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246577 tn?1202741376

Ablation vs. Medication

I've had SVT for several years, but ended up in the ER this week and had to be converted.  My doctor has offered the choice of medication or the ablation procedure.  I'm 58, active and don't want to take medicine the rest of my life.  I am going to the Cleveland Clinic for a consultation regarding catheter ablation.  My family is against this.  I've been having an SVT episode about once a month now for 2 years.  I'm always able to convert, until now.  I just want to be rid of it, but I don't want to do anything foolish either.  I'm just confused and would like to hear anyone who also had to make this choice and how it turned out for them.
60 Responses
230125 tn?1193369457
That is a very logical concern.  I trained at the Cleveland Clinic.  I trust them.  They will present you with options and risks and you will be able to make an informed decision.  There may be medications that will can permanantly suppress the arrhythmia--it depends on what type of arrhythmia it is. If it is AVNRT (the most common in your age group), this is usually a very simple and safe procedure.  One episode a month is pretty frequent, especially if you require shocks to get you out of it.  This all comes down to a risks/benefits decision.  After they talk to you about the risks/benefits/alternatives to the procedure, youcan make a more informed decision.  I would tell you the options myself but I cannot do it without knowing what type of SVT it is.

If your arrhythmia is atrial fibrillation, you will need a trial of medications before ablation to be compliant with the current guidelines for atrial fib ablations -- but I think you would know the name of the SVT if it was atrial fib.

I hope this answers your question.  Please let us know what you decide to do and why after you visit the Cleveland Clinic.

Who is your appointment with?

Good luck!
187666 tn?1331176945
I've had 3 ablations to improve my heart arrhythmias. It's not a terrible procedure. They use light sedation to keep you comfortable and there's usually a bit of bruising in the groin afterwards. That's about it. You didn't specify what type of SVT you have - PSVT, atrial flutter or fib? An ablation for a-fib is more complex than the average PSVT like I have. I agree with you that having the ablation sounds much better than taking meds with possible side effects the rest of your life. I'm sure your family is worried about the procedure but it sounds scarier than it really is. For me, the ablation was the way to go. I don't take any meds and my heart, although not perfect, is greatly improved. I'm happy with that.
Avatar universal
I had an ablation for AVNRT about 3 weeks ago.  The procedure itself was not a problem.  I had some slight chest discomfort for a few hours, lying still was probably the worst part it.  My heart rate was in the low 90's for about a week, and with minor exertion it would be 130 which was unexpected.  Resting heart rate is now 60 and I am having minor palpitations frequently.  My EP says this will settle down and he will consider the procedure successful if original symptoms don't return in 6 months.  I think the bottom line is, everyone is different.  If I had a choice, I would try medication first.
110220 tn?1309310461
When you decided to have your ablation, how ofter were you experiencing your AVNRT?  I'm not sure that I want to go that route yet.  I have had two episodes in the last two years.  I have just started taking a beta blocker in hopes that it will take care of the AVNRT.  Did you cardio doc give you any alternatives outside of the ablation?  I read in a a magazine re: SVT, that there is a "pill in the pocket" that would stop SVT....was that shared with you?    

How are you doing now?  Hopefully much better.  Have you ever tried medication, if not why?

Thank you
Avatar universal
Episodes of AVNRT are scary and unpleasant to say the least.  I started having them in my twenties, and have had episodes as often as once a month.  I have found that while I can drink coffee, the combination of caffeine, OTC cold medications containing pseudoephedrine, and major stress increases the odds of AVNRT.  My GP told me that although episodes are annoying and unpleasant, they are not dangerous (yeah, I know this is hard to believe).  I learned to stop them using the valsalva maneuver...not always on the first try, but I never went to the ER.

I decided that at fifty, I would see an EP.  He said AVNRT is the most common cause of tacycardia, and that it was nothing to worry about at my age, but twenty years from now it was likely that an episode would caue fainting spells.  He thought that ablation was the treatment of choice and did not even suggest a trial of medication since ablation often cures AVNRT.  He is welll respected in the medical community and I know other patients have been very pleased with the results of their ablations.  If things settle down, and he says they will, then its a good thing.  

