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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
MEDICAL PROFESSIONAL
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!
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