Fearful of ablation for possible SVT or VT

Question

When I was 15, had ablation for WPW, which unbeknownst to me was the cause behind my crazy fast heart rate during gym class, etc. 10 years later (aged 25), the fast unsettling heart rate revisits ones day while I was emotional/at a funeral/ and bending to pee in the toilet. It's been recurring on ave. once every 2-3 months during exercise since then (for 2 years I'm 27 now) and lasts anywhere from 10 sec.-3 minutes. Been to 3 different cardiologists...first one couldn't "catch" it with a 30 day event monitor and dismissed me totally after a normal echo and stress test. Second cardiologist caught a palpitation on the 30 day monitor but it wasn't the exact fast heart rate that I was most concerned about and he wanted to "wait and see" if the fast heart rate rhythm happened again at which time he would recommend EP study and ablation. My primary care physician got it in his head that the ablation was "incomplete" and finally has sent me to one of his favorite EP doctor. SO, this 3rd doctor (EP doc) has recommended EP study with intent for ablation. He said he thought by looking at my normal ecg and my abnormal palp recording that he suspected either I still have WPW from incomplete ablation, some other SVT or a VT. I came home researched cardiac ablation a little bit more and now have questions...is it possible the past ablation could have caused a VT 10 years later? Is it possible the undergoing another ablation could add to the problem or cause afib down the road in life? Are ablations really as well understood as we think they are or should I cancel my ablation until the irregular rhythms become much more severe and frequent? The EP doctor gave me the impression that although he recommended an EP and ablation, it wasn't completely necessary...

starlite1247 · Answer

Hello My name is Jessica and Im 25yrs old who lives in WNY. Im having an ep study and ablation done in july. If anyone has had this done before, what should I expect during the procedure? What are the side effects after having this done? How long did it take to heal? Is it uncommon for me to be dealing with this at my age? If anyone has anything they would like to comment on this, please respond thank you :o)

LindaTX · Answer

I don't know if you've already gotten the second ablation or not but if I were you I would weigh all the posibilities before you commit to a second and possibly 3rd ablation.  It sounds like you have some time to research the subject and evaluate all the pros and cons.

PikaPika88 · Answer

May be the next visit to the EP, you can ask a question.  Does he expect you'll get A-Fib later on (when?)  My EP was expecting (waiting) for my A-Fib to come.  I'm not sure, would A-Fib result later in the life of an ablation/s?  Or most wpw will end up with A-Fib later in their life?  This is the hidden conclusion in most EP minds but they won't tell the patients.  

The scars after the ablation remain in my curiosity?  A pin point spot of course won't cause any problem but if more than 10 spots in a little heart....  When the heart grows and scars area also widen.  The heart muscle of course will not move as best as the one without scars.  It is what I think of.  Would the EP tell us the truth? 

The EP can tell if the wpw from incomplete ablation by ECG or holter.  Only when the accessory pathway is active when you're on that minutes of ECG or that 24 hours on holter.  If I were you, I'll attend the ER and catch that episode "exact fast heart rate that I was most concerned".  Get a copy of that and see your EP or may be a second opinion if necessary.

I also have wpw syndrome diagnosed at 15.  I had my His bundle ablation when I was 24.  Now I'm still having wpw.  I'm not sure is syndrome or pattern now because all my rhythms are controlled or policed by the pacemaker.  Take care.

Jerry_NJ · Answer

Ablation, like any invasive procedure, has risks.  So, unintended results or complications can result.

This is the reason, to my understanding, that you and you doctor have to decide if the probability of an improvement justifies the risk.

For example, I have permanent atrial fibrillation, but as my symptoms are limited to a reduced physical endurance (then too I am an old person, so that doesn't help either).  I tolerated anticoagulant medication and beta blocker (to control/lower HR) well. This and the fact that studies have shown that longevity is not improved by somehow getting a person with AFib back into normal sinus rhythm leads my doctors to the conclusion that they will not prescribe an ablation attempt to stop my AFib.