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2109196 tn?1334186552

54 year old man with SVT being caused by A-Fib

I am 54 and Kaiser doctors say I need an ablation for multiple 240 BPM SVT but I am terrified because the EP specialist at Kaiser doesn't believe my 2 documented reports of A-Fib from 1982 and 2001 because he said he "must see the actual strips" and anyone could say I had a-fib in a report. When they pump that adrenalin into my heart, I fear it will stop. I had SCA in 1973 at age 16 when having my wisdom teeth out. 20 seconds then it started on it's own, dentist did some CPR. If this Kaiser EP doctor starts the procedure and I go into A-fib, I fear he will say the SVT is a result of the A-fib, which I know it is. SVT episodes started a few weeks after AiFib episodes in 1982 and 2001. Kaiser won't pay for me to go elsewhere. I need help with this cursed SVT at least 5x a month especially after exercise, any info for me?
27 Responses
612551 tn?1450025775
COMMUNITY LEADER
I can't say I fully understand your post, so my input may be off the mark.

I suffer from permanent AFib and my EP and Cardiologist (both in the same association, but not a private hospital) say the risk/benefit of an ablation says the risk is too high, so no ablation.  I am not trying to scare you, my benefit factor is part of the problem.  For reasons you may understand reading my profile, the probability of an ablation working on me isn't good, so any risk may be too much.  Said another way, I am able to maintain a reasonable heart rate, with some irregularity, with the help of beta blockers, and calcium channel blockers.  I take warfarin to lower my associated risk of clot formation/stroke.  That is I am on "rate control and anticoagulant" and I tolerate these medications well.  So, no ablation.

I would be willing to take the risk (low, I don't have number, ask your doctors) associated with an ablation if the doctors believe they have better than a 75% chance of success.  If you read my profile (I think it is in there) you'll see I underwent a mini maze procedure when I had a heart valve repaired and that didn't stop the AFib. My AFib is rock solid.

So, if you are able to live a reasonable life style using medications, discuss with you doctor just going forward that way.  Again, if the estimate is 75% or higher that an ablation will cure the problem, I'd say go for it.
1423357 tn?1511089042
I had mine done at 59 after nearly a lifetime of SVT which towards the end was occuring 3-5 times per month.  For me, the few drugs that I tried were totally ineffective in lowering the number of episoides I was experiencing.  My doctor was becoming concerned with the number of events, and the high rate I would experience while having one.  So I had my EP study and was successfully cured.

The thing to remember is when you're in the cath lab, you have everyone there that you'd want in case of an emergency.

No doubt you'll have an opportunity to speak with the electrophysiologist prior to the procedure.  Speak to him about your concerns, and perhaps that will set your mind at ease.  SVT is a curse, and it was a relief to get rid of it after 54 years.
2109196 tn?1334186552
Thank-you for your reply, Jerry. I took Flecainide for 6 days and had to stop it. No SVT, but I lost 17 pounds in 1 week and had 2 ER visits with squeezing chest pain. I took 100 mg of Flecainide 2x daily with 25 mg of Atenolol (which I've taken every day since 1988 when I nearly passed out from a terrible SVT event over 165 BPM, extreme tunnel vision). I also took 2 mg of Ativan. Here is what Flecainide did. I take it, get dizzy about 30 minutes, am okay for about 7 hours, then SQUEEZING chest pain and SOB for the next 5 hours before the next dose. Vivid, horrible nightmares. I then tried Sotalol 60mg 2x daily which I only dosed 3 times. Dry-heave vomiting, anxiety, when I ate I'd go up to 150 bpm. Now I'm just taking Atenolol 75 MG a day and 4 mg Ativan to relax. Can't work and can't exercise.

If they start the ablation for SVT and see I have A-fib, then what? An A-fib ablation right there with only 28% rate or an SVT ablation first and then A-fib later? Kaiser doctors just shrug. This SVT is debilitating, I haven't worked for over 2 months, but if it gets worse after the ablation then life isn't worth living, can't go anywhere or do anything! Thank-you to you both, appreciate any advice/suggestions.
Avatar universal
I had an episode of afib after having svt for many, many years.  My doctor felt like there was a very good chance that the afib was triggered by the svt.  He recommended an ablation for the svt in hopes that would eliminate all of the svt episodes I was having, along with stopping future afib episodes.  Before having the ablation, I asked him if he could check for afib while doing the svt ablation and just take care of that at the same time.  He said no, that the triggers were in two different areas and that he would only be looking for/working on the sites that trigger the svt.  He said the svt ablations were much less risky and statistically much more successful.  That's not to say that he would never do an ablation for afib, cause he does them all the time, but that was not something that would be done at the same time as an svt ablation.

I went ahead and had the svt ablation and it was a success.  As scared as I was going into it, it really wasn't bad at all and I would do it again in an instant to be rid of the svt.  

It sounds from your post like maybe your doctor isn't very easy to talk to.  Is there a chance you could go to another doctor??  He should be giving you more information than just a shrug when you ask him questions.
2109196 tn?1334186552
Thank-you for that reply, Annie. I am most definitely thinking of seeing another EP doctor at Kaiser. This fellow didn't believe I had A-fib on 2 5-hour occasions before, didn't believe my "Oregon Scientific" heart monitor watch was accurate, (It is, I check it with ER monitors and it is right on) and he didn't believe I had a 265 BPM episode in 1988 when I was just on Verapamil and still stayed conscious, even though I told him I could barely see through my tunnel vision. And yet, this doctor's reviews are almost all positive! Maybe those are just the ones he posts?

It is hopeful to me that since most people have successful SVT ablations that mine will be. Most sites I've been on say they are 98% successful, while Afib ablations are only 28% successful.

My A-fib episodes happen like this: 2 violent PVCs in a row with no beat inbetween, then SVT, then A-fib for about 5 hours which usually corrects with a bowel movement. That is how I've escaped the 200+ SVT episodes in the past 29 years (since 1983!) by holding my breath and bearing down. But on 1-30-12 I had an SVT episode that I couldn't valsalva out of.
Avatar universal
My afib episode also occurred as I converted out of an svt episode.  It lasted for 12 hours and finally stopped with IV  medicine given to me in the hospital.  My ep said that sometimes svt can cause afib, with your heart converting out of svt and into afib.  That's when I knew it was time to get the svt taken care of asap!  Sounds like you are at that point too, especially if you couldn't get your svt to stop in January.  Good luck!
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