Aa
ablation for atrial tachycardia-anyone?
I am considering an ablation for persistent, intermittent atrial tachycardia. I was having multiple episodes per day, and now it is fewer. I am afraid to really do too much for fear it will start and get too high, which would set off my ICD. I am on meds, which help, but still am constantly checking my pulse before I go down stairs, etc. I really want to go back to my normal life. I never use caffiene, products with fermented soy or MSG, don't use any alcohol( i MISS my red wine), don't use aspartame. Has anyone had an ablation for this? Thanks-Debi
I am considering myself to be very lucky right now. First of all I'm fortunate my cardiologist recommended consulting with an EP for an ablation, second I think I was very fortunate to get sent to a very good EP and thirdly I knew I only had a 2/3 chance of being cured after the first ablation still those are pretty good odds for a procedure that isn't considered high risk.
I was told several times that an ablation is low risk but not no risk. Afterall some people die getting their wisdom teeth removed. I was told that there was a solid 1% risk of stroke, my EP said his experience confirmed that result. Since they monitore your blood so closely he said none of his patients who had strokes suffered as the result of an ablation had permanent damage but this wasn't something that could be guaranteed. I had to inject myself with fragmin, an anti clotting drug for 8 days when I got home before my INR got back up into the therapeutic range. I hated thae injections too.
Besides the usual echocardiogram, stress test and holter test, I had an MRI on my heart a week or two before the ablation. I don't know how people who are claustrophobic can handle them. Immediately prior to the procedure I went into an ultrasound type lab where they inserted a wand down my throat to check for clots in my heart before starting. The first question the doctor/technician performing the ultrasound asked was how many ablations I had had. I told him this was my first one. He jokingly said 0h - me too.
Anyway they showed up in my hospital room about 6 AM the morning of the procedure and inserted the bladder catheter. Not sure what type it was just know it wasn't a fun procedure having it installed. Another fellow I know, who had the same procedure, told me afterwards that he had declined it and used a bottle whenever necessaary in the EP lab. I was never told anything about the bladder catheter until the nurse showed up to install it. I never had one before and hopefully won't need to have one again for a long time. Getting it removed was as you described it too.
My procedure lasted from start to finish about 5 hours (not counting the ultrasound down my esophagus). They had four large monitors above me and I was able to see at least some of what was being done. I'm a fairly laid back and calm type of personality and wanted to watch what was going on as much as possible. I've read other posts from people who wanted to be right out.
I listened to lots of discussion going on while the ablation was being done I asked the occasional question but since I was on versed and fentynel (sp) like most people are, I drifted in and out of sleep. My EP said afterwards I was a textbook case. At one time I heard someone give a whoop and say wow look at it go. (I could feel my heart going into Afib when he said this). Later the EP told me he was ablating around my inferior pulmonary vein when a foci triggered as he was watching it and it put me into Afib. He said it was extremely unusual to see it trigger like that.
Anyway right after the procedure he told me he was practically 100% sure he had fixed it. He also cautioned me that I wouldn't know for sure until everything was healed.
On a side note I had the ablation done as part of a l study being done that is looking at whether RF ablation should be the first line treatment for Afib. When I walked into his office for the first time before Christmas he was very excited to see that while I had been prescribed metoprolol (beta blocker) no one had ever put me on an antiarrhythmic drug so I qualified for the study. It was a double blind study so I had a 50% chance of being put on meds but I really hoped for an ablation. The research assistant said the advantage for being in the study was if I drew the ablation straw I would have one as soon as they had kept my INR in the 2-3 range with coumodin for a month. This was a strong selling point since there was normally a three month waiting line to get the procedure done at the Montreal Heart Institute after your comoudin levels have stabilized. I was told if I needed a second ablation it would be done as soon as the need was diagnosed.
Since I am part of this study I get to play with some interesting technology. I have been given a little device the size of a tv remote to record an ECG at home every two weeks, or everytime I have an arrhythmia. I just place it on my chest and hit record. I call into a computer somewhere afterwards, press play and it ships the ECG to the institute's computer. (they also used it early on to confirm exaactly the types of arrhythmias I was having. With 3-5 afibs a day I killed a forest with ECG print outs. I am also being followed for the next two years and have to go in for another MRI, a holter ,a CT scan etc. at different times over the next number of months.
Would I do it again? Yes I would. My Afib was getting constantly worse and while it always reset itself I felt I was getting to the point it wouldn't. I'm also one of those who feels it everytime my heart acts up so it was always stressful. I knew it wasn't likely going to kill me but I found it very disruptive to my life. I'm only 50 and didn't want to consider myself physically limited if I could have it cured.
I was told several times that an ablation is low risk but not no risk. Afterall some people die getting their wisdom teeth removed. I was told that there was a solid 1% risk of stroke, my EP said his experience confirmed that result. Since they monitore your blood so closely he said none of his patients who had strokes suffered as the result of an ablation had permanent damage but this wasn't something that could be guaranteed. I had to inject myself with fragmin, an anti clotting drug for 8 days when I got home before my INR got back up into the therapeutic range. I hated thae injections too.
Besides the usual echocardiogram, stress test and holter test, I had an MRI on my heart a week or two before the ablation. I don't know how people who are claustrophobic can handle them. Immediately prior to the procedure I went into an ultrasound type lab where they inserted a wand down my throat to check for clots in my heart before starting. The first question the doctor/technician performing the ultrasound asked was how many ablations I had had. I told him this was my first one. He jokingly said 0h - me too.
Anyway they showed up in my hospital room about 6 AM the morning of the procedure and inserted the bladder catheter. Not sure what type it was just know it wasn't a fun procedure having it installed. Another fellow I know, who had the same procedure, told me afterwards that he had declined it and used a bottle whenever necessaary in the EP lab. I was never told anything about the bladder catheter until the nurse showed up to install it. I never had one before and hopefully won't need to have one again for a long time. Getting it removed was as you described it too.
