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Alcohol septal ablation for PVC's??

After 2 failed ablations for tachycardia and frequent pvcs (>50,000/day), my EP has suggested trying what I'm assuming is called an alcohol septal ablation. He told me that they would inject a contrast dye into my arteries around my heart, and then inject an alcohol solution into my heart tissue to induce a small controlled heart attack. This would damage that area of the heart and hopefully eliminate the pvc's. I haven't been able to find much information on this type of ablation being used for arrhythmias. Any feedback or personal experience with this procedure would be appreciated! Thanks so much.  
5 Responses
1807132 tn?1318747197
I have not heard of the procedure and it sounds a bit drastic to me but I am not myself dealing with the extremely heavy load of pvcs that you are having.  So what were the other 2 ablations for?  Where did they ablate, the same spot he wants to kill off?  Were you pvc free for a time and then they come back?  Are they worse or better or the same from each of the previous ablations?  Have you heard of the ablation where they work on the outside of the heart?  I am sorry I don't know more info about it but have heard of that being tried as well.  This is a very big decision you have to make and considering you are not finding much online about it makes it sound to me to be so new as to be almost experimental.  I would really question your EP on what it is all about and how many of these they have done and what the results were. What are the possible complications, worse case scenario, would you need a pacemaker or ICD even?  Killing off part of the heart seems like a very big deal to me and I would really want to know what risks I am putting myself in.   I would then spend a lot of time listening to your gut.  Think of the two options, doing it and not doing it and try to gauge which option gives you more of a sense of peace.  Even if both are a bit unsettling one may stand out as being just a bit less unsettling so just do your best to center your self and allow the options and your gut to guide you and you can't go wrong.  There is a lot to consider here so just take your time and make an informed decision on what the best option for your quality of life is.  I wish you the best of luck whatever you decide to do.  Please keep us informed.
Avatar universal
     My first ablation was supposed to be a simple procedure (>95% success rate).My pvcs were believed to be coming from within the right ventricle. When the doctor got in, he discovered the area was on the outside of my heart, and very close to a main artery. He referred me to a better equipped hospital, and the 2nd ablation was attempted. This doctor was going to do a surgical approach, and go in through a small incision under my ribcage, and attempt to ablate the area near the artery from the outside. But while he was doing some mapping, he discovered an area in my right ventricle, and ablated there. It seemed to eliminate my pvcs, so he didn't even attempt the surgical approach. but when I woke up they came back full force. I've since been on flecainide, and then propafenone. The flecainide controlled my pvc's, but the side effects were too harsh, and when they tried to lower my dosage, the pvc's came back. Propafenone did not work at all.
     From what my EP told me, the risk of them causing a small heart attack by ablating near the artery is moderate. (which is why they were considering trying the alcohol ablation, it would be a controlled heart attack). The risk of causing a massive heart attack is small. 1 in 200. I'm not sure if the alcohol kills a portion of the heart, or if it simply leaves scar tissue, much like a catheter ablation would. My quality of life has drastically changed in the past year and a half. I'm no longer able to exercise, and I've gained over 30 lbs (I was in great shape prior to all of these issues). I also stay tired and short of breath 24/7. Although my ejection fraction is still in the lower limits of normal at 55%, my doctor says the frequent pvc's can cause the SOB. I definitely want to do something about it, but I still hate going into a surgery that I can find so little information about. Thank you for getting back to me.
1807132 tn?1318747197
So it looks like the choices are to go outside and risk a massive heart attack or just do a controlled heart attack from the start.  I have to assume the spot they would try to kill off would be as small as possible.  I would definitely ask about the scarring and what it is they hope to achieve structure wise.  As well what possible complications or new issues could arise like what are the chances of this creating a situation where you would be in sustained VT.  As well how many of these types of procedures has the EP done and what have the results been.  I can completely understand you wanting to try anything to get your quality of life back.  I wish you the very best of luck with all of it.  
Avatar universal
hi im ellie and have the same problem.  I was wondering how many pvcs do you have a day when you are on a heart monitor.  I have 28,000 or more and I had a heart ablation and it did not work.  Im thinking about having another one but changing doctors.  maybe Cleveland heart hospital?  did you have your 3rd procedure yet and did it work?  thanks
Avatar universal
Ellie, My most recent holter monitor done a couple of weeks ago showed about 50,000 pvcs. I don't know the exact number,  but my doctor said they accounted for 47% of my total heart beats. I have not had my 3rd procedure yet, they are scheduling it sometime next month. I'm being seen at UVA health center right now, but if my next ablation doesn't work, I want to try Duke or maybe Jonn Hopkins if I can get a referral. Do you have any other issues with your heart other than the pvcs?
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