Aa
Ablation question
Hello again. I'm 38, good health. I've had palps. for almost 7 yrs. In July I had a-fib for the first time. It was stopped by a Cardizem drip and I haven't had a-fib since. I had another echo, blood work and Holter monitor. Blood work and echo normal. The Holter shows PAC's and atrial tach. My Dr. thinks the atrial tach. is what triggered the a-fib. I had been taking beta-blockers but they increased my palps and caused my BP to drop too low. so they stopped them.
He sent me to an EP dr. and he said I would be a good candidate for an ablation. He said I could take anti-arrhythmia meds but he didn't recommend them because they may not work and they have a lot of side effects. He said if the PAC's were coming from the same arrhythmia then they would be gone too if I got the ablation. But he said if my heart was quiet the day of the ablation, then they wouldn't be able to find anything.
He said this won't kill me and I can live with it, but he worries that over time everything will get worse and they'll have a hard time keeping me out of a-fib.
I feel like I have no other options but an ablation. He told me all the risks and I have 2 small children so I don't want to take any risks I don't need to. Are there any other options for me? Is it really possible to get rid of the PAC's? I've read how everyone else still has palps after an ablation.
He told me not rush and think about it and call him if I want to schedule. Is there anything else left for me?
Thanks, Sue
He sent me to an EP dr. and he said I would be a good candidate for an ablation. He said I could take anti-arrhythmia meds but he didn't recommend them because they may not work and they have a lot of side effects. He said if the PAC's were coming from the same arrhythmia then they would be gone too if I got the ablation. But he said if my heart was quiet the day of the ablation, then they wouldn't be able to find anything.
He said this won't kill me and I can live with it, but he worries that over time everything will get worse and they'll have a hard time keeping me out of a-fib.
I feel like I have no other options but an ablation. He told me all the risks and I have 2 small children so I don't want to take any risks I don't need to. Are there any other options for me? Is it really possible to get rid of the PAC's? I've read how everyone else still has palps after an ablation.
He told me not rush and think about it and call him if I want to schedule. Is there anything else left for me?
Thanks, Sue
Thanks again Hankstar. I certainly hope that's not the case, but I have an appointment with my caridologist. I'll let you know the outcome. By the way, are you a doctor or in the medical field? You're excellent!
Thank you for the candid and helpful reply.
Your comment about the emergency room cardiologist's diagnosis was eerily familar. A similar thing happened to me, when I had an arrhythmia attack which brought me to a local emergency room, here in California.
Like some others in this forum, I'm prone to "measure" pulse rates. I guess the bottom line is that (as you seem to be saying) part of the problem is overcoming the (I think, natural) tendency to be concerned with (and about) one's arrhythmias and the associated symptoms. I suppose it's because many of us who have them need help in understanding them, dealing with them, and treating them.
NHS
Your comment about the emergency room cardiologist's diagnosis was eerily familar. A similar thing happened to me, when I had an arrhythmia attack which brought me to a local emergency room, here in California.
Like some others in this forum, I'm prone to "measure" pulse rates. I guess the bottom line is that (as you seem to be saying) part of the problem is overcoming the (I think, natural) tendency to be concerned with (and about) one's arrhythmias and the associated symptoms. I suppose it's because many of us who have them need help in understanding them, dealing with them, and treating them.
NHS
Okay, here I am again, I had my heart ablation about six weeks ago. My chest still hurts when I breath in and I'm exhausted constantly. My doctor put me on Toprol-XL which I stopped within days since I felt too weak to continue the drug even though I was on a low dosage (went from 50mg to 25mg) then totally off.
Other than now having atrial tachycardia too, I've been so tied ever since the ablation. I also experience shortness of breath with any type exertion, walking in a food store to just to the car, etc. Is this unusal? Has anyone else experienced exhaustion too? Am I just not giving myself time to heal?
Other than now having atrial tachycardia too, I've been so tied ever since the ablation. I also experience shortness of breath with any type exertion, walking in a food store to just to the car, etc. Is this unusal? Has anyone else experienced exhaustion too? Am I just not giving myself time to heal?
I, like many others on this forum who experience PACs or PVCs, and perhaps other more troubling arrhythmias, was just as prone to go into anxiety mode when first learning of the problem. It was excacerbated by an idiot cardiologist (who I was unlucky enough to be assigned to after an emergency room visit for PAF), who suggested an ablation and pacemaker as a solution. So, of course, being athletic all my life and faced with a possible pacemaker option, my mind rocketed into high anxiety. I was in this frame of mind for about a year, during which I consulted and was examined by three other cardiologists, a thoracic surgeon, a pulmonary specialist and a gastroentorologist, while experiencing four more PAF attacks...(you can see that my feet didn't touch the ground). After all these examinations and after reading the world's literature on the subject of PAF, I was luck enough to be referred to an EP who actually new what was going on (the PC foci thing) and new what to do about it. It took about 6 more months after the ablation to get my mind around the problem...ie, I had become obsessed with measuring my pulse several times a day and could feel every skip and every beat, especially at night.
It occurred to me that if the condition (skips of 0-6/min) was truly benign (which is truly is), then I need to convince myself. The first and most important step was to focus on the one most obvious routine that I could control, and that is, stop taking my pulse. It was that simple. And it was incredibly difficult. However, once I got to the point where I could effectively ignore the compulsion to check up on myself, I had trouble noticing those skips, and I could hardly feel the beat of my heart at night...so, in this way, was was able to overcome the initial anxiety (which was feeding on itself) and settle into a normal life. It did take about a year to completely convince myself to stop fretting. This is indeed the most difficult task you face.
If you check out the books the cardiologists read...you will find that they all strongly suggest that the cardiologist's first action be to calm the patient in order to avoid kicking in the anxiety mode. There's a real good reason for that, as I found out over a period of almost two years. You can tell by the posts of some folks herein, that they may never be able to get around it...take care, and don't fall victim to your own mind.
-Arthur
It occurred to me that if the condition (skips of 0-6/min) was truly benign (which is truly is), then I need to convince myself. The first and most important step was to focus on the one most obvious routine that I could control, and that is, stop taking my pulse. It was that simple. And it was incredibly difficult. However, once I got to the point where I could effectively ignore the compulsion to check up on myself, I had trouble noticing those skips, and I could hardly feel the beat of my heart at night...so, in this way, was was able to overcome the initial anxiety (which was feeding on itself) and settle into a normal life. It did take about a year to completely convince myself to stop fretting. This is indeed the most difficult task you face.
If you check out the books the cardiologists read...you will find that they all strongly suggest that the cardiologist's first action be to calm the patient in order to avoid kicking in the anxiety mode. There's a real good reason for that, as I found out over a period of almost two years. You can tell by the posts of some folks herein, that they may never be able to get around it...take care, and don't fall victim to your own mind.
-Arthur
Thank you again for a quick and informative reply.
As you may have guessed from my messages, I'm concerned that I may still get arrhythmias after the ablation. Hopefully, this won't happen. But if it does, I think I may be told that I must continue taking Norpace. Although it seems to have some postive effect, Norpace is causing a signifcant side effect. Unfortunately, at this point, it seems like the EP isn't willing to try any other med and that Norpace is "the end of the line" for those he's willing to prescribe for me.
However, it looks to me like you found a "med-free" solution that helped your own lingering arrhythmias. In an earlier e-mail, I think you commented that you used to take medicine, and then, after a time, opted for meditation (or perhaps another relaxation technique?) From what I understood you to say, this seemed to work for you. Could you describe the technique(s)you use?
Thanks.
NHS
As you may have guessed from my messages, I'm concerned that I may still get arrhythmias after the ablation. Hopefully, this won't happen. But if it does, I think I may be told that I must continue taking Norpace. Although it seems to have some postive effect, Norpace is causing a signifcant side effect. Unfortunately, at this point, it seems like the EP isn't willing to try any other med and that Norpace is "the end of the line" for those he's willing to prescribe for me.
However, it looks to me like you found a "med-free" solution that helped your own lingering arrhythmias. In an earlier e-mail, I think you commented that you used to take medicine, and then, after a time, opted for meditation (or perhaps another relaxation technique?) From what I understood you to say, this seemed to work for you. Could you describe the technique(s)you use?
Thanks.
NHS
re. runs of PACs
Over the period of 3 years post ablation, I have experienced three such runs. Each lasted 5-10 min and each was precipitated by a change in temperature after exercising (2 from cold drinks and one from a cold shower). These are the result of an abrupt change in autonomic tone caused by the temparature change and likely provided the remaining foci a chance to send their signals into the pacemaker system. These runs were difficult to identify as they were reminiscent of PAF (very chaotic), but within minutes became tachy-like and eventually went away.
The EP who performed the ablation had found that one focus did indeed result in PAF on the table in 1 out of 9 inductions. The focus which caused 8 out of 9 PAFs was ablated. So, I expect that one focus has the capability under specific circumstances to generate enough noise to cause a transient PAF attack.
As this event is fairly extreme and unusual, I consider it a non-entity. Like I stated earlier, technology today may permit the EP to knock out any and all suspect foci, as the approach appears to be centered on electrically isolating a larger area.
-Arthur
Over the period of 3 years post ablation, I have experienced three such runs. Each lasted 5-10 min and each was precipitated by a change in temperature after exercising (2 from cold drinks and one from a cold shower). These are the result of an abrupt change in autonomic tone caused by the temparature change and likely provided the remaining foci a chance to send their signals into the pacemaker system. These runs were difficult to identify as they were reminiscent of PAF (very chaotic), but within minutes became tachy-like and eventually went away.
