  Need some suggestions and a plan of action.  Plz help im desperate!  

[Theresed]

I'm so sorry to hear about your complications, but glad to hear I'm not the only one who had this happen after an SVT ablation. I was in the procedure for 8.5 hours, and afterward developed extreme pain which has been diagnosed as pericarditis. I've been on colchicine and ibuprofen for a month and still have a lot of chest pain, palpitations, and light headedness. I'm curious to find out if you are doing better, and how long it took to improve? Hope you fully recovered soon after this post.

[senga1]

Scary story. I am also dogged by complications. Thanks for the insight.

[jenny197241]

CPericarditherom previous message.
my husband ended up calling the answering service to the EP doctor again. They took the information about my worsening symptoms and told me the doctor would be in touch with me shortly. By 05 :45 AM the doctor had not called us back so the answering service called to check on me and my husband said nevermind we are going to the nearest hospital. I was taken 2 a different hospital then what my Ablation had been performed at. When I got to the hospital,  Me & my husband told them of the procedure I had and the symptoms I was having ( by this time I was having trouble talking and breathing and was in such severe pain I just wanted to be knocked out, it felt like I had been in a car crash and had whiplash or a broken neck). THE heart TEAM immediately performed an e kg which SHOWED I had A significant ST ELEVATION and I was having and ischemic event and Pericarditis.  Troponin was in 20 range, echo showed fluid around pericardium.  V/S were stable except RR in 40's. They had performed a CT Of  the head and neck which showed No damage to my brain or no broken bones.  A CXR was performed and it showed that I had fluid around my Pericardium.  My EP Dr arrived at at the hospital to review the test that were performed, And came in and told me and my husband that I had pericarditis because of the ablation of the left extra electrical pathway. He told us that the heart had been irritated and this was a complication from the ABLATION.  he told my husband that he was going to call and check on me at 7:30 a.m. But his answering service had called and told him that I I was on my way to the hospital. He said that it was not full blown cardiac Tamponade.  He said we had got to it in time. he admitted me too the CV PCU unit for further monitoring and medication. He put me on Salumedrol 40 mg bid iv, colchicine 0.6mg qd, indocin 50mg daily, hydrocodone 5/325mg q6h prn and morphine 2 -4mg q3h.  I was in the hospital for 5 fays and daily got an ekg and echo, and lab draws Troponin, cbc and bmp. Daily the test showed improvement,  less fluid, ST elevation decreasing,  trop decreasing. HGB WAS 6.9 ON 4TH DAY OF hospital stay( 2 months prior to the ablation it was 13, and day of ablation it was 10.6 post op hgb on day of d/ c from ablation stay it was 8.0. ) I forgot to mention my right groin was severely bruised from knee to pubis wrapped around my leg. My RUE was very tender that I guarded it with any movement. I didn't really complain of it because sob and cp were my worries.  So the EP Dr ordered an ultrasound of my right groin site,   the results read  no fistula and no active bleeding. So since my hgb was 6.9 I received 2 units PRBCs.  He said it could be a reason why I had shortness of breath and was very weak. On the day of discharge my hemoglobin was at 10 .3. My wbc count was 18 at admission and it was 16 on d/c day. He did not order me any antibiotics for the high white blood cell count because he said it was a part of Pericarditis.
More of the story to come on next message with some questions: