PVC ablation coming up...any advice or real experiences?

[tronious]

Hi everyone,

First time caller long time listener.  I've suffered with these for quite some time.  I say suffered because those of you who have PVCs and other rhythm problems know what I mean.  Those WITHOUT rhythm problems usually dont get it...especially the mental toll it takes.

I played basketball in college, workout A LOT.  Love fitness.

I'm a musician also.. look me up on YouTube :) Search for "tronious"

I have RVOT pvcs apparently...although my EP said theres a possibility they are EPIcardial meaning they're coming from the outside of my heart.  If that's the case it's unlikely he will try to ablate them.

Essentially I have had every test known to man.  Multiple EKGs, stress test, nuclear stress test, stress echo, regular echo, cardiac MRI, lots of blood work.

Always told "your heart is great".  On my good days I'll feel about 200 of these suckers a day.  Bad days are thousands for sure.

Holter showed 7 beat run of NSVT so I decided to take things in my own hands and find a good EP doc.

I found a gentleman named Amit Thosani with AGH hospital in Pgh.

I told him.."look...I need you to fix me.  Atenolol sucks.  It works from time to time.  Mag doesnt do much, Potassium doesnt do much.  I need something to fix me.  I'm 43...I have two kids 6 and 4.  I am very physically active and love to workout.  These things are killing me"

Those of you with them will relate.  When I know we have to go on vacation or anywhere...in my mind I'm thinking #@!1 hope my heart doesnt act up.  I dont say "sweet cant wait to have fun" I just want to make it through.

I told him that with no question in my mind, my stomach and digestion is related to my issues.  For once, a dr. didnt look at me like I was crazy.  In fact he said...absolutely that can happen.

I asked him how he could fix me...and out the gate he said "let's do an ablation.  He said it might not worm but I've done a lot and have had a lot of success.  It really comes down to where it is located and of it is safe to ablate.

I spoke to a couple others who said he is an awesome EP and one of the top around.

I feel confident in his abilities. I am not scared.  I'm a bit anxious but not scared.

With that can anyone offer me their experience with going through this?

My questions specifically:

1.  Were you awake??  I believe I will be awake.  Im ok with this...just want to know if this is typical for others.

2.  Do you feel them a late?  I can handle the pain if so...I'm just curious.

3.  Would you do it again?

4.  Was it a success?  If not why did your dr say it was not.

5.  Are you still on meds?

6.  Can you describe the procedure start to finish?

LASTLY - I GIVE MY WORD that I will come back to this site and neither update this thread or create a new one heavily detailing my experience so others can read about it.

[nanoart]

No pain, usually under general anaestetic. if EP is good - go for it! The main point you need to have (plenty) of PVC during procedure - bail out if there are none going into ablation. Only after 2-3-6 months you will know the true results, you may be cured instantly too. Good luck! I am now 15k a day after 2nd ablation, that did something but seem so far missed it, but a good EP is essential.

[Careful35]

I had an EP study 10 years ago for SVT and I believe short runs of NSVT. Unfortunately, he wasn't able to provoke either long enough for mapping and so I didn't get to have the ablation.

I was awake sorta... They do give you some medication where your awake but your kinda out of it.  The deal was that we would start out that way and if he was able to do the ablation he would knock me out then. I really can only remember bits and pieces. I did not have any pain, I just could feel my heart racing and him asking me questions here and there.  

When I made it to the hospital they brought me into a room to prepare (start an IV, get into a gown etc). I hung out there for a little bit and then after a short time they brought me into the study room, which was CRAZY COLD but really cool looking. That transferred me onto the table, started some  loopy meds in my IV and started to place the cather into my groin area. He talked to me pretty much the whole time and told me things he was doing and how I would probably feel like, "I am gonna give you some medication now that's gonna make your heart go really fast and your probably going to feel uncomfortable but not in a painful way but not to be afraid cause its normal and what needs to be done to provoke an irregular heartbeat".. he joked around a little, asked me if it felt like i had s horse running in my chest and beyond that I really dont remember much else about being back there.
When it was over they brought me back to the same room where my mom and husband were waiting for me and told me I had to lie flat for 6 to 8 hours to allow a blood clot to form in my artery and after that I was discharged home...

I do get a lot of PVCS and PACS. I get more PVCS then I do PACS. To the best of my knowledge drs here wont do an EP study for just PVCS unless someone is having more then 20,000 per 24 hours.

I hope your procedure is a success.