The EP who performed the ablation had found that one focus did indeed result in PAF on the table in 1 out of 9 inductions. The focus which caused 8 out of 9 PAFs was ablated. So, I expect that one focus has the capability under specific circumstances to generate enough noise to cause a transient PAF attack.
As this event is fairly extreme and unusual, I consider it a non-entity. Like I stated earlier, technology today may permit the EP to knock out any and all suspect foci, as the approach appears to be centered on electrically isolating a larger area.
-Arthur
Thank you, for your kind message. This was my first experience with an e-mail forum. Exchanging thoughts and information this way has been quite an experience for me, so far.
I can see by the messages you've posted that you take a friendly interest in sharing your opinions, etc. with others who are seeking a serious dialog on a subject that's so important to us all.
NHS
I can see by the messages you've posted that you take a friendly interest in sharing your opinions, etc. with others who are seeking a serious dialog on a subject that's so important to us all.
NHS
I apologize for having spoken in error. It was difficult to describe what I read when I arrived at that website -- since it was rather general in nature, although it apparently pertained to Norpace. Apparently, I mischaracterized what was there.
Please understand that I have no desire to pursue anything that even hints of a lawsuit. I was simply trying to find out more information about what seemed to be at that website address.
I didn't mean to offend anyone's sensibilities or to commit a breach of etiquette, and I'm very sorry if this is what happened.
NHS
Please understand that I have no desire to pursue anything that even hints of a lawsuit. I was simply trying to find out more information about what seemed to be at that website address.
I didn't mean to offend anyone's sensibilities or to commit a breach of etiquette, and I'm very sorry if this is what happened.
NHS
re. PACs after ablation...
In my case, I began by taking some meds in an attempt to alleviate the PAC production which seemed to show at a rate of 3-6 per min each and every day (shortly after the ablation). The meds were Toprol XL and Tambocor, in order to make the foci less responsive to adrenaline surges and autonomic nervous system fluctuations. After a couple of months I decided that taking these drugs was not really the answer. I had become somewhat OCD'd on the topic of my pulse and the PACs, which of course constituted a wonderful self-fullfilling circle of anxiety. BTW, this appears to be a common side effect of such arrythmias as is easily seen by the posts herein. As I read more and discussed the topic with specialists, it became evident that everyone has foci and the ease with which the noise from these buggers travels is controlled by the state of your autonomic nervous system...thus with anxiety, the highway is toll-free, and lots more PACs are bound to show up. (It's the reason that the good doctors on this forum occassionally suggest meditative approaches). My heightened awareness of these PACs simply led to more.
I stopped taking the meds. And it took a good year to force myself to stop paying attention to the PAC production. Spot checking since then has revealed an enormously decreased level of PACs (0-1 per min), more than was ever achieved with meds alone. I now can claim to be completely cured with the ablation procedure, since the cure was dependent on knocking out the right focus and taking on the right attitude.
At this point I am 56 years old; I participate actively in competitive sports (soccer), which includes very rigorous and regular physical workouts, at the same level as when I was 30. I am no superman, and I consider myself lucky to have avoided (thus far, knock on wood) any serious injuries. I just wanted to make the point about exercise, since the PAF I had experienced did threaten to take it away. Now I can train and play at the highest level and not worry about triggering an arrhythmia.
I am sure that the ablation will do it's thing...the rest is up to you.
-Arthur
In my case, I began by taking some meds in an attempt to alleviate the PAC production which seemed to show at a rate of 3-6 per min each and every day (shortly after the ablation). The meds were Toprol XL and Tambocor, in order to make the foci less responsive to adrenaline surges and autonomic nervous system fluctuations. After a couple of months I decided that taking these drugs was not really the answer. I had become somewhat OCD'd on the topic of my pulse and the PACs, which of course constituted a wonderful self-fullfilling circle of anxiety. BTW, this appears to be a common side effect of such arrythmias as is easily seen by the posts herein. As I read more and discussed the topic with specialists, it became evident that everyone has foci and the ease with which the noise from these buggers travels is controlled by the state of your autonomic nervous system...thus with anxiety, the highway is toll-free, and lots more PACs are bound to show up. (It's the reason that the good doctors on this forum occassionally suggest meditative approaches). My heightened awareness of these PACs simply led to more.
I stopped taking the meds. And it took a good year to force myself to stop paying attention to the PAC production. Spot checking since then has revealed an enormously decreased level of PACs (0-1 per min), more than was ever achieved with meds alone. I now can claim to be completely cured with the ablation procedure, since the cure was dependent on knocking out the right focus and taking on the right attitude.
