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Is it possible to have radio frequency ablation with a mechanical aortic valve ?

I had an AVR in early 2009. All went well with surgery other than nasty keloid scar, an episode of AF in hospital and an episode of SVT or junctional tachycardia 5 weeks after surgery.  Have had annoying PVC's for well over 10 years and in recent years very infrequent 20 to 30 second runs of SVT like symptoms while at rest.  However a few days ago I had a 2 minute episode of SVT like symptoms during excercise. As I'm a very keen bushwalker and do other related activities away from built up areas this episode really threw me.  It is quite scary and puts you into a kind of shock.  You can still walk, however perhaps at half pace. Hypnosis 18 months ago really helped the PVC's enormously together with managing GERD better.  Can you have ablation at all if you have a mechanical valve or is it an absolute no no ? Are there other options to stop continuous arrhythmias when off the beaten track & excercising ?
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Avatar universal
Hi Jerry,

Thanks again for your input. I don't profess to fully understand your condition, however I feel for your plight. It sounds like you have learnt to live with it though. If you are suddenly or slowly deprived of the activities you have enjoyed and need for years it causes great angst.  I suppose some of us are really tested by what our bodies serve up to us in our lifetimes. There is no doubt from a physical experience point of view, panic attacks, vertigo and heart arrhythmias are among the most frightening and 'instantly' debilitating.  I've had them all and don't want to add a few more that I've never suffered from !  In reading this blog and many other similar ones, I can't help being moved by the plight of all suffering heart arrhythmias.  While nearly all these
heart rhythm irregularities are not fatal in the short, medium & long term, non-sufferers for the most part would not have a clue what we go through.  Indeed one becomes completely fed up with living in fear.  I suppose most of us need to be thankful for not having many other more morbid conditions. We have many home grown & imported reality medical shows in Australia, however very little has been shown on heart arrhythmias.  Hopefully this will change. It’s great to be able to share our concerns on a blog like this though.
I hope things improve for you as your condition is obviously more significant than mine. Currently I have no physical restrictions imposed on me other than the fear of last Sunday's 90 seconds of SVT or whatever it was,  I'll report back in due course after my
Cardiologist appointment & pray bushwalking will not become a thing of the past.

I lived in Melbourne for a few years many years ago.  Very nice city but atrocious in winter by most Australian standards.  Jerry, I'll keep an eye out for your comments on this blog.

PS Thanks Tom_h for that comment.
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1423357 tn?1511085442
Nosing around on the web, I've found a number of references to ablation therapy with the presence of mechanical valves.  Wouldn't hurt to look into it further.
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612551 tn?1450022175
COMMUNITY LEADER
I read my response to review what I had said.  First I note my "scar" not "scare" is not very visible :)  Of course there was some "scare" too when my cardiologist told me to talk with a surgeon about the need for heart surgery to repair/replace my mitral valve.

My INR is usually around 2.5, ideal for the objective set my by cardiologist.  I have minimal side effects from warfarin.  I do not bruise easily, but my aging skin is beginning to display "age spots", unrelated to warfarin I believe.  My heart valve was repaired so that has nothing to do with my INR objective.  If the maze had stopped the AFib I believe I'd be completely free of medication for arrhythmia problems.

My level of exercise is limited by at least three factors, the INR is not one of them.  
1)  My AFib even with beta blocker and calcium channel blocker medications drives my resting HR to the mid 80s, and it reduces the efficiency of my heart.  It does not affect my Ejection Fraction, about 60%, which is mostly a function of my ventricles and valves, but the fibrillation makes the loading of the left ventricle less efficient.    These contribute to an elevated HR with exercise.  Walking on the level at a serious stroll (less than 4 mph) gets me into the 130 HR range, and any uphill will bring it up to 140.  At my age that is about the maximum HR.  I no longer jog or even power walk.
2) BB and CCB are noted for the fatigue as a side effect.  I believe I experience that side effect, albeit I may have gotten lazy.
3) My age is taking its toll, even with a reasonable body weight (about 230 pounds at 6' 6" up to the age of 65) and exercise history, the body is getting weaker, and heavier, now about 250 pounts...  I now have some knee problems, I do not think due to past running as the problem didn't come on until just last March when my left knee stopped me in my tracks on a simple exercise walk - doing close to 4 mph on a level road.  

I had one visit to Melbourne on business in about 1995 and had several Australian colleagues and friends at that time - I have lost contact with them over the years.  I also enjoyed a book on Australia by Bill Bryson, I have read several of his great books.  I always though if I didn't live in the USA, Australia would be my pick for a place to live.      

As I had heard years ago:  "growing old aint for sissies" .  "ain't" used as a emphasis for "isn't" in colloquial USA-English.
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Avatar universal
Thanks for your reply.  You may guess I am in fact an Aussie. Bushwalking is mostly walking on formed tracks in our National Parks
with a bit of rock hopping here & there.  And yes, I am on that wretched Warfarin, however my INR level is kept around 2.5.  The maker of my mechanical valve (ONX) state they are investigating if an INR of 2.0 might be sufficient.  Your Afib sounds similar to a friend of mine.  He is amazing the way he copes with it.  For years he gets on his bike or goes for a run to stop the Afib !  Jerry, do you still exercise ?  What intensity ?
Afib was only a 2 hour ordeal 3 days after surgery for me.  Though closely related I believe SVT is different and there are many types of it. You live to learn to live with
single & double PVC’s, however it’s when they cluster together, some sort of continual
atrial based arrhythmia becomes possible or likely.  
My concern is still getting symptoms of this while exercising for the first time.  Even although this rhythm reverted in perhaps 90 seconds, you worry it might happen again in some remote location and it won't revert.  That's why I've been doing some homework on the net about ablation & mechanical heart valves. Annual check up with cardiologist is in 3 weeks so I suppose I can 'drive him up the wall' with my arrhythmia concerns like I usually do.
I think I've been fairly lucky with Warfarin so far. Clotting with minor grazes & cuts is little different to before Warfarin. You do bruise more easily though.  Thanks again Jerry for your input and hope your arrhythmias are not making your life a misery.
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612551 tn?1450022175
COMMUNITY LEADER
My heart atrial fibrillation symptoms showed up at about your current age, mid-50s.  I managed to continue to do hard exercise (running) until the age of 67, when my AFib went permanent and the medications and age took all of my "extra energy".  I had heart surgery at age 67 to repair my Mitral Valve.  My surgery scare is almost invisible now, 5 years later.

To your question, I don't have any factual knowledge, but will offer the opinion that is is possible to have a mechanical valve and an ablation.  An ablation for PVC is, I believe, less invasive than one for AFib.  I had a maze procedure done when I had heart surgery, but it gave only temporary relief form AFib.  I mention this again as I recall discussion with my cardiologist the possible of an ablation if the Maze didn't work.  He said we could consider if necessary.  At that time it was not know if my valve could be repaired, and my option was to go mechanical if the repair could not be effected.

I assume you are on a high dose anticoagulant, INR between 2.5 and 3.5.  I'm sure you know to be extra careful, and while I don't know what "brushwaling" is all about, it sounds alike an activity that should include carrying something to stop bleeding should your activity cause any serious abrasions of you skin.

Good luck.
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