Ablation Procedure

[Cashiers]

Wow finally got one in!  44 female was in good shape until last abaltion, just have not been able to do much, I get all kinds of symtoms worst one dazed and confused feeling, will hit mid sentence with customers.  Very embarassing

I am scheduled to go to Duke (Dr Bahnson) next week for second ablation, 1st  ablation was in April 04 for PSVT, re-entry loop was happening.  Since then have had only one event of psvt end of Sept. but very symtomatic to point of not being able to drive at times, rate all over the place with PACs / PVCs.

Since end of sept event something happened it was really tough one like no other.  So had all tests, monitor reports event and holtor shows definite issues and they want to do another for eptopic atrial tach, each time i stand or use any effort the rate goes up to 150's and stays.  They say they will get the PVCs hopefully too.

My Questions

An EP study is neccessary for each ablation isn't it?

Will the PVCs kick in harder if the tach is ablated and they don't get all PVCs or can one develop more?

In most cases do you give some kind of beta blocker or something else right after procedure besides aspirin?

Are there different cathetors used to ablate diff foci?

1st ablation dr said he couldn't get the PVCs didn't have right cath.  Saw them all over. I have terrible pressure and discomfort in chest to point of not being able to wear a bra for year or so.  

I am a builder and outside and in office.  I'm trying hard to ignore all this discomfort but there are days I just can't do it

Thank you so much for your time
Laura

[axg9504]

Thanks, my situation is not as compelling as yours. Apparently I have paroxysmal Afib and it (as far as I know) happens when I do aerobic exercise for 20 mts or so. I do have missed heartbeats once in a while, it's not really bothersome, when I take my pulse I can see a miss once in every 10 beats or so. And you might be right about nights without sleep, they do seem to correlate the next day with PVC's/PAC's. I have been asked to take Coumadin and I have so far resisted. (VA_TONY and I discussed this here on the forum - I'm doing a second round of event monitoring before I decide). I am in Rock Hill SC and while there are good interventional cardio's here, no EP's. My cardio highly recommends MidCarolina in Charlotte. I'm thinking of going there next year for another opinion when my insurance changes next year. I wish you all the best

[Cashiers]

HI

No I didn't consider either of those clinics, didn't know about them.  Was recommended to see Dr Bock at Charlotte Cariology, so I did.

Had ablation in april, it went well I quess, but was plagued with pvcs and other arrythimias.  After an event monitor for amonth, so much stuff showed up, dr Bock just wanted to medicate me so I asked for a referal to Duke to see Dr Bahnson he is chief of EP and Abation.  Was in er for another svt event and the doc called and got appt sooner.  So next week 2nd ablation.
I just hope pvcs will appear, I was thinking I would stay up allnight maybe drink a little wine so I feel fatiqued some.  They are worst when sleep deprived, don't you guys agree.

I will be in Kannapolis for the recovery time, have house there and daughter. If you are close I can give you a buz let you know.

[Ling]

I had an ablation for SVT, re-entry circuit about 3 1/2 weeks ago.  I am also plagued with  bigeminy or constant pvc's.  The ablation for the svt has thus far been successful, the pvc's are about the same.  They are however more random, where as before I would have bigeminy, mostly always, now I pop in and out of bi, tri, just palps everywhere.  I am supposed to get a holter monitor today or tomorrow for 30 days.  I can say after reading a lot of info and talking to the nurses, that ablating PVC's seems to be hit or miss.  I guess mine was a miss.  I hate to be negative I am still in the healing process, but good lord, these things are everywhere now.  Anyone else experience this post ablation?

Michelle

[axg9504]

I live near Charlotte and have been thinking of going to either Sanger or Mid-Carolina Cardiology for a consult. Wonder if you considered either of these or whether you did and they sent you to Duke.

[va_tony]

Thanks again Connie,

I think it's a very natural tendency to avoid meds because the more varieties you take the greater your chance of a serious side-effect, not to mention the $$$ involved and the inconvenience.  Yet the docs are intent on prescribing more and more.  I basically consider myself healthy for a 62 year old but am already taking 5 drugs daily (cardizem, altace & HCTZ for BP, rythmol and coumadin because of the afib). I'm currently "refusing" zetia for cholesterol control (my total C is about 210 with an HDL in the high 60s).  No doubt, I'll regret that also in a few years.

Thanks for pointing out that one is typically unconscious during the TEE.  That's a relief. I once had upper GI endoscopy (for suspected ulcer)and, other than receiving valium, was awake during the whole procedure.  Not a pleasant experience!