My procedure lasted from start to finish about 5 hours (not counting the ultrasound down my esophagus). They had four large monitors above me and I was able to see at least some of what was being done. I'm a fairly laid back and calm type of personality and wanted to watch what was going on as much as possible. I've read other posts from people who wanted to be right out.
I listened to lots of discussion going on while the ablation was being done I asked the occasional question but since I was on versed and fentynel (sp) like most people are, I drifted in and out of sleep. My EP said afterwards I was a textbook case. At one time I heard someone give a whoop and say wow look at it go. (I could feel my heart going into Afib when he said this). Later the EP told me he was ablating around my inferior pulmonary vein when a foci triggered as he was watching it and it put me into Afib. He said it was extremely unusual to see it trigger like that.
Anyway right after the procedure he told me he was practically 100% sure he had fixed it. He also cautioned me that I wouldn't know for sure until everything was healed.
On a side note I had the ablation done as part of a l study being done that is looking at whether RF ablation should be the first line treatment for Afib. When I walked into his office for the first time before Christmas he was very excited to see that while I had been prescribed metoprolol (beta blocker) no one had ever put me on an antiarrhythmic drug so I qualified for the study. It was a double blind study so I had a 50% chance of being put on meds but I really hoped for an ablation. The research assistant said the advantage for being in the study was if I drew the ablation straw I would have one as soon as they had kept my INR in the 2-3 range with coumodin for a month. This was a strong selling point since there was normally a three month waiting line to get the procedure done at the Montreal Heart Institute after your comoudin levels have stabilized. I was told if I needed a second ablation it would be done as soon as the need was diagnosed.
Since I am part of this study I get to play with some interesting technology. I have been given a little device the size of a tv remote to record an ECG at home every two weeks, or everytime I have an arrhythmia. I just place it on my chest and hit record. I call into a computer somewhere afterwards, press play and it ships the ECG to the institute's computer. (they also used it early on to confirm exaactly the types of arrhythmias I was having. With 3-5 afibs a day I killed a forest with ECG print outs. I am also being followed for the next two years and have to go in for another MRI, a holter ,a CT scan etc. at different times over the next number of months.
Would I do it again? Yes I would. My Afib was getting constantly worse and while it always reset itself I felt I was getting to the point it wouldn't. I'm also one of those who feels it everytime my heart acts up so it was always stressful. I knew it wasn't likely going to kill me but I found it very disruptive to my life. I'm only 50 and didn't want to consider myself physically limited if I could have it cured.
Thanks for your comments. I am so sorry you have had to live with this for so long. It is pretty dismal. I was having the same thing-going fromheart rate of 40 to 160 rapidly. It sucks! I had a 2nd lead put in to control the afib, but still have the tachycardia. It is not terrible, but I am very symptomatic. I really want the ablation. I really appreciate your feedback.Thanks for taking time to write. And I mean that from the part of my heart that functions the best! Debi
Debi, I livet with Paroxysmal Atrial Tachycardia (PAT) and Paroxysmal Atrial Fibrillation (PAF) for right around 10 years. In the beginning meds controlled it fairly well but it got out of control and I went into full blown chronic a-fib some time last fall. Myh electrophysiologist told me that the progression is quite common. Anyhow, now, with no signal coming from the atria, my ventricles are doing what any synchronized system does in the absence of the sync signal. They are "hunting". I go from V-tach (175 bpm) to bradicardia (as low as 30 bpm) and never have a consistent rhythm. I always marched to the beat of a different drummer but now the guy can't keep a beat to save my life . If your heart doc is recommending RF ablation, consider it.
Lorne, you were apparently among the 60% that are "cured" by a single ablation. Lucky guy! I hope I am in your group. You said you "found it interesting". How long did it take? How did they make it interesting for you? Did they put a monitor or something for you to watch the procedure? Did they talk you through it?
Oh, and Lorne, what's that about a catheter(I'm guessing it was a stardard foley)? Nobody has said anything to me about a foley. I've had 'em a couple of times but never was awake for the insertion. Removing the thing was like slamming your thumb in a door - it felt SOOOO GOOD when it was over.
Anyhow, good luck Debi. I mean that from - you should excuse the expression - the bottom of my heart.
Bill
Lorne, you were apparently among the 60% that are "cured" by a single ablation. Lucky guy! I hope I am in your group. You said you "found it interesting". How long did it take? How did they make it interesting for you? Did they put a monitor or something for you to watch the procedure? Did they talk you through it?
Oh, and Lorne, what's that about a catheter(I'm guessing it was a stardard foley)? Nobody has said anything to me about a foley. I've had 'em a couple of times but never was awake for the insertion. Removing the thing was like slamming your thumb in a door - it felt SOOOO GOOD when it was over.
Anyhow, good luck Debi. I mean that from - you should excuse the expression - the bottom of my heart.
Bill
Thanks for your feedback. I am pretty sure I will have it. I am glad it was successful for you. Good luck-Debi
I had an ablation for atrial fibrillation a month ago. While it was for a slightly different condition I would recommend having one if your doctor recommends it. The procedure is considered to be low risk and as far as my own experience went the procedure wasn't particularly rigorous. I was awake for much of it and found it interesting. The worst part of the whole proedure by far was having the bladder catheter installed. I was in the hospital 36 hours and have to go back for an MRI in three months. I had a couple bouts of arrhythmia a week after the procedure and went in to emergency to have it checked out once. I was told everything was benign and that it was quite normal to have episodes while your heart was healing. Since then I've felt generally better each day and except for the very odd extra beat I have had no arrhythmias in almost three weeks. Prior to the procedure I had 3-5 a day.
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