At this point I am 56 years old; I participate actively in competitive sports (soccer), which includes very rigorous and regular physical workouts, at the same level as when I was 30. I am no superman, and I consider myself lucky to have avoided (thus far, knock on wood) any serious injuries. I just wanted to make the point about exercise, since the PAF I had experienced did threaten to take it away. Now I can train and play at the highest level and not worry about triggering an arrhythmia.
I am sure that the ablation will do it's thing...the rest is up to you.
-Arthur
Thank you for sharing your thoughts and experiences, and for providing encouragement.
You mentioned that you're now experiencing fewer PACs. Do you ever have sustained "runs" of PACs? If so, could you say how many times a day/week/month/year this happens, how long the "runs" continue, and how this compares with your pre-ablation PACs?
Thanks again.
NHS
You mentioned that you're now experiencing fewer PACs. Do you ever have sustained "runs" of PACs? If so, could you say how many times a day/week/month/year this happens, how long the "runs" continue, and how this compares with your pre-ablation PACs?
Thanks again.
NHS
Thanks once more, for your help.
By the way, I looked up the www address you provided, RE; Norpace. I'd be curious to know more about the details of the legal action that's being taken. I didn't find anything additional on the website, so I did a preliminary search on Google, which didn't yield much more. If you find anything please let me know.
Thanks.
NHS
By the way, I looked up the www address you provided, RE; Norpace. I'd be curious to know more about the details of the legal action that's being taken. I didn't find anything additional on the website, so I did a preliminary search on Google, which didn't yield much more. If you find anything please let me know.
Thanks.
NHS
Thanks so much for the clarification/information, as well as your support.
Arthur, what you said about the likelihood of "new arrhythmias" seems to coincide with what was said by the EP and by the specialist the EP recommended. Do you need to take medicine to control/alleviate the PACs you experience?
Hankstar, what you said about having an ablation (or not)is quite true. One needs to weigh the risks/benefits of one's options and go with the option that seems to be the most promising. I understand from you and from the e-mails posted on this board, that the best plan is to have the ablation performed by the most qualified doctor(s), and to have it done at a facility that's a "center" for such a procedure.
Right now, I'm looking at having it done by two docs (together). They're on staff at UCLA and/or Ceders-Sinai and they seem well qualified. They were recommended by the EP I've been seeing. I looked them up on the AMA website (for qualifications and for disciplinary actions, if any). One of them is included in a "Best Doctors" list.
Both Cedars and UCLA seem to be set up for ablations, because many of them are performed there each year, and because each of these facilities has two "cath labs" -- something which seems to bear this out.
I was hoping to get additional information about other docs/facilities in Southern California from people who have had an ablation and who use this board, but so far I haven't received any replies in this vein.
Unfortunately, I'm not sure how to post an e-mail to Dr.Natale, to ask him for some feedback on this subject.
Meanwhile, hankstar and arthur, I'm looking forward to hearing from you.
NHS
Arthur, what you said about the likelihood of "new arrhythmias" seems to coincide with what was said by the EP and by the specialist the EP recommended. Do you need to take medicine to control/alleviate the PACs you experience?
Hankstar, what you said about having an ablation (or not)is quite true. One needs to weigh the risks/benefits of one's options and go with the option that seems to be the most promising. I understand from you and from the e-mails posted on this board, that the best plan is to have the ablation performed by the most qualified doctor(s), and to have it done at a facility that's a "center" for such a procedure.
Right now, I'm looking at having it done by two docs (together). They're on staff at UCLA and/or Ceders-Sinai and they seem well qualified. They were recommended by the EP I've been seeing. I looked them up on the AMA website (for qualifications and for disciplinary actions, if any). One of them is included in a "Best Doctors" list.
Both Cedars and UCLA seem to be set up for ablations, because many of them are performed there each year, and because each of these facilities has two "cath labs" -- something which seems to bear this out.
I was hoping to get additional information about other docs/facilities in Southern California from people who have had an ablation and who use this board, but so far I haven't received any replies in this vein.
Unfortunately, I'm not sure how to post an e-mail to Dr.Natale, to ask him for some feedback on this subject.
Meanwhile, hankstar and arthur, I'm looking forward to hearing from you.
NHS
Ablations may seem to "cause" a new arrhythmia, only because the original noise (focal signalling) was removed, and now, foci which didn't have a chance to express themselves, can.
Although this sort of thing can occur, my personal feeling is that it's not too common. For example, I have a number of unablated foci, and these seem to confine themselves to producing PACs. I believe the secret is in the EP mapping procedure (during your ablation session) which preceeds the actual ablation, which is designed to locate all active foci. Even after the ablation is performed, the EP should be checking further by attempting to induce further arrhythmia.
As Hankstar has stated, the supraventricular stuff is generally easy to access and ablate, so chances are that things will go ok.
Good luck!