Regards,

Tony

[va_tony]

Wow Dotty,

Of course, you been through a lot and perhaps 27 pills a day is justified. Still, I can see why you would want to reduce the number somewhat.  The costs of some meds are astronomical. I pay an $80 co-pay for 3 months of Rythmol and my medical insurance pays the rest (over $800 more). My mother, 90 and on medicare, pays full cost on her medications and it's a few thousand a year. And she's healthy, considering her age. My wife and I were hoping to do a little traveling when I retire in a few years.  I can see that it's likely to be back and forth to Canada to get cheaper drugs.

Regards,

Tony

[DottyCece]

I have had several TEEs.  Once I was pretty much asleep.  The last one I had, I was given sedation but was really awake through the whole thing..I knew what they were doing.  The hardest part is swallowing the scope...once I did that, it was no big deal.  Having an endotracheal tube is far worse...that is something I can never get use to.

My theory has always been to take the least amount of medications as possible.  They all have side effects and then when they are taken together, who knows for sure how one will respond.  Finances are a huge problem for me.  I take 17 pills in the morning and 10 in the evening.  Everytime I go to the Doctor, I beg to off some and I have been assured that I can begin to withdraw some and see how I do.

[uptowngirl]

Hi.  I do not know about the different size catheters used for ablation on different foci.  
I've only been to Duke once and have heard very good comments on Dr. Bahnson. The individuals in the medical field that we inquired of all directed us to Dr. Bahnson. I did not see him because he has a long appt. wait list. But then again the good Drs. ususally do!!  
I did not need an ablation or EP study since mine was more of a structural problem, (valve) rather than electrical issue. My cardios here are able to treat me just fine, but wanted to refer me over for one visit to cover all bases.

I'll say Duke is not the friendliest place I've been. (It's in kind of what we call the "new south", not real reminisent of the real south!) I felt like it was very sterile, serious, and technical.  Our particular Dr. was not very good. He was very domineering,rude (took cell phone calls in our exam room while we were there) and impersonal.  I couldn't wait to get home.  Now, I DO believe that my experience would have been different had I seen another Dr., but I could not wait 6 months.

Cashiers--I'll contact you on your email address to answer your other questions.

Thanks,
Uptown

[MaryRoe]

I have tried for the past 3 months to logg on here and maybe one of these years I will hit the jack-pot.

I have a question:  What is ablation used for?  I have an area of blockage in the distal LAD that they told me they stented until I found out otherwise.  They said there is no hope to unblock this area as it is too small of a vessel and no by pass either. Does anyone know if abalation would help me.  I am in Houston. The mid LAD was stented for 99% but they left the distal LAD.

Thanks to anyone who can answer this. I have no idea if blood is getting through this area.  EF fraction is around 70%.

[Cashiers]

Yes I am from Cashiers.  PSVT started when I was around 20 yr, I am now 44.  Through the yrs it would happen every few yrs then became more often til last 4 yrs was many times then last yr could feel come on almost weekly or daily. off and on different blockers just don't agree with me.

I first went to charlotte Cardio. Had 1st ablation there seemed to help with the wild svt.  Until end of sept had an event after wearing event monitor for month this showed alot going on many diff arrythmias from all over.  

The doc at charlotte felt it was to much to deal with for him so got referred to Duke and I located chief of ablation services. Dr Bahnson  Been there once and liked him seemed very efficent.  Had many tests next day, echo, stress, blood work.  Had already had Heart cath, new I was clear.  Went home with 48 hr holter which showed alot.  He did put me on prescribed potassium, magnesium, these levels were very below normal.  Checked thyroid (normal).  All in all so far so good with Duke.  I will see him on 13 then 15 is procedure.  

Where in Carolinas do you live you can email ***@****

[Momto3]

Are there different cathetors used to ablate diff foci?


I had albations for pvcs and they used a couple of different sizes.  I know they had to remove one of the catheters because it did not "fit over the aortic arch."  Exchanged it for another...

How do you guys like the EP program at Duke?  I may be looking into their program.  Any suggestions on doctors?

[Momto3]

Uptown,

Thanks for the info on Duke.....Maybe I'll try another facility if the need arises.  

Tony,

No room on the other thread, so I hope you get this...

Reading your response to taking a diuretic made me laugh. Why is it that we fight taking the meds that will help us?  

