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Avatar universal

cardiac ablation

I am just home after being unable to have the proceedure without medications
am scheduled now for Nov 17th with general anesthia
what is the difference?
which is better?
I take metropol XR 50 each night and for the most part this has keep the palpatations under control
reading all the stories of after ablation surgery and pain am I better off with out it?
I am now terrified to have the proceedure any hel[ is greatly appreciated thanks
61 Responses
1423357 tn?1511085442
I sorry to hear about your false start,  Can you tell us what hapened?  I'm getting mine done  one day before yours.
1137980 tn?1281285446
I am a little confused by your post....when you said you are unable to have the procedure without medications...what does that mean exactly?  Were you in the EP Lab and they began the ablation and then stopped and if so what was the issue with what medications?  Were you going to tough it out without anything and then you became to stressed?  Did your heart start acting up?  Did you just go to see the EP doc and they said they want you on general anest, to knock you out during the procedure...or are they talking about a twightlight medication?  I am sorry i am just sort of really confused by what happened here.  We usually stop taking the meds under the doctors order about three days before the procedure for good reasons.  I want to help but i need you to help me out a little here on this one.  Why would you now be terrified to have the ablation when it sounds like you weren;t before.  As far as after your ablation goes it you are just having a simple catheter ablation thru the groin area there really isn;'t any pain after the procedure ....the worst part is just a dull ache in the groin and usually we're told just to put ice on it for a couple of hours and it works.  The anest. won't have anything at all to do with your pain levels after any surgery except to make you a little loopy and tired until it wears off.  Maybe you could re post exactly what happened to you and what was said....
Avatar universal
I went in tuesday morning was prepped and into the operating room  but
I was shaking and afraid and the doctor said he was not going to give me any medication until the catheter was in my heart and he knew where the defect was located  and I got even more afraid because he kept saying you have to lie straight and not move at all or the catheder could move inside my heart and cause damage.  the anestheiologist and I talked and it was determined that I would do better under general anesthea so they took off the leads etc and sent me back to my room  and I have to say that I was relieved.  He was so adiment about not moving and not medicated until the location was found that I just said I
dont want to have it today and that was fine with all there
as far as the preparation I did stop medication four days before and had one episode last sunday and was told to take the short fast acting metoprolol which stopped the racing  I think I am still scared after my failure yesterday
I am booked for Nov 17 under general anesthia and will have time to talk over with the anesthiologist on Nov10. to go over everything before
It was my decision with the input from the anesthiologist yesterday
I do wonder what the difference is because he wouldn't even give me a valium to calm me down prior to the treatment because it would slow my heart down and now general anesthea doesnt that slow everything down also?

Also reading some of the post surgery problems on the blog makes me think  does anyone have a successful cure from this?
1398166 tn?1358870523
They did my ablation under general anesthesia.  I had somebody here question that, so I asked my doc.  He said there's +/- to general vs. twilight. The negative of twilight being: the patient can experience pain and flinch wihch moves the catheter or in your case too nervous.

They did me under general... I haven't had an SVT since.  I'm really settling into this new ticker.

Also, if your doc told you it was 90% chance of success, and only a small 1% chance of them nicking your lung or whatever complication (assuming you don't wiggle! ;-) ) then go into that surgery 90% PUMPED THAT THEY'RE GOING TO FIX YOU, 10% Cautious that it could possibly not work and <1% nervous that you're going to be hurt.

I'm not a nervous guy... so I was pretty cool about the whole thing.
1423357 tn?1511085442
Ok on all that you posted.  WIth all the team assembled there, I wonder why they didn't give you general right then?

At any rate, I hope your second trip in is a success.  I am pretty anxious too.  I spoke with the scheduler today and asked him about whether I'd be under or not.  "General anesthesia" he said.  That's what I wanted to hear!
1465650 tn?1316231160
I had my ablation with nothing, no meds at all.
I was shaking like mad on the table but when the procedure started and the numbing of the groin was over a calmness came over me. I just wanted the SVT to be gone and would do anything to get it over and done with.
It is not a pleasant experience at all but it is a tolerable one and one that can be done without medication.
I did ask the cardiologist as I was getting on the table if he could give me some sedatives, but he said he didn't want to as it is difficult to find the problem. I just went with the flow and did as they said.
I may end up going again as It was 50/50 for success, will see soon.
Avatar universal
I think that taking the general anesthia is the best way to go.  I have had 3 EPs and Ablations and had a bad experience with the 'twilight' option the first time around (woke up to being de-fibd during the procedure...hurts like nothing else).  The last 2 went smooth, woke up later that day and went home the next morning.  However, the Dr did say that it is not common for the patient to be aware of things at that point in the procedure.  
Avatar universal
Why rush it? If your having bad feelings about the procedure put it off. It's not like the statistics show its a guarantee to fix your problem. Many people need additional treatments.

