Aa
Failed Ablation
Hello and thanks for taking Questions as usual.
Quick recap of my situation: MAle, 30, structuarlly normal heart, occasional PVCs since I was 12. 4 months ago began having PVCs 300~hr. Tried Toprol XL, didn't seem to help any. I scheduled an ablation for 8/9/2004, the doc orders me off Toprol 5 days prior. In those 5 days, my PVCs steadily disappear. By the 9th, I was having none, so I called it off. 4 days later they came back, worse this time. I called to reschedule and thankfully the doc was understanding. A week ago I had an episode of what I believe to be SVT that lasted around 5 minutes, so I was really looking forward to my rescheduled ablation which was yesterday. However, just like last time, 3-4 days ago my PVCs dried up. They spent two and half hours trying to induce and got nothing, they did manage to trigger A-fib which resulted in a short run of SVT, but no PVCs. I have yet to re-consult with the doc as he was gone by the time I was coherent. My questions are as follows:
Is it even worth it to try another ablation? When my PVCs are happening they are very, very frequent and extremely bothersome. But when they are gone it seems they cannot even be drug-induced. Stress, fear, alcohol and caffiene are the four guaranteed triggers of my PVCs, and I don't know how you would recreate those in an EP study. Also, should I be at all concerned with the A-fib and resulting SVT?
Quick recap of my situation: MAle, 30, structuarlly normal heart, occasional PVCs since I was 12. 4 months ago began having PVCs 300~hr. Tried Toprol XL, didn't seem to help any. I scheduled an ablation for 8/9/2004, the doc orders me off Toprol 5 days prior. In those 5 days, my PVCs steadily disappear. By the 9th, I was having none, so I called it off. 4 days later they came back, worse this time. I called to reschedule and thankfully the doc was understanding. A week ago I had an episode of what I believe to be SVT that lasted around 5 minutes, so I was really looking forward to my rescheduled ablation which was yesterday. However, just like last time, 3-4 days ago my PVCs dried up. They spent two and half hours trying to induce and got nothing, they did manage to trigger A-fib which resulted in a short run of SVT, but no PVCs. I have yet to re-consult with the doc as he was gone by the time I was coherent. My questions are as follows:
Is it even worth it to try another ablation? When my PVCs are happening they are very, very frequent and extremely bothersome. But when they are gone it seems they cannot even be drug-induced. Stress, fear, alcohol and caffiene are the four guaranteed triggers of my PVCs, and I don't know how you would recreate those in an EP study. Also, should I be at all concerned with the A-fib and resulting SVT?
MEDICAL PROFESSIONAL
tommy,
Pvcs are very difficult to treat with ablation as you can often have multiple sites that they occur from. They can also be hard to treat as medicines that work in some do not work in others. Most importantly, they can be very difficult for some to live with, but many have dealt with their symptoms through different mechanisms including things like relaxation techniques.
I think unless you truly are completely disbabled by your symptoms, trying alternative mechanisms to deal with them is the best route before attemptng further invasive procedures.
With respect to the other rhythms you expereiced during the procedure, they were related to the manipulation of your heart, and I wouldnt worry about them unless you were to have a recurrence in the future.
good luck
Pvcs are very difficult to treat with ablation as you can often have multiple sites that they occur from. They can also be hard to treat as medicines that work in some do not work in others. Most importantly, they can be very difficult for some to live with, but many have dealt with their symptoms through different mechanisms including things like relaxation techniques.
I think unless you truly are completely disbabled by your symptoms, trying alternative mechanisms to deal with them is the best route before attemptng further invasive procedures.
With respect to the other rhythms you expereiced during the procedure, they were related to the manipulation of your heart, and I wouldnt worry about them unless you were to have a recurrence in the future.
good luck
A related discussion, Ablation for PVC'S? was started.
Good Morning : )
Glad to see you visiting the forum!!