I would definately take a wait and see approach if your episodes are infrequent, especially if a pill in the pocket is an option.  If things get progressively worse, you might reconsider.  It is a relatively safe procedure, but your EP will not know the exact location of the problem until he does the EP study.  
Avatar universal
I'm a 24 year old female who has been diagnosed with RVOT VT with about 25,000 PVC's a day. Over the past year, I tried living with this, but my episodes started becoming more frequent and more intolerable (dizzyness, extreme fatigue, palpitations, chest pain).  For the past few weeks, i have been taking a beta blocker (Sotolol) and so far it's been very effective.  However, i am concerned about the long term side effects of beta blockers and am debating if i should get ablation done.  Has anyone here choosen ablation even when the beta blockers were working? Thanks!
110220 tn?1309310461
First let me say thank you so much for sharing your experiences with me.  This disorder weighs heavy on my mind and it's so nice to talk to people who actually can relate to AVNRT.

When you would have an episode, how fast would your heart rate go and for how long before you could stop it?  Also, what manuver worked best for you?  If this should occur again, I'd like to try to stop it myself, if possible. Boy I just can't imagine experiencing an episode monthly.  I sincerely hope that the ablation works for you.

It is hard to say if the beta blocker is working.  Since I have only had two episodes in the last 21 months, I will have to wait and see.  I am going to visit an EP specialist and ask about the pill in the pocket.  I will keep posting to update and hopefully learn more about your progress as well as others.  Thanks again
Avatar universal
My heart rate was between 160 and 200, maybe higher...but its hard to count when you're in that condition.  During the first episodes, it would stop on its own, just as suddenly as it started.  I read about the valsalva maneuver, and found that by laying on the floor, holding my breath and bearing down, the heart rhythm would convert.  I often had to try it more than once.  The quicker I caught it, the easier it was to stop. I once had an episode that lasted for two days, it converted spontaneously.  My GP said it was nerves (and my husband was in NICU at the time so I believed him).

When I realized this wasn't life threatening, I learned to live with it.  That said, there's something about turning fifty that makes this kind of thing a little more frightening.  You mentioned that you enjoy travelling.  I have never let this keep me from travelling, and never had an episode during a flight.  I admit to a overdoing the cafe con leche in Madrid last year and paying for it...but, it was worth it!  Wait and see, and try not to worry too much.

Thanks for your concern.  I'm pretty optimistic that the ablation will work and all will be well.   I'll check back and see how you're doing!

Avatar universal
I just had an ablation done two days ago and it wasnt that bad...feel free to email me if you want to chat about it!  ***@****
110220 tn?1309310461
Glad to hear that you are doing well.  What made you have the ablation?  Please tell me about your condition and how long you lived with it before having the ablation.  I recently had a second episode with AVNRT after 20 months of freedom and now it has hit me hard.  I'm on beta blockers now, but am giving some thought to ablation.  Like many, I worry about the procedure and results.  Please share...Thank you.
110220 tn?1309310461
I surely understand how one can't count their bpm when experiencing an episode, we can only count so fast....You sharing your experience really helps. I am 51 and very healthy outside of AVNRT.  I will take my beta blocker now and continue to explore my options.  If and when I have another episode, i will try to convert myself.  It hard to keep your head when you have a heart rate of 225, but I did better this last time  then the first time  I experienced an episode.  Thanks you and best wishes!
246577 tn?1202741376
I have my appt. for the Cleveland Clinic this Thursday.  You asked who my appt. was with and they say it's with Dr. Dressing.  I tried looking him up on the CC list of docs and they say there's no such Dr.  This makes me nervous.  He's too new to list??  That's a scary thought for me.  At any rate, I plan on listening to all the information provided and making an informed decision.  Thanks to you and all who have listened.  PG1949
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