Personally I felt like my Dr. was in a rush to do it to me. Glad I didn't go that route.
Avatar universal
I have been being in treatment 5 months and the medications cause allergic reactions so I have to take benedryl about 4 x a day and am very itchey drive you nuts itchey so the MD suggested the proceedure
the general anesthia should work better for me as I was shaking too much for them to do it and my MD would not do twighlight so we decided on general anesthia.  I am to talk it over with an anesthiologist 7 days prior to the surgery  I will ask about additional treatments and why
since my MD said 95% success rate and I'll ask what does that mean an end to palptations and ER visits I hope
Thanks for the support it promises to be a long month waiting again.JYANT how are you manageing your symptoms?
Avatar universal
Don't be afraid to get 2nd opinions, I think I heard that 2nd opinions change treatment 30% of the time.

I tried a couple different drugs before honing in on verapamil which doesn't get rid of the problem only makes them less intense/frequent. I am very sensitive to any drug but rarely if ever have I gotten itchey. Isn't that a sign of allergic reation to it? I would find a drug that doesn't do that.

My understanding of the 95% success rate is only after multiple attempts, that is NOT a once time only success rate that I have read in any study. I also read that you want a Doctor/Hospital that has done numerous procedures, this ablation does have risks albeit small.

Because mine are benign, unless of course I went to say 225 bpm and couldn't come back down. I just try not to focus on them, knowing they won't kill me. It's hard and teh fear of death is hard to shake. If they get bad, I go lay down and sleep, seems to help. Or I read that if you catch them early in an attack, Ice Cold water on face/neck, I use a rag in bowl of ice will generally stop or slow them to a manageable stat.

I dont think one can actually manage this (if severe)...thus we all head for ablation. I'm just of the opinion, why rush it.
Avatar universal
One other thing that I've read, and there may be more current studies out there which I would love to read. Is that the ablation treatment is not an overnight success. It takes time for scar tissue to build up on the outside of the heart to ultimately stop the electrical paths they are trying to destroy. Up to 6 months in waiting for determination.

If futher evidence is available, again I would like to read it.
Avatar universal
From my Electrophysiologym Cardio Dr. who being from Los Angeles area has done thousands of Albation procedures, told me he has patients that have waited upwards of 4 years to have the procedure before it drove them back to him.

Again, take a deep breathe and get as much info as you need to feel relaxed in your condition.
967168 tn?1477584489
how many are you having daily and are you sympotmatic with them? If you're not in the 15%-20% range of pvc's (15,000+ daily in the normal heart which beats approximately 100,000 daily) or not having symtpoms, I'd try meds and lifestyle changes first; that's just my personal opinion and I've lived with some green eyed monsters

Versed (twilight sedation) did well for me and I really didn't feel anything but could talk to them in the OR and knew what was going on - my ablation did not work for me and I was told 90% curative - but there were a few weeks that I was pvc free. I developed PAC's the day after surgery and then PVC's came back and increased again within a few months time.  I do have to have another ablation; which I've put off since December 2009, but I have alot of other problems that I'm going to be forced to do the surgery again

Even with complications for me, the worst part like Cindy said is the place in the groin, mine was more from them holding the area for so long which hurt like heck :P  it does take awhile for your heart to heal from the ablation; I think they say normally 4-6 months

