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RVOT PVC ablation to get off Flecainide
Hello, anyone had a Right Ventricle Outflow Tract (RVOT) ablation for very frequent PVCs? and if so did it work?
I had very Frequent RVOT PVC's and mainly ventricular bigeminy and frequent couplets that were driving me round the bend and making me dizzy/lightheaded with episodes. My cardiologist said there were so many that there was the possibility the PVCs could develop into VT because of the area of the heart they originate in. I had an EP study, but because i also have autonomic dysfunction and Inappropriate Sinus Tachycardia, my heart took off to about 170bpm when the doc put the sheaths in and totally overrided the PVC's. So the ablation was a waste of time.
Since then i have been on 200mg Flecainide CR and this has abolished the problem. 2 years on, my cardiologist wants to try the ablation again to see if he can get me off of flecainide. I REALLY like the idea of having the ablation if i KNEW it was going to work, but it's quite dissapointing if it doesn't. Anyone had an ablation for this? did it work straight away? Anyone else only get crap loads of PVC's when their heart rate is slow, and then dissapear when it speeds up. So frustrating.
I had very Frequent RVOT PVC's and mainly ventricular bigeminy and frequent couplets that were driving me round the bend and making me dizzy/lightheaded with episodes. My cardiologist said there were so many that there was the possibility the PVCs could develop into VT because of the area of the heart they originate in. I had an EP study, but because i also have autonomic dysfunction and Inappropriate Sinus Tachycardia, my heart took off to about 170bpm when the doc put the sheaths in and totally overrided the PVC's. So the ablation was a waste of time.
Since then i have been on 200mg Flecainide CR and this has abolished the problem. 2 years on, my cardiologist wants to try the ablation again to see if he can get me off of flecainide. I REALLY like the idea of having the ablation if i KNEW it was going to work, but it's quite dissapointing if it doesn't. Anyone had an ablation for this? did it work straight away? Anyone else only get crap loads of PVC's when their heart rate is slow, and then dissapear when it speeds up. So frustrating.
No recent Syncope as such. although when my BP is low in the morning i basically have a constant near syncope feeling, but havent had any true syncope in ages. Although a few months i go, i went on to Clonidine to try and control blood pressure, but it made my blood pressure bottom out completely. Spent some time in hospital because BP went so low it causes spasm of arteries and chest pain. We decided it was better to leave my blood pressure out of control than have this happen again.
Was just reading your profile to remind myself of your story. I didn't realise you also had IST? Gees, as if you already didn't have enough problems. What are they treating you with for that. I was taking Carvedilol to help with my IST but i was pretty debilitated in the morning coz of hypotension, so now i am taking Ivabradine, the sinus node (If) inhibitor and it is great. So much better than beta blockers for me. Still taking some Carvedilol tho.
I am also not vaguely concerned about Cardiomyopathy or anything. I know most people with Tachycardia/rhythm problems are terrified something is seriously wrong with their hearts/ scared they are going to drop dead. But honestly this has never worried me in the slightest. I have just been obsessed with wanting the symptoms to go away. I had a Trans-Eosphageal Echo to look for damage or whatever but they said it was pretty good considering.
Overall i am doing pretty good. It's just when you stack a few problems on top of eachother it can feel a bit like your being attacked from angles, as i'm sure you know.
Keep hanging in there. wish i knew what caused all this stuff in the first place
Was just reading your profile to remind myself of your story. I didn't realise you also had IST? Gees, as if you already didn't have enough problems. What are they treating you with for that. I was taking Carvedilol to help with my IST but i was pretty debilitated in the morning coz of hypotension, so now i am taking Ivabradine, the sinus node (If) inhibitor and it is great. So much better than beta blockers for me. Still taking some Carvedilol tho.
I am also not vaguely concerned about Cardiomyopathy or anything. I know most people with Tachycardia/rhythm problems are terrified something is seriously wrong with their hearts/ scared they are going to drop dead. But honestly this has never worried me in the slightest. I have just been obsessed with wanting the symptoms to go away. I had a Trans-Eosphageal Echo to look for damage or whatever but they said it was pretty good considering.
Overall i am doing pretty good. It's just when you stack a few problems on top of eachother it can feel a bit like your being attacked from angles, as i'm sure you know.
Keep hanging in there. wish i knew what caused all this stuff in the first place
I do remember you mentioning the problems you were having with flucuating BP...have you had anymore syncopal episodes?
Yes, I've been through quite a bit in the years past...but I always try to keep in mind, that there are so many that are in alot worse shape than me. As for the bigeminy, after dealing so long with it...I have just learned to live the best I can in it...Some days are certainly harder than others. I like you attitude, it's similar to mine..."oh well thats life!"
