Need advice on Svt/Ablation Please!

[emilycaitlin]

Hi there,
I am having an appt with my cardio soon to discuss the toprol xl I have been taking for my svt. Anyone's advice or input would be much appreciated, as the cardio said if this had not improved my svt I would need to go on and have the ablation which he originally recommened 3yrs ago. I declined at that time b/c I was scared of it and thought my svt might improve over time as well.
I was taking nothing and having svt episodes lasting 8-10hrs 2-3x per week with a sustained hr of 180+. Since starting the toprol xl my svt has been more like 3x per week with sustained hr of 150 for only 4hrs. My cardio did double the toprol xl doseage but said if I had no significant improvement I will need to go on and have ablation, which he originally recommended 3yrs ago but I declined. He said he did not even want to try a 2cd med for my svt but go straight to ablation, does this sound reasonable? I would be interested in at least giving a 2cd med a try, such a s Sotalol or Flecanaide, before going to ablation, which I am quite wary of because I have heard so many stories of people having even more problems afterwards.
I am still having a resting hr of 100+ which has not improved since starting the toprol xl, and I am concerned it will cause problems or damage in the long term.
Any suggestions of things I can talk over with the cardio or questions I can ask him are very much appreciated, thanks alot, em.

[arthur]

Ask about the risks of an ablation verses the risks of continued SVT episodes.  I had an ablation for PAF some years ago, and may need to have a second one done later this year.  PAF is a lot less of a problem than SVT (in my opinion).  I chose the ablation because I wanted to continue a lifestyle which included vigorous exercise (exercise induced the PAF episodes).  I knew what the risks were, and I knew what the percentages of complications were at the hands of my EP.  At that time, the risks of an invasive procedure like the catheter driven ablation were on the order of 1-2% (complications do include death).  I don't know what the risks are for SVT, but I'm sure your cardio can quote you some stats.  Some folks prefer avoiding an invasive procedure, and opt to try a variety of anti-arrhythmic drugs.  Some folks can't stand the drugs.  It's a very personal decision, with no clear correct path forward.  The best you can do is act on information at hand.

-Arthur

[kitcurious]

I know of a very little girl who just had an ablation and it went very well. Nothing ( including an anti-arryhthmic drug) is entirely safe.

Your doctor just may be right you know. I wouldn't try to second guess my doc from reading the Internet. It's pretty shallow water. If you don't trust your doc's opinion see another doc.

Might be worth a shot to try and get rid of the problem rather than nurse it along indefinitely...

[CollegeGirl143]

i had ablation for svt, the risks are less than 1% of complications, and success rate over 98%, thats a pretty damn good ratio! Its less than 2% chance of the svt EVER coming back if you have a successful ablation. It sounds much scarier than it is, and is even considered safer than some dental work.. If you have any specific questions i can try and answer them for you from my own experiences. The ablation was the best thing ive ever done for myself.

[anacyde]

I would go with your doctor's recommendation.  Sustained tachycardia can lead to weakening of your heart (cardiomyopathy) and if it were me, I'd prefer to have the ablation done while my heart was still strong, to prevent that damage from happening.  I understand your fears, but clearly your doctor believes that the benefits outweigh the risks or he/she would not recommend ablation.  It seems that, while your Toprol has helped, it hasn't helped enough.

If the ablation is a success, and SVT ablations are often very successful, think of life without this constant irritation.  I'm guessing your only regret afterward will be that you didn't do it sooner ;)

[massage therapy]

hi,
i definitely relate to your fears. if you don't feel entirely confident about the ablation and you're feeling that you'd like to try other meds to see what happens, what i would recommend is getting a second opinion from another cardiologist.
the more information you have, the better. if another cardio has the same suggestion, you will feel more assured is you decide to go for the ablation. whichever happens, ablation has come a very long way since i had mine 15 years ago, and it's a safe, quick and effective procedure.
do your best to relax your mind and try not to think about this so much! i know it's hard to not obsess, but the more relaxed you are, the more confident you'll feel about your decision.
hang in there!

[emilycaitlin]

Hi there,
Thanks so much everyone for your comments and reassurances!
arthur-I hope your 2cd ablation later this year goes smoothly, please let us know how you do.
kitcurious-I know what you mean about the internet and info/I can't seem to break away from the comp but need to do so for sure. This site is great but some places can really make me wonder haha.
collegegirl-I was thinking I had read somewhere in a previous comment of yours that you had had one. I'm glad yours was successful. If I end up scheduling one I may have a few questions for you, thanks very much for your offer to talk with me about it:)
anacyde-yeah, life without the irritation would be great, and I do worry about the effect the constant tach is having, more than I really worry about the svt. I think the ccf dr may have been correct about me having some sort of ist. Hope you are doing ok, nice to speak with you :)
massage therapy-yeah, I'm sort of torn now about wanting a 2cd opinion, the cardio I have is supposed to be one of the best around here and all, and I really don't like all the testing a new cardio would want, you know the monitors and treadmills and all, but on the other hans it would be nice to hear what another doc has to say about this. thanks for your reply too.
Thanks again everybody, take care, em