it's a personal decision really, can you live with them and the symptoms? if not, then try the ablation and see if it cures yours; some of us get lucky on the first go round =)
1398166 tn?1358870523
My ablation was overnight success. My heart did skip beats for a while... little weird flutters... during recovery, as expected... but I've had ZERO POINT ZERO eipsodes of SVT since.  My last SVT can be witnessed here:
http://connect.garmin.com/activity/42225659
1423357 tn?1511085442
Interesting graph.  I see the spike at 201bpm, the low valley, then the return to what appears to be your running pace.  Did this convert on its own, you did you have some intervention? I ask this because never converts on its own.  It would go on unitl it gave out.  If I'm active and at high respiration levels, conversion may take 30 minutes or so until my respiration returns to resting levels, and adrenaline goes down.
1137980 tn?1281285446
I had my ablation a little over 4 years ago now...i am and have been 100% SVT free since.  It does not take multiple ablations.  For the most part "burning" is an antiquated way to do the procedure and not the option of choice for most docs because of the issues that arise after the procedure because of the scar tissue build up after.  Cryo or freezing or RF waves or radio frequency waves are the way that most docs go now.  There is not scarring when it is done in either way.  Saying that is not an overnite success...you are semi right...we all had to wait for the healing process to be over because we were poked prodded penetrated and zapped so the full recovery with simple random quick runs takes a couple of months...i know with myself i had a total of 4 i think and they only lasted a couple of seconds...except for one of them and i had to be chemically converted on that one and that was my own fault because i thought i was good to go too soon but once i got converted it was done.  My heart raced into the 300's before the procedure was done w. atrial fib and SVT .  I was on Versed or the twighlight med during the procedure and i have to say if i had to do it over again i definately would have gone with a general anesthesia because i woke up 2X during my procedure and the first time tried to crawl off of the table with the cath in my heart (obviously not good).  The doc said it was the true fight or flight response.  If for any reason i ever have to go back and i pray i don't i am def. going w. a general.  The only time that scar tissue builds up on the heart is w. the cauterization or burning and not the way to go. Jyant so did you have an ablation because thats not clear to me...or are you waiting?  I think it depends of what each of our situations are My doc one of the best in the world in the San Francisco area had done over 1500 of them by the time he did mine and i think the bottom line is the bottom line...if you trust your doc go with it because to me to live w. atrial fib and SVT we are simply waiting for a time bomb to go boom...especially with atrial fib because it can get progressive on us.  I think as we all know SVT is nothing to mess around with because of the cause and effect.  If something popped up in the future i would not even hesitate for a New York minutes to go back in for another ablation...it was a no brainer, painless, simple and back to work after 4 days and back to the gym after 2 weeks.  I know that i was not an usual case as long as there is no underlying issues for most people its a done deal.  The earmark is we are supposed to be in the 70% or higher success rate range and if Nellie is in the 95%, had a great doc, trusts him/her and they have a high success rate i would run not walk to the EP lab next month.  I believe she is about to get her life handed back to her on a golden platter.  I was a one time ablater with lots of issues and trust me i drop on my knees almost every day and say thank you for giving me my life back.....Nellie don't be afraid....its normal for all of us to feel that way but pick and chose what you read and concentrate on those of us who have been there done that good bad or indifferent....i think your life is about to change for the better..there is no feeling like we get when we are suddenly free...just remember to pay it forward after you have it done to help others on the site like lots of us have done.....
1423357 tn?1511085442
"...just remember to pay it forward after you have it done to help others on the site like lots of us have done....."

Exactly.  Good insight for us "about-to-be", cindy.
Avatar universal
Cindy

It's great news that you are PVC free. I have had them for a little over a year and have been diagnosed with PSVT currently under 240 mg ER of verapamil (about 3 months now). No doubt I have had in excess of 10,000 per day on a regular basis. I have had my good days and bad days. My wife and I decided ablation was not for us atm and I am glad we made that choice. Today I am 13 days free of any PVC's that I know of and that is just a huge relief. I have started walking again to build to jogging which I have missed for a year. As quickly as the PVC's came on, they have now gone . We know the medical community has few answers as to the origin of these in healthy individuals. My Lord made a perfect body and I am of the opinion that there must be a cause and effect. I have taken my time and not rushed to ablation and look at me! Sure it was just horrible the last year at times, but I'm alive and feel great now.

I just don't like the pushy pushy to ablation, it's not 100% and can cause more troubles than you entered the hospital with. Would be a shame if you were like me and the course changed for the better for what ever reason.

Our buddy at livestrong.com
http://www.livestrong.com/cardiac-ablation-procedures/
Also click the link on page, dangers of Cardiac Ablation

Our buddies at the Mayo Clinic
http://www.mayoclinic.com/health/cardiac-ablation/MY00706/DSECTION=risks

Our budies at Emedicine
http://emedicine.medscape.com/article/1828541-treatment

Shortly I start the process to get holtered up and get off verapamil to see if by small chance it was the drug that stopped the PVC's or it was a miracle, the heart mending itself or some other complex reason that is unknown, just like what got me here.

Srry rolling a 9 out of 10 dice isn't for me. I'm self employed and still have 2 youngens at home. I delt with my bad days.

BTW do we know the long term effects of ablation now that its being done like a tooth extraction?

I came here for an answer to a question I had, not to shove down my opinions.