Glad to see you visiting the forum!!
sorry a t popped in
Four years ago, I was diagnosed as having paroxysmal atrial fibrillation. The first medicine that was tried was Cardizem. It didn't help. Then, Atenolol was tried -- successfully. After an initial dose adjustment, I began taking 12.5 mg of Atenolol once a day. This helped for a while. However, the Atenolol began to lose some of its effectiveness. So, I was switched to Rhythmol. I wasn't on it for very long before I began to experience unpleasant side-effects. Chief among them was nausea. So, the doctor switched me back to Atenolol. After about two years on this medicine, it no longer helped. So, I was put on Norpace CR 100 mg. It took a while for it to get up to speed, but it did help the problem. However, it triggered a latent physical problem which is very unpleasant. So, I began to consider having an ablation.
For me, the comments made by others in this Forum have put a-fib into perspective. I hope that you, too, will find them helpful.
NHS
For me, the comments made by others in this Forum have put a-fib into perspective. I hope that you, too, will find them helpful.
NHS
Nice to see you popping back in, we have missed you!
wmac
wmac
Hello folks,
I'm in my 4th year of PVC's and their on the up, I have a question for all you guys with supposed bengign PVC's and are on Anti-arrythmic drugs.
Were\are you guys supervised in Hospital when you started these types of medication, the reason I ask is, I have been offered Propafanone hydrochloride to offer relief for my frequent PVC's (max 30\min so far, average 15\min) But I have reservations about taking them (Anti-arrythmics) because all the medical websites I have seen suggest they should not be used for "benign" PVC's as they are a very toxic class of medicine and the pro arrythmis qualities outweigh the benefits.
I'd be very interested to hear peoples experiences of them re. supressing PVC's.
On another note, i had a stress test a few weeks back - my PVC's are no longer supressed on exercise, which, from what I have learnt doesnt seem too good. Compared to 2 years ago, when my last stress test showed the PVC's were completely supressed. I also got PAC's too, which as I understand it arent as significant.
Regards
Craig
I'm in my 4th year of PVC's and their on the up, I have a question for all you guys with supposed bengign PVC's and are on Anti-arrythmic drugs.
Were\are you guys supervised in Hospital when you started these types of medication, the reason I ask is, I have been offered Propafanone hydrochloride to offer relief for my frequent PVC's (max 30\min so far, average 15\min) But I have reservations about taking them (Anti-arrythmics) because all the medical websites I have seen suggest they should not be used for "benign" PVC's as they are a very toxic class of medicine and the pro arrythmis qualities outweigh the benefits.
I'd be very interested to hear peoples experiences of them re. supressing PVC's.
On another note, i had a stress test a few weeks back - my PVC's are no longer supressed on exercise, which, from what I have learnt doesnt seem too good. Compared to 2 years ago, when my last stress test showed the PVC's were completely supressed. I also got PAC's too, which as I understand it arent as significant.
Regards
Craig
Hi Craig,
I had benign pvcs for many years, but a little over a year ago, they were determined to be the catalyst for a developing cardiomyopathy. That's when I was told I needed to try the antiarrythmics or possible an ablation. I was hospitalized for 2-3 days while the doctors monitored any ectopic activity as a result of the new RX. The doctor said that although they sometimes prescribe the RX without hospitalization, it is a good idea so they can monitor any "activity."
I started with tambacor (flecainide) and was taking 50 mg 2x per day. Medicine worked well, but I had some uncomfortable side effects. I was switched to rhythmol (propafenone) and had fewer side effects. At a follow up appointment I asked the doctor how long I would have to take the propafenone and she said, "forever" unless you want to try an ablation. I didn't realize I would always have to take it, so I opted for the ablation. Had 2 ablations in 2003 and the pvcs are insignificant compared to a year ago.
I assume that your doctor is comfortable prescribing the antiarrythmics and that he/she suspects you will tolerate them well. Let us know what you decide.
BTW, the meds definitely suppressed the pvcs!! It was so nice to walk around with a normal heartbeat.
connie
I had benign pvcs for many years, but a little over a year ago, they were determined to be the catalyst for a developing cardiomyopathy. That's when I was told I needed to try the antiarrythmics or possible an ablation. I was hospitalized for 2-3 days while the doctors monitored any ectopic activity as a result of the new RX. The doctor said that although they sometimes prescribe the RX without hospitalization, it is a good idea so they can monitor any "activity."