[tronious]

Many thanks for your response.   That's what I was looking to find out.

I think what I'm hoping for is if he gives it great.   If not then id like to have the final piece of mind knowing that he can or cannot induce a bad sustainable rhythm.

Thanks again for the time you took to reply.   I really appreciate it.

[tronious]

Curious what do you do to manage the arrythmia now?  Any meds? Just toughing it out so to speak?

Is your husband supportive?  I know sometimes those who don't deal with these stupid things dont get the anxiety and/or frustrations they can cause at times

[Careful35]

I tried beta blockers but I tend to get a lot more PACS when my heart rate drops. I also tried Flecainide for a time but once I read the side effects I was afraid to continue taking it. Now I just deal with it all the best way I can. My cardio wanted me to go back on beta blockers because of the lightheaded spells  but the EP said he doesn't want me to take them right now. I am getting a loop recorder implanted this coming Friday but I'm scared. These spells really scare me.

[Careful35]

And my husband is mostly supportive as he himself suffers from arrythmia's.

[tronious]

I wish you all the best.  The one thing I've learned so far on this journey is that emotions tend to play a lot into these even when we think we aren't amp'd up we are and that makes things in our hearts sensitive.

If I get frustrated or annoyed mine will be guaranteed to kick up.

Really though all the best to you.   I know the fears and anxiety these things can cause.

If you think back to how long you've been dealing with these then you realize they haven't harmed you yet.  They just suck.

In the end l will work out.  Hang in there and thank you for sharing your experience with me.

[Careful35]

Yeah I'm really not concerned with the ectopics nor the SVT... I deal pretty good with them, I have come to accept that it's just the way my heart is and there isn't nothing i can do about it. Worrying will change nothing.... buttt sometimes they do get to me...
My sole concern is the near fainting spells....

[tom_h]

Reread your post.  I would think that most physicians would consider several thousand PVC's a day as manageable, and probably wouldn't do anything physical until they reached 20,000 per day or more.

[tronious]

Tom thanks for the reply.  So ultimately this is more of a quality of life thing for me.  I have "toughed through them" for many many years.

I've had at least 3 30 day monitors all of which show a "load" of roughly 200-3000 depending on the day.

The EP that I'm visiting is highly highly regarded in the Pgh area and has done many of these with a high success rate.  As you know, I'm sure, every case is different from person to person so the success rate depends greatly on the individual and their circumstances.  

This will begin as an EP study and if he can induce the spot that is really being a problem for me he will make a judgement call at the time depending on its proximity to other things in my heart.

I'm certainly not rushing into this.  My GP and others who have been to him all regard him as one of the best and the hospital is well regarded for their EP division.  Their head takes care a lot of the Steelers, Pirates, Penguins, etc...

The decision to (or not to) do it is not necessarily what I'm looking for.

I'm looking more for experiences...especially with PVCs since it's a procedure I'll be awake for.  Most ablation experiences I read about are for afib where folks are basically asleep.

[tronious]

Darn sorry I wish I could edit these posts after making them.  What I meant to say was that as far as being AWAKE...the Dr indicated that often times sedation can suppress the PVCs.  It would be interesting to know if I don't need to be awake.

Thanks for the info

[nanoart]

This is correct - even half-awake sedation I had for the first ablation and local anaestetic did supress the PVC's. For the second one under GA - the doctor used isoprenaline (adrenomimetic I guess) to trigger the bigeminy  successfully when it was wearing out. Good luck!

[tom_h]

First, what is your PVC load?  That is how many are you having per day?

Second, there is usually no reason TODAY why you need to be awake for this procedure.  Its uncomfortable, and can be of long duration.  I had an ablation in 2010 for SVT at UMass, and my daughter had one for AFib last January at U of P in Philly.  Both of us had general anesthesia.
This procedure usually requires and overnight stay for observation, whereupon you're discharged the following morning.  The nature of the procedure allows you to travel freely to whomever you want to use.  You're not forced to use a physician in your area.  Has this physician put you on a long term monitor?  Has he examined your particular data from a long term monitor.  What is his success rate?  I would act with caution if this physician wants to do an electrophysiology procedure without thoroughly examining your case.
Would I do it again? Both of us would.  It was a very positive experience for both of us.  It seemingly cured my daughter of AFib, and me of a near lifetime of SVT episodes.  Dont rush into this.  Proceed with caution.

[tronious]

So that should say "either" update this post or create a new thread...sorry.  dont know how to update my original post :)