Patience is a Virtue
1398166 tn?1358870523
Oh - I've been out here telling people who are all flippant about "Oh go get ablated" no problem.  Well the risks are LOOOOW.  The expense is HIGH. And SVT wasn't invented 8 years ago, so people have dealt (lived) with it for years.

You're waaaaay more risk averse than me... and prlly most people.
I waaaaay more drug averse than you.

If the drugs work for you - cool. I chose not to have a chemical dependency problem for the rest of my life.
Avatar universal
I read a few of your posts and while the financial cost for you has been high, I have great insurance and it has cost me little. I like you, just hate drugs. Aspirin is my best friend on occasion. My body is very sensitive to any drug so I hate the feelings most give me, they are foreign objects on my body.

Don't you find it somewhat interesting that alot of these PSVT's are coming from folks in exercise programs? Did it ever occur to you that due to your heavy training your heart might have enlarged slighty in the upper chambers or stretched, thus causing electrical pathways to disconnect? Maybe coupled with a bout of sickness or lack of nutrients? Tooth problems? All in the drive to be super competitive or lacking financial resources to go get checked, put it off. Maybe the stress over the whole colapse of our financial world helped too?

I think thats what happened to me..I think...and it has now taken a year for my heart to mend itself.

But hey, you see little green men, freeze em
1398166 tn?1358870523
I have a very good job in a huge Fortune 500 corporation that *every* American knows the name, logo and branding.  Our insurance has to be competitive in order to attract and retain the top workforce.

Over the years my costs have been low (factoring premiums).  Again - to anybody reading: what is your MAXIMUM OUT OF POCKET?  Be prepared to pay that if you're Ablated. I'd suggest getting ablated in January, so if you need another... then the second (and all subsequent med expenses) will be free.  For instance, I'm getting septoplasty next month. Free to me, but would have cost a few k... that's why I kept putting it off.  I'll be happy to have the left side of my head back!

Exercise induced SVT is because the heart is getting high revs in the first place and that exacerbates the underlying condition. I'd get SVT in non-exercise situations... just not frequently (once a month or so).  They were mild.  If that were the only frequency, I would not have been ablated or taken meds.  I'd just deal with it once a month.  However, not exercising was making me fat... because I like to eat.  My dad is hypertensive... my grandpa probably paid for his cardiologist's vacation home in Vail on his own.  But all that stuff is from: COUCH-POTATO-ITIS.  So, get ablated and sustain my exercise and 23 BMI or get fat and see the cardiologist on the other end of the hall????
Avatar universal
Exercise induced SVT is because the heart is getting high revs in the first place and that exacerbates the "underlying condition".

This is a great point, the point I'm making is there is no "underlying condition" in healthy people having PSVT's. Dr.s rarely can put their finger on the exact cause. Such as you or me I presume.

Maybe you had the wrong surgery first? Maybe your deviated septum was the cause of your pvc's? Not getting enough oxigen under severe exercise then coupled with a sort of apnea on a night or two during the month causing a pvc's bout the next day under normal conditions...who nose's?

Hospitals are for profit as are most Dr.s nowadays. Lemme check that colon, yes we removed a polyp, we'll have it checked for you..wink wink cha ching. Any a-hole will have polyps. I smell this in the ablation industry for normally healthy individuals rushing in for a quick fix and not determining the "underlying condition".

"cyberchondria" doesn't help us, not calling you out, but we know they exist.
1423357 tn?1511085442
I can tell you this.  I've had SVT since I was 6, years before I was a nationally ranked speed skater. I got it as a kid.  I got it while in supreme physical condition, and I still get .nit today at the age of 60.  In fact, I get it more now just watching television.
1423357 tn?1511085442
...sorry, I was mobile on my Droid, and could finish this...

".....the point I'm making is there is no "underlying condition" in healthy people having PSVT's. Dr.s rarely can put their finger on the exact cause....."

I have to disagree with you on this point jyant.  I couldn't have been more healthy in my competitive days, and still am today for the most part.  I can't max out a stress test like I use to, but I still can do 14 minutes on the standard test.  Yet, there's an "underlying condition" that switches on whenever it feels like it that literally brings a halt to my life.  I been years on Metoprolol and it continues to break through.  My plan was to try a different drug, the doctors know what it is, and now have a cure that is much safer and more assured than a pharmacological approach FOR MY TYPE of SVT.  jyant, if your curative path does not involve ablation, I hope it works for you.  There's without a doubt, more people taking that route.
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