-Arthur
Although this sort of thing can occur, my personal feeling is that it's not too common. For example, I have a number of unablated foci, and these seem to confine themselves to producing PACs. I believe the secret is in the EP mapping procedure (during your ablation session) which preceeds the actual ablation, which is designed to locate all active foci. Even after the ablation is performed, the EP should be checking further by attempting to induce further arrhythmia.
As Hankstar has stated, the supraventricular stuff is generally easy to access and ablate, so chances are that things will go ok.
Good luck!
-Arthur
Thank you for the information about SVT, Norpace, etc.
The SVT was caught on tracings recorded while I was hospitalized in September. I was hooked up to a portable monitor, which, in turn sent data/tracings to a computer terminal at the nurses' desk, 24/7. Someone was always on duty to watch the tracings and evaluate them from time to time, for the doctors.
As I recall, they referred to the SVT tracings as "runs" which lasted several minutes each. Most of them occurred during a single night, while I was asleep or in a semi-waking state. The PACs were also caught in the tracings taken at the hospital, as well as on some of the EKGs that were done in an out-patient setting, in the past.
I did learn about torsade de pointes, before I decided to take Norpace. When I expressed concern about it to the doctor who prescribed it, I understood him to say that, since I'm taking such a low dose (100 mgs twice a day), and since my heart is otherwise "healthy" (no history of heart attacks and no structural problems), the risk of developing torsades is very low. I decided to take the chance because nothing else seemed to be working and no one was recommending an ablation at that time.
All that's changed. The Norpace has kicked up an inner ear problem and I've learned a lot more about ablations than I knew at that time. The down side to ablation (as I see it) is that it may not "cure" my problem and may, in fact, cause "new' arrhthymias. I understand this, from what I've read in teh messages on this board (and elsewhere) and from other sources.
What do you think?
NHS
The SVT was caught on tracings recorded while I was hospitalized in September. I was hooked up to a portable monitor, which, in turn sent data/tracings to a computer terminal at the nurses' desk, 24/7. Someone was always on duty to watch the tracings and evaluate them from time to time, for the doctors.
As I recall, they referred to the SVT tracings as "runs" which lasted several minutes each. Most of them occurred during a single night, while I was asleep or in a semi-waking state. The PACs were also caught in the tracings taken at the hospital, as well as on some of the EKGs that were done in an out-patient setting, in the past.
I did learn about torsade de pointes, before I decided to take Norpace. When I expressed concern about it to the doctor who prescribed it, I understood him to say that, since I'm taking such a low dose (100 mgs twice a day), and since my heart is otherwise "healthy" (no history of heart attacks and no structural problems), the risk of developing torsades is very low. I decided to take the chance because nothing else seemed to be working and no one was recommending an ablation at that time.
All that's changed. The Norpace has kicked up an inner ear problem and I've learned a lot more about ablations than I knew at that time. The down side to ablation (as I see it) is that it may not "cure" my problem and may, in fact, cause "new' arrhthymias. I understand this, from what I've read in teh messages on this board (and elsewhere) and from other sources.
What do you think?
NHS
Hankstar and Arthur --
My husband just reminded me that, after reveiwing the most recent set of echocardiograms, the EP had said I have superventricular tachycardia. As I understand it, this may differ from PAF, but I'm not sure exactly how it does.
Do either of you have any information about this?
Also, I'd like to know if either of you (or anyone else reading these messages) has (or is) taking Norpace or Norpace CR?
As noted in my first message, I've been taking it for about three months. I'm experiencing some side effects and would like to know if anyone else has, too.
Looking forward to replies.
NHS
My husband just reminded me that, after reveiwing the most recent set of echocardiograms, the EP had said I have superventricular tachycardia. As I understand it, this may differ from PAF, but I'm not sure exactly how it does.
Do either of you have any information about this?
Also, I'd like to know if either of you (or anyone else reading these messages) has (or is) taking Norpace or Norpace CR?
As noted in my first message, I've been taking it for about three months. I'm experiencing some side effects and would like to know if anyone else has, too.
Looking forward to replies.
NHS
Thank you both so much for your helpful replies.
Arrhythmia symptoms are indeed distressing and they do interfere with quality of life, if not peace of mind. Like some of the other folks who posted messages, I wear a heart monitor/wrist watch. At times, I've seen my resting heart rate go from its normal 59 to 65 beats a minute to 188. My heart races and I feel as if I'm about to pass out. Although this only lasts for a very short time, it's scary.
If the meds were helping I might not be considering an ablation. But, since they aren't terribly effective, since the episodes are becoming more frequent, and since(as I understand it)the likelihood of having a successful catheter ablation does decrease as time goes by, I've decided to go ahead.
A doctor who was recommended by the EP told me that I have a 25% chance of experiencing post-ablation arrhythmia(s) and that the likelihood that these would be permanent is very low. I understood this person to say that he's been performing ablations since 1989.