Hey, it may help you to know that when I had my TEE at the CCF, I didn

[hankstar]

Ablation is radiofrequency waves of heat used to burn a specific foci or focis causing arrhythmias, such as renrty loops or bypass tracts such as AVNRT, AVRT, WPW syndrome , atrial fib and atrial flutter, even some type VTs.

  Unless you have an arrhythmia, an ablation will not help, you apparently have a blockage in your LAD (Left anterior descending artery), they apparently took care of the blockage that could cause significant problems and left the other one alone, if I remember your post correcrtly , some blockages don't require treatment as they don't lead to significant reduction in blood supply to the heart muscle and will cause no damage, they are best left alone.

Plaes NOTE: I am not a medical doctor , this only my understanding of ablation and of the problem you described. Your doctor doctor could provide you with much more accurate information.


Good luck with posting , try between 7 am EST and noon EST., you are on central time, if in Texas, one hour behind, clue, if no questions are posted for that day, just keep hitting the post a question slot about every 2 minutes if you have the patience, usually it takes luck and persistence, the window of opportunity is approximately 5-10 minutes, if no questions are posted when the window is opened , no questions will be posted for that day.

Best wishes and Good luck.

[dquenzer]

I had an ablation 2/2004 for afib, atrial flutter, and pac's at Mayo.

They put me on 50 mg of Atenolol to primarily help with the irritation issue.  Wanted to put in me on an anti-arrythmic drug, but I didn't want to stay in the hospital for 3 more days.

I was also put on coumadin to prevent blod clots developing.

As to catheter size, I really don't know mucha about.  All I know is that they used three catheter openings.  One by each groin and one down my neck.  

So far so good.

[MaryRoe]

Thanks so much Hank,

I got more information from you ( a stranger) than my own docs at a reknowned Medical Center.  I have been worried sick about the residual blockages left in the distal LAD.  Unlike Clinton who aced his tests but had smart enough doctors to go ahead with a Heart Cath, doctors here do not listen to women and their heart complaints.  It was not until I saw a female heart doctor on ABC news in August that I got really mouthy and finally after 3 years of severe chest pains, had a Heart Cath.  By this time, I was 99% blocked in LAD and RCA.   This wonderful female doctor wrote me and said "my mouthiness" saved my life. No, she saved my life.  

Thank again Hank, I will try and post per your instructions. (-:

[hankstar]

Usually when someone first presents with a-fib at the ER, they usually give them a diltiazem(cardizem) drip to restore normal sinus rhythm, it is usually very effective in lone atrial fibrillation, but not as effective when secondary causes are present.

You are very wise after reading this thread to reassess the accuracy and true amount MR you have, slight swelling of the ankles, an enlarged atria  all give suspicions to some degree of heart failure be it only mild, while most echocardiograms are fairly accurate and give a fairly accurate picture of a normal heart structure, sometimes other testing is required, it would perhaps in your case be wise to have the severity of the MR assessed more accurately!!

Happy Holidays and Happy New Year to everyone, I might not be commenting on the forum for quite sometime, not at least for a few weeks.

Take care,
     Hank.

[va_tony]

I appreciate your thoughts about undergoing more accurate tests to assess MVR severity. I have a regularly scheduled appointment with my cardiologist in mid-January and will discuss this with him. Hopefully, he'll agree and prescribe the needed tests. Thanks!!

Happy Holidays and have a great New Year!!

Regards,

Tony

[uptowngirl]

Hi Cashiers,
I'm curious to know at what age you began to have symptoms of the SVT, if you don't mind me asking. I'm also curious to know what you thought of the Cardios at Duke.  I have been there once, and am also a Carolinian!!  Are you from the Cashiers area?
Sincerely,
Uptown

[CCF-M.D.-MJM]

Hello,

Sorry you've had trouble posting, it seems the demand is pretty high.

An EP study is neccessary for each ablation isn't it?

There are different variations to EP studies depending on the target.  For example, if you know someone has atrial flutter, there is no need to try to induce sustained VT.  The methods will vary depending on the target.

Will the PVCs kick in harder if the tach is ablated and they don't get all PVCs or can one develop more?

Good question, but I don't know if such a relationship exists.  There may be some more feed back from other posters later today.

In most cases do you give some kind of beta blocker or something else right after procedure besides aspirin?

Not usually for atrial arrhythmias that we think were succesfully ablated.

Are there different cathetors used to ablate diff foci?

There are many different types (sizes, shapes, etc) of catheters.  Anyone catheter can usually do the job as long as it has the shape to attain good contact with the area of interest.

I hope this next ablation works for you.  Thanks for posting....