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Successful ablation without SVT inducement?
My Cardiologist recently did my ablation for AVNRT and said that the procedure was successful despite him being unable to induce the SVT. He said that he ablated a pathway close to my A/V node. Everything I've read about ablations states that SVT inducement is required in order to determine the abnormal electrical pathway. Can anyone explain how my Cardiologist may have located the problematic pathway? I was drowsy when he spoke with me following the procedure and did not think to ask him. I will ask at my next appointment in a month.
Fellows, thanks again for your support. Yes, the EP is great, definitely the best I've had of three EPs. He is like a motivated detective, working on a challenging case. I've described my SVT symptoms to many doctors, since I was in my 20s, and none ever referred me to a Cardiologist- they all assumed it was related to my RBBB and said it was harmless. It was only after I started using a heart rate monitor during my running and cycling that I realized the prolonged high heart rate, for hours, then I researched for myself on the internet, thought I may have some type of SVT, and referred myself to an EP. I'll update after the next appointment, if my EP explains, in detail, how he located the slow pathway.
Thanks for your explanation and best of luck. Sounds like you have a great EP there.
I didn't mention the PM because my EP said during the year its been implanted it has only paced my heart between 1-2% of the total time and nearly all of that is during sleep, maintaining a minimum HR.
I just met with my EP- he doesn't think my PM is a factor here. He believes the HR, during exercise, will gradually decrease to near my normal levels, over the next 1-2 months. He said it was a very good sign that I've only experienced a total of about 10 PVCs over the last 10 days, none of which preceded an SVT. In reference to finding the slow pathway despite not being able to induce an SVT during my procedure, he said during mapping, since I had AVNRT, the slow pathway is nearly always within a small range in respect to the A/V node. I'll ask for more details about his locating the slow pathway at my regular appointment in 5 weeks. He worked me in today & I didn't want to take too much of his time.
I just met with my EP- he doesn't think my PM is a factor here. He believes the HR, during exercise, will gradually decrease to near my normal levels, over the next 1-2 months. He said it was a very good sign that I've only experienced a total of about 10 PVCs over the last 10 days, none of which preceded an SVT. In reference to finding the slow pathway despite not being able to induce an SVT during my procedure, he said during mapping, since I had AVNRT, the slow pathway is nearly always within a small range in respect to the A/V node. I'll ask for more details about his locating the slow pathway at my regular appointment in 5 weeks. He worked me in today & I didn't want to take too much of his time.
"......I have a pacemaker......"
LOL!.... there's one "small" detail you didn't mention until now. That could be the key to your new rate. Let us know how you make out.
LOL!.... there's one "small" detail you didn't mention until now. That could be the key to your new rate. Let us know how you make out.
I appreciate your support. I decided earlier, since my last post, to contact my Doctor tomorrow and let him know about my higher-than-usual HR, rather than waiting 5 weeks until my next appointment. I have a pacemaker and if they didn't change the settings on it to be compatible with my changed heart, then that may be the reason for the higher heart rate. I'll post again with an update on that issue.
Get a copy of your procedure notes, if your doc has them. On mine they took detailed timing measurements before and after the procedure. You may discover why your heart rate has changed.
That is a really interesting story you have there. Like Tom, I too was under the impression that they had to be able to reproduce this to ablate it. Isuppose that is not necessarily the case though, if they can find the fast and slow pathways...
Thanks for posting, and glad to hear things worked out for you.
That is a really interesting story you have there. Like Tom, I too was under the impression that they had to be able to reproduce this to ablate it. Isuppose that is not necessarily the case though, if they can find the fast and slow pathways...
Thanks for posting, and glad to hear things worked out for you.
Thanks again for the comments and link...valuable info.
I'm becoming more confident than a couple of days ago, that my procedure was successful. I've done my second and third runs, yesterday and today, and have continued not experiencing SVT events. Before the ablation procedure, PVC(s) always preceded my SVT episodes. In three runs, I've only experienced about two brief PVCs per run with no SVTs following. However, my HR, as measured by my Polar HRM, during these slow jogs is approaching 160 bpm, towards the end of the third mile, and averaging about 147 BPM overall. I'm hoping that this higher (10-15 bpm) than usual HR is just indicative of having to recover from my ablation procedure about 10 days ago.
I'm becoming more confident than a couple of days ago, that my procedure was successful. I've done my second and third runs, yesterday and today, and have continued not experiencing SVT events. Before the ablation procedure, PVC(s) always preceded my SVT episodes. In three runs, I've only experienced about two brief PVCs per run with no SVTs following. However, my HR, as measured by my Polar HRM, during these slow jogs is approaching 160 bpm, towards the end of the third mile, and averaging about 147 BPM overall. I'm hoping that this higher (10-15 bpm) than usual HR is just indicative of having to recover from my ablation procedure about 10 days ago.
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"In 90% or more patients, it is possible to produce the supraventricular tachycardia. However if it is not possible to produce the tachycardia, it usually is not possible to treat the patient with catheter ablation. Sometimes there are indirect clues to the type and location of the site to be ablated even if it cannot be produced but this is not always the case. For most supraventricular tachycardias catheter ablation is highly successful with initial success being 90% or more. However, difficulty producing the supraventricular tachycardia prior to the ablation may make it more difficult to tell reliably that the supraventricular tachycardia has been successfully treated..........."
I can also tell you that there have had a number of forum members here who have undergone "failed" electrophysiology procedures where SVT could not be induced and consequently no treatment was actually performed.