Apparently, my echocardiograms indicate that the arryhthmias are all in the upper region of the heart, in an area that isn't near the pulmonary vein(?).
I like the suggestion to ask Dr. Natale for some information about CA docs/facilities. And, again, I thank you for your moral support and help.
NHS
Arrhythmia symptoms are indeed distressing and they do interfere with quality of life, if not peace of mind. Like some of the other folks who posted messages, I wear a heart monitor/wrist watch. At times, I've seen my resting heart rate go from its normal 59 to 65 beats a minute to 188. My heart races and I feel as if I'm about to pass out. Although this only lasts for a very short time, it's scary.
If the meds were helping I might not be considering an ablation. But, since they aren't terribly effective, since the episodes are becoming more frequent, and since(as I understand it)the likelihood of having a successful catheter ablation does decrease as time goes by, I've decided to go ahead.
A doctor who was recommended by the EP told me that I have a 25% chance of experiencing post-ablation arrhythmia(s) and that the likelihood that these would be permanent is very low. I understood this person to say that he's been performing ablations since 1989.
Apparently, my echocardiograms indicate that the arryhthmias are all in the upper region of the heart, in an area that isn't near the pulmonary vein(?).
I like the suggestion to ask Dr. Natale for some information about CA docs/facilities. And, again, I thank you for your moral support and help.
NHS
I have had a successful ablation for PAF. It was carried out about 3 years ago at the Univ of Penn Hospital by Dr. Francis Marchlinksi. At the time, his rf ablation procedure had a 0% complication rate (stenosis, stroke, etc), and he and his group had carried out 50-60 ablations for PAF triggered by PV foci (his group had carried out hundreds of ablations for a variety of arrhythmias). I found him very knowledgable and extremely conservative (thus accounting for the very low complication rate)...for example, in my case, I spent six hours on the table while he put me in PAF about nine times, basically to confirm and re-confirm the location of the offending focus. He ablated only this focus, leaving behind several others which he found caused nothing more than occassional PACs (0-5/min, mostly near 0-1/min). These days, EPs are likely to ablate all suspicious foci, as the technology has advanced to allow this without significantly increasing the complication rate.
I agree with Hankstar that the best place to go is a place that has a huge amount of experience (like the Cleveland Clinic). I am not familiar with what's available in CA, but if you ask Dr. Natale, perhaps he knows of a few large clinics there.
Good luck! PAF is curable (as of a couple of years ago, the cure rate was about 60-70% after the first rf ablation, and 80-90% after the second, if necessary).
-Arthur
I agree with Hankstar that the best place to go is a place that has a huge amount of experience (like the Cleveland Clinic). I am not familiar with what's available in CA, but if you ask Dr. Natale, perhaps he knows of a few large clinics there.
Good luck! PAF is curable (as of a couple of years ago, the cure rate was about 60-70% after the first rf ablation, and 80-90% after the second, if necessary).
-Arthur
Dear Hankstar,
Thank you so much for your prompt response. I see from your comments to me and others, you're very knowledgeable in the medical field.
I feel better knowing that you can relate to my symptoms.
Thanks again for your response and well wishes Hankstar!
Thank you so much for your prompt response. I see from your comments to me and others, you're very knowledgeable in the medical field.
I feel better knowing that you can relate to my symptoms.
Thanks again for your response and well wishes Hankstar!
I had an ablation done four weeks today. I was diagnosed with Supraventricular Tachycardia. I was at a wedding and had an attack. They called 911 and I passed out after 45 minutes and I was shocked. That had to have been one of the worse experiences I've ever medically have had! They normally just inject me with the heart medication to bring my heart back down to normal rhythm, but these guys decided differently since I was passed out and unresponsive. I was admitted, surprisingly since I'm usually always discharged right after the event. But, they founds some abnormalities in my EKG. After all tests were performed, I agreed to have the ablation done. I just turned 50 and felt it's time I put these episodes behind me once and for all.
After the ablation, I felt pretty good the next day. As soon as I got home from the hospital, I started to clean my house and I stressed out my heart by over-extertion. My doctor told me to call 911 and was admitted again for observation. I'm now having atrial tachycardia caused by POTS. Postural Orthostatic Tachycardia Syndrome. My questions are:
Has anyone been diagnosed with this too and how serious do you this diagnosis is?
What was your recovery period after the ablation?
I wasn't given any restrictions or any recovery period. I stayed home from work for three weeks. Any type of exertion seems to stress my heart and beats more rapidly from the atrium. I have been feeling fatique more quickly since the ablation. I can only work part time hours until I can get back to normal routine. My chest has had a burning feeling whenever I breath in. I also hear each and every heart beat every second. Is this normal after the ablation?
I appreciate your comments. THANK YOU EVERYONE!!
