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
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!
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