I have stress echos on a yearly basis to keep on top of things...so far, no cardiomyopathy to speak of. My cardiologist said that when he is concerned, he'd let me know, until then I have been told not to worry about it...He knows better than I...so if he says "don't worry now" I am going to listen to him and not worry over something that may not ever happen :)
Yes, I've been through quite a bit in the years past...but I always try to keep in mind, that there are so many that are in alot worse shape than me. As for the bigeminy, after dealing so long with it...I have just learned to live the best I can in it...Some days are certainly harder than others. I like you attitude, it's similar to mine..."oh well thats life!"
I have stress echos on a yearly basis to keep on top of things...so far, no cardiomyopathy to speak of. My cardiologist said that when he is concerned, he'd let me know, until then I have been told not to worry about it...He knows better than I...so if he says "don't worry now" I am going to listen to him and not worry over something that may not ever happen :)
Hi Brooke,
Yes it has been a while! No i havent booked the procedure, mainly because the last two years have been hideous for me, i have been in hospital again with blood pressure swinging from 70 sys to 200sys in the same day. So the main aim for a while has been trying to sort that out. So now that we have that somewhat stable, my EP is looking to the future and i guess thinking that long term Flecainide is not a good plan when your 24. I am only just starting to feel better, so kinda don;t wanna rock the boat.
Im thinking that if i do go ahead with the ablation, that doing it with Beta blockers and Ivabradine still on board may be a good idea. That way my HR will be slow and hopefully the PVCs will show up. My EP says sedation is a no go, as this usually makes any arrhythmia less likely to happen.
Brooke, you really have been through it havent you! I take my hat off you, for being able to deal with constant bigeminy etc. It really isn't conducive to sleeping! Although i admit i am whinging about this, i am also very very grateful that Flecainide is such an effective medicine and that i have had no problems from taking this. Just ***** that it now seems i have Dysautonomia!!! Oh well thats life!
Oh.......What does your Cardiologist have to say about Frequent PVCs causing Cardiomyopathy etc? It is always in the very back of their minds isn't it?
Yes it has been a while! No i havent booked the procedure, mainly because the last two years have been hideous for me, i have been in hospital again with blood pressure swinging from 70 sys to 200sys in the same day. So the main aim for a while has been trying to sort that out. So now that we have that somewhat stable, my EP is looking to the future and i guess thinking that long term Flecainide is not a good plan when your 24. I am only just starting to feel better, so kinda don;t wanna rock the boat.
Im thinking that if i do go ahead with the ablation, that doing it with Beta blockers and Ivabradine still on board may be a good idea. That way my HR will be slow and hopefully the PVCs will show up. My EP says sedation is a no go, as this usually makes any arrhythmia less likely to happen.
Brooke, you really have been through it havent you! I take my hat off you, for being able to deal with constant bigeminy etc. It really isn't conducive to sleeping! Although i admit i am whinging about this, i am also very very grateful that Flecainide is such an effective medicine and that i have had no problems from taking this. Just ***** that it now seems i have Dysautonomia!!! Oh well thats life!
Oh.......What does your Cardiologist have to say about Frequent PVCs causing Cardiomyopathy etc? It is always in the very back of their minds isn't it?
Hi Lauren!
It's been awhile since I last spoke to you...I had my ablation for RVOT-VT in Aug. 08. I, like you, was quite hesitant about the porcedure...after being through failed procedures for other arrhythmias, I was quite skeptical that this was going to work.
That being said, I trusted my EP and went forward with the ablation. Now, almost 2 yrs later, while I have not gone into VT (that has been documented) I feel the ablation for this was a sucess. I still have daily Ventricular Bigeminy and sometimes Trigeminy. My cardiologist suspects that this may be coming from the left ventricle for which he is hesitant to venture into. As sad as it sounds, I'm pleased to deal with this than the threat of VT.
Have you booked your procedure yet?
It's been awhile since I last spoke to you...I had my ablation for RVOT-VT in Aug. 08. I, like you, was quite hesitant about the porcedure...after being through failed procedures for other arrhythmias, I was quite skeptical that this was going to work.
That being said, I trusted my EP and went forward with the ablation. Now, almost 2 yrs later, while I have not gone into VT (that has been documented) I feel the ablation for this was a sucess. I still have daily Ventricular Bigeminy and sometimes Trigeminy. My cardiologist suspects that this may be coming from the left ventricle for which he is hesitant to venture into. As sad as it sounds, I'm pleased to deal with this than the threat of VT.
Have you booked your procedure yet?
COMMUNITY LEADER
Sorry I can't answer your questions from personal experience but as you post is 11 hours old I'll offer this advice.
At you young age fixing the problem is vastly better than long term medication treatment, even if it works. Get the ablation done again if you doctor(s) think it can work. Knowing what happened the first time they may be able to give you more sedative/relaxant or some other calming medications to keep your heart in more "normal" operations.
Good luck, many on the Community have reported good result from ablation surgery.
At you young age fixing the problem is vastly better than long term medication treatment, even if it works. Get the ablation done again if you doctor(s) think it can work. Knowing what happened the first time they may be able to give you more sedative/relaxant or some other calming medications to keep your heart in more "normal" operations.
Good luck, many on the Community have reported good result from ablation surgery.
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