After the ablation, I felt pretty good the next day. As soon as I got home from the hospital, I started to clean my house and I stressed out my heart by over-extertion. My doctor told me to call 911 and was admitted again for observation. I'm now having atrial tachycardia caused by POTS. Postural Orthostatic Tachycardia Syndrome. My questions are:
Has anyone been diagnosed with this too and how serious do you this diagnosis is?
What was your recovery period after the ablation?
I wasn't given any restrictions or any recovery period. I stayed home from work for three weeks. Any type of exertion seems to stress my heart and beats more rapidly from the atrium. I have been feeling fatique more quickly since the ablation. I can only work part time hours until I can get back to normal routine. My chest has had a burning feeling whenever I breath in. I also hear each and every heart beat every second. Is this normal after the ablation?
I appreciate your comments. THANK YOU EVERYONE!!
I've been reading with interest the comments on the "success rate" of catheter ablations and on post-ablation problems.
I'm a 60 year old female who has been diagnosed as having paroxysmal atrial fibrillation. The episodes began in the year 2000. Holter monitor results and EKGs indicate that I've had ectopic beats, PACs, and occasional SVT. I tried atenolol (with and then without lanoxin). It helped for about two years. Then, I tried Rhythmol, but only took it for two weeks because of the side effects. I've been taking Norpace CR since September of this year, but it doesn't seem to be helping consistently.
Recently, the EP recommended that I have a catheter ablation. I'm trying to get as much information as possible about the best place(s) to have one done and about the best people to perform one.
I already have the EP's point of view on this. But I think sometimes the best information comes from the people who have had the procedure done on them.
Since I live in Southern California, I'd especially like to hear from anyone who has had a catheter ablation preformed in this geographic area. Please let me know your age, what your diagnosis was, where you had the ablation done, who performed it, and how satisfied you are with the results.
I'd like to schedule the ablation soon. So, I'm eagerly awaiting your replies.
NHS
I'm a 60 year old female who has been diagnosed as having paroxysmal atrial fibrillation. The episodes began in the year 2000. Holter monitor results and EKGs indicate that I've had ectopic beats, PACs, and occasional SVT. I tried atenolol (with and then without lanoxin). It helped for about two years. Then, I tried Rhythmol, but only took it for two weeks because of the side effects. I've been taking Norpace CR since September of this year, but it doesn't seem to be helping consistently.
Recently, the EP recommended that I have a catheter ablation. I'm trying to get as much information as possible about the best place(s) to have one done and about the best people to perform one.
I already have the EP's point of view on this. But I think sometimes the best information comes from the people who have had the procedure done on them.
Since I live in Southern California, I'd especially like to hear from anyone who has had a catheter ablation preformed in this geographic area. Please let me know your age, what your diagnosis was, where you had the ablation done, who performed it, and how satisfied you are with the results.
I'd like to schedule the ablation soon. So, I'm eagerly awaiting your replies.
NHS
Yep, I do believe it is because of the cardiomyopathy that they are being so cautious. After all those years of benign pvcs, it turned out that I was one of the rare ones : )
Hi Hankstar, Yes, they were able to ablate a foci in the RVOT. After the procedure the Dr. told us that she felt 70% confident that she successfully ablated a major foci. So that would fall right in line with what you have read. I am not certain what percentage my pvcs have decreased. I do know that I am multifocal and that it is presumed that I have (had) 2-3 major foci. I also know that on a previous holter I registered around 22000 ventricular ectopics, 3000 couplets, some runs, and very frequent bigeminy. Subsequent report showed frequent activity as well. This last report (mid Oct) showed about 6000 isolated pvcs, and only 54 couplets...marked improvement! The doctors are being extremely cautious and conservative because of cardiomyopathy issues. I've had benign pvcs for many years and have been on beta blockers on/off. Some success initially, but eventually seemed to be more problematic. Since the pvcs were benign, I was able to use BB on an as needed basis, and that worked great.
Last year after an annual checkup, my EF had declined enough to indicate cardiomyopathy. That's a very long story, but the bottom line is that the doctors are confident that the CM was a result of the frequency of pvcs. After 3 months on Tambacor this year, EF improved 10%. Although the antiarrythmics appeared to be effective, I did not like the side effects, and knew I would have to take them forever. I also have MVP/MR and there is a possibility that the valve will need repair in the future. With that in mind, it would be ideal to have no CM and good EF.
I am very fortunate because my doctor is extremely conservative and would not recommend the procedure withou very careful consideration. Although the pvcs are annoying, I have pretty much learned to live with them. Absent the CM issue, my doctor probably would designate them as benign. However, my records have been reviewed by MANY doctos and this seems to be the consensus.
It does take time for the heart to heal. In August,the pvc activity was markedly reduced. About week 6, the activity picked up. Event montitor and holter showed significant enough frequency to warrant further treatment. Otherwise, I face the RX again...UGH!!! Thanks for asking.
