update...need advice

i had told you a few weeks ago about my nephew who was 40 and had ablation on his heart because the rate goes over 250 and each time he has to go to e r /.the thing thats rare is its on the bottom of his heart. the first ablation didnt work and they discussed sending him to university of alabama.....heres the thing,,he went back to day after 2 months since first ablation.the doctor said his heart hasnt healed completely {they did no test today} and that in dec they will wean him off the medicine hes on and in jan. go in again a see IF  they feel they feel confident enough to do the 2nd ablation   if they feel they will have to burn more of the heart than they are comfortable with,they will send him on to alabama.    heres my questions: i thought i remembered the doc saying they could redo ablation after 2 months  ?  how long is the normal wait til the 2nd one?? } it dont make sense to go in his heart unless they are SURE  they can do it....seems like to me if they werent sure they could do it,they should just say you go on to alabama and that way he only goes thur one heart surgery ..instead of possibly 2...does anyone have any suggestions to know how long it takes for the heart to heal after the ablation? ..\

[jennyfi1234]

I am sure someone with knowledge will reply soon, but I just wanted to say---if they are willing to do something they are NOT comfortable with, I would NOT have them do anything! No one will care about the effects of this risk as much as your nephew. If any harm is done, he will live with it daily, while others will go on about their lives. I hope he goes elsewhere.

[cindy707]

Your doc sounds like a pretty good doc telling you that it takes up to the six month mark to heal because they are very very right.  Usually after the four month mark things really settle down...if your nephew is just eight weeks out of the ablation yep its too soon to know..you have to remember that his heart was poked, prodded, penetrated and then unfortunately burned and i personally think they would be totally derilect in their duties if anyone even attempted to ablate this soon after the original ablation.  I had mine done four years ago...i definately had a couple of runs where my heart rate zoomed over the 300 mark after the procedure...the heart is a funny thing Barbara ...it has to re teach itself to go back into the normal electrical firing pattern that its supposed to and now it is trying to go back the wrong way...there may also be issues involved because you said that the doc "burned" the areas...there are many many reasons why docs prefer to either use cryo or freezing or RF radio frequency waves. When the heart is burned scar tissue builds up and its an up hill battle to try to get back into the correct firing pattern because there are now little hills and valleys and uneven areas the electrical has to go up  around and over where with the other two methods there is none of this going on because the surface of the heart stays flat and smooth.  I would definately talk to the doc and ask them if there is a possiblity if your nephew does indeed need another procedure that they use one of the other ways of ablating because the success rates are alot higher.  So no...its not smart at all to attack w. a 2nd ablation until the six month mark has passed and everything has calmed down...basically it takes a full four to six months to know if the procedure is a fail or not......and listen to Jenny she had some good advice for you ....all in all in the first 4 months after my ablation i had i think 3 different incidences where during one of those i had to be converted...its a no brainer...iv line and an additive to calm my heart down and convert it back the ways its supposed to be...you are dealing w. something different tho where the recovery may be a little more difficult because your nephew was cauterized or burned...the recovery is the same but the burning makes it a little more difficult for recovery...good luck to you and your nephew...you are a great aunt to care so much....

[barbara6]

thanks so much jenny and cindy...that relieves me alot knowing its normally longer then 2 months..  I said burned because i guess thats what i thought ablation was..also the doctor described the procedure as mmaking scar tissue  big enough so the heart skips over the part that short circuits   and they told him since he has had 2 episodes since the ablation that meant it wasnt successful...now hes not good about asking questions and wont let anyone go with him...said made him look like a big baby...some men just has too much pride,,,,id be crying for my mama!   also  you seem to know alot about this so  im wondering if you know anything about the difference if its at the top of the heart or when at the bottom...they told us its very rare at the bottom{where his is} and  its   more      harder to get to....ii love my nephew very much and worry so much about him but my sister{his mom is worrying herself sick not knowing when she will get a call hes in the e.r. shes lost 20 lb and looks dreadful.. so if i can help her understand the procedure and give her hope it could still work maybe she could rest a little...  thanks again

[jennyfi1234]

Well I will pass this question to Cindy who has a really good understanding of this procedure as she has been there herself and also I (THINK) she may work as a nurse or something---I may be wrong--but either way--she has been a tremendous help to me--- I am sure she will get back to you asap. Jenny

[bypeep]

Barbara,

There's another recent thread discussing ventricular ablation.  If you scroll through the messages on the first couple of pages on the board, you're sure to find it.  It's a person who has been diagnosed with v-tach coming from the bottom of the heart, where it's more dangerous and difficult to ablate.  Maybe you could message her or at least read her posts. I'll see if I can find it and link in a follow-up response.

[bypeep]

The thread is named "PVC in RV Apex" - may not be identical problem, but deals with ablating the ventricles in the less optimal areas.

[Mom2four85]

for any who want to see; here's the picture I was talking about in the other thread - it's a bit confusing when you think RV Apex because I wanted to associate it with the rvot or right ventricular outflow tract by the HiS bundle (hopefully I get this right)

the rv apex is actually at the bottom of the heart and is a very thin difficult place to ablate becuse the tools they normally use aren't flexible so they can't get in that crevice or v at the bottom of the ventricle

it's the RVA here: http://www.medhelp.org/user_photos/show/165880?personal_page_id=610106 - or check my profile pictures, it's listed there

also, if there is any type of "thickening, swelling, inflammation" etc such as with hypertrophy it makes it even more difficult to reach the site

barbara, I would encourage your nephew to get a copy of the procedure notes to for his records - check to see if it shows in the report the RV Apex