I started with tambacor (flecainide) and was taking 50 mg 2x per day. Medicine worked well, but I had some uncomfortable side effects. I was switched to rhythmol (propafenone) and had fewer side effects. At a follow up appointment I asked the doctor how long I would have to take the propafenone and she said, "forever" unless you want to try an ablation. I didn't realize I would always have to take it, so I opted for the ablation. Had 2 ablations in 2003 and the pvcs are insignificant compared to a year ago.
I assume that your doctor is comfortable prescribing the antiarrythmics and that he/she suspects you will tolerate them well. Let us know what you decide.
BTW, the meds definitely suppressed the pvcs!! It was so nice to walk around with a normal heartbeat.
connie
Sorry after all you went through, things didn't work out. I think the CCF doc gave you some good advice though, hopefully they will disappear for years at times. Just checked back in to see if things had worked out for you.
Best wishes.
This year I have been struggling with pvc's, yes good days no palps jumping around. Then boom here they come again, I had a couple of good weeks very few pvc's then this week they came on like gang busters. Uggh, I agree we cannot sit and bed and worry about them, I have been one of those to sit and take my pulse all day long.
I am female and yes its the week of my cycle they do seem to be more prevelant around that time.I also have Hashimoto's thyroid syndrome not on meds for that. It has been helpful to find this site all of your replies make me feel hopeful and to enjoy those pvc free days with gusto.Yes, I have read where keeping well hydrated helps, magnesuim has helped me as well. Any other helpful hints please post. Big hugs to all who have to live with arthymia.
I am female and yes its the week of my cycle they do seem to be more prevelant around that time.I also have Hashimoto's thyroid syndrome not on meds for that. It has been helpful to find this site all of your replies make me feel hopeful and to enjoy those pvc free days with gusto.Yes, I have read where keeping well hydrated helps, magnesuim has helped me as well. Any other helpful hints please post. Big hugs to all who have to live with arthymia.
I to have lived with those cursed PVCs for almost 17 years and for the past 3 or 4 years get thousands per day. i've had all the tests and taken many meds and tried many things to get rid of them. A med I'd taken for 2 years awhile back was flecainide which was very effectve after beta blockers lost effectiveness. But after some problems with the med I went off it and have been for several years. My solution was not to pursue ablation [maybe some day if they can refine it for PVCs or if they start to effect cardiac function} but rather to not let them control my life. My solution involves excercise and activity, avoiding things that trigger them, staying hydrated,eating well and not sitting on the couch or in bed and taking your pulse all day!!!!Believe me you'll have good days and bad and just when you think they are gone they will return but don't let it get you down keep on truckin. It isn't easy but you can do it. Remember as one of the posts said EPs are in business to do procedures and as the doc said PVC ablations are tricky . Remember you are not alone and you can can conquer them! Gaspipe
I am sorry to hear of the distresses PVC's cause. I have them terribly. So I do sympathize with you.
If possible, have your Dr. that does the ablations to agree for you to come in immediately when you start having PVC's so they can pinpoint the origin and hopefully ablate them.
My EP will schedule three days in secession when he schedules for ablating pvc's in case they are not happening the first day, then try the second day and if none hopefully they will be occurring the third day.
Glenn
If possible, have your Dr. that does the ablations to agree for you to come in immediately when you start having PVC's so they can pinpoint the origin and hopefully ablate them.
My EP will schedule three days in secession when he schedules for ablating pvc's in case they are not happening the first day, then try the second day and if none hopefully they will be occurring the third day.
Glenn
Sorry to hear about your problems. I would be concerned about an EP who attempts an ablation for PVC's after only waiting for four months and only trying one drug. Some drugs work for some people and not others. Ablation is SO expensive and does have risks as it's an invasive procedure. Ablation for PVC's isn't even proven yet. In my opinion, and I'm an RN, some of the EP guys are rather quick to suggest ablation. They get more practice that way, and just may help someone. This is why our health care costs are so high folks! I would try one or two or three more drugs if the PVC's are so bothersome, before I would resort to yet another ablation. Also, I would assume that you have eliminated the alcohol and caffeine as they are triggers you can control?
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