Oh, once the first foci was ablated, they did try to identify other foci, but my extra beats settled down. The doctor said the heart settled down immediately after she ablated, what is perceived to be, a major foci....
Last year after an annual checkup, my EF had declined enough to indicate cardiomyopathy. That's a very long story, but the bottom line is that the doctors are confident that the CM was a result of the frequency of pvcs. After 3 months on Tambacor this year, EF improved 10%. Although the antiarrythmics appeared to be effective, I did not like the side effects, and knew I would have to take them forever. I also have MVP/MR and there is a possibility that the valve will need repair in the future. With that in mind, it would be ideal to have no CM and good EF.
I am very fortunate because my doctor is extremely conservative and would not recommend the procedure withou very careful consideration. Although the pvcs are annoying, I have pretty much learned to live with them. Absent the CM issue, my doctor probably would designate them as benign. However, my records have been reviewed by MANY doctos and this seems to be the consensus.
It does take time for the heart to heal. In August,the pvc activity was markedly reduced. About week 6, the activity picked up. Event montitor and holter showed significant enough frequency to warrant further treatment. Otherwise, I face the RX again...UGH!!! Thanks for asking.
Oh, once the first foci was ablated, they did try to identify other foci, but my extra beats settled down. The doctor said the heart settled down immediately after she ablated, what is perceived to be, a major foci....
Hi Hankstar, Yes, they were able to ablate a foci in the RVOT. After the procedure the Dr. told us that she felt 70% confident that she successfully ablated a major foci. So that would fall right in line with what you have read. I am not certain what percentage my pvcs have decreased. I do know that I am multifocal and that it is presumed that I have (had) 2-3 major foci. I also know that on a previous holter I registered around 22000 ventricular ectopics, 3000 couplets, some runs, and very frequent bigeminy. Subsequent report showed frequent activity as well. This last report (mid Oct) showed about 6000 isolated pvcs, and only 54 couplets...marked improvement! The doctors are being extremely cautious and conservative because of cardiomyopathy issues. I've had benign pvcs for many years and have been on beta blockers on/off. Some success initially, but eventually seemed to be more problematic. Since the pvcs were benign, I was able to use BB on an as needed basis, and that worked great.
Last year after an annual checkup, my EF had declined enough to indicate cardiomyopathy. That's a very long story, but the bottom line is that the doctors are confident that the CM was a result of the frequency of pvcs. After 3 months on Tambacor this year, EF improved 10%. Although the antiarrythmics appeared to be effective, I did not like the side effects, and knew I would have to take them forever. I also have MVP/MR and there is a possibility that the valve will need repair in the future. With that in mind, it would be ideal to have no CM and good EF.
I am very fortunate because my doctor is extremely conservative and would not recommend the procedure withou very careful consideration. Although the pvcs are annoying, I have pretty much learned to live with them. Absent the CM issue, my doctor probably would designate them as benign. However, my records have been reviewed by MANY doctos and this seems to be the consensus.
It does take time for the heart to heal. In August,the pvc activity was markedly reduced. About week 6, the activity picked up. Event montitor and holter showed significant enough frequency to warrant further treatment. Otherwise, I face the RX again...UGH!!! Thanks for asking.
Last year after an annual checkup, my EF had declined enough to indicate cardiomyopathy. That's a very long story, but the bottom line is that the doctors are confident that the CM was a result of the frequency of pvcs. After 3 months on Tambacor this year, EF improved 10%. Although the antiarrythmics appeared to be effective, I did not like the side effects, and knew I would have to take them forever. I also have MVP/MR and there is a possibility that the valve will need repair in the future. With that in mind, it would be ideal to have no CM and good EF.
I am very fortunate because my doctor is extremely conservative and would not recommend the procedure withou very careful consideration. Although the pvcs are annoying, I have pretty much learned to live with them. Absent the CM issue, my doctor probably would designate them as benign. However, my records have been reviewed by MANY doctos and this seems to be the consensus.
It does take time for the heart to heal. In August,the pvc activity was markedly reduced. About week 6, the activity picked up. Event montitor and holter showed significant enough frequency to warrant further treatment. Otherwise, I face the RX again...UGH!!! Thanks for asking.
Sue, Count me in on successful ablations (Hi Glassheart-It'sME!)
I had an ablation for frequent pvcs in August and it was considered a success. I am scheduled to go back in November so they can try and ablate another foci as I am multi-focal. The doctors are being conservative and that's OK by me!! I have been on beta blockers and more recently Tambacor and Rythmol, but opted for the ablation rather than the medicine. Good luck...
I had an ablation for frequent pvcs in August and it was considered a success. I am scheduled to go back in November so they can try and ablate another foci as I am multi-focal. The doctors are being conservative and that's OK by me!! I have been on beta blockers and more recently Tambacor and Rythmol, but opted for the ablation rather than the medicine. Good luck...
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