fluid build up after loop monitor removal??

[hiker73]

Hi,
I had my loop monitor removed this past Monday.  It was implanted pretty much centered on top of my sternum.  At first, the spot where my monitor was located was a little indented, but Tuesday night, it started filling up with fluid.  I really do not think it is infected - there is no redness, swelling or heat around the incision or around the pocket of fluid.  The fluid is in the "pocket" they had to create when they put the monitor in me.  It's actually in the exact shape of the monitor.  I had my EP study & loop monitor removed in Philly, and I live about an hour & a half from the hospital, or I'd go in to have it checked.  I called and spoke with the nurse, but she didn't know what to tell me, other than telling me I could come in to have it checked.  
Has anyone ever heard of this?  I'm wondering if it's just my body's way of healing, and the fluid will eventually be reabsorbed?  I have a post-op appointment on the 18th, but that's a ways away.
My history is:  38yo female with SVT/ Atrial tachycardia for the past year, due to a virus last October.  This was my second EP study/attempted ablation, unfortunately without success.  The loop monitor did it's job by pinpointing the exact type of arrhythmia I have, but it was extremely uncomfortable because I'm so thin and it sat right on my sternum.  So, the doc said I could have it removed.  Unfortunately, the pain of having it removed has been just as bad as when it was put in.  
Anyway, I'd appreciate any thoughts on this!  Thank you!

[itdood]

You could go to your primary family doc to have it checked.  The concern is infection, of course, so I think your family doc could do an assessment.  Especially if you have a fever or notice redness.  Call the nurse up you spoke with before and ask them if that's a possibility, and the family doc could even call up the folks that did the removal to tell them what they're seeing.

[MichelleP_3811]

Only being able to tolerate 15-20 seconds sounds like ventricular tachycardia more than an atrial tachycardia.  Everyone's blood pressure drops during an episode because the heart is beating too fast to supply the right amount of blood through the body.  But the going theory is atrial tachycardias do not cause anyone to pass out.  You feel like you might but it doesn't generally happen.  Well that is what I read online anyways but I am sure most cases are not exactly the same because each body composition is different.  Do you have chronic low bp?  If so I might ask if you can add a bit of salt to your diet.  I read online that the medical community was looking at it as a possible help for people with autonomic disorders, people who pass out a lot because of drops in bp.  Also if you drink any caffeine I might consider giving it up.  It will aggravate the pvcs.  Well considering how much you have been through I am sure you have all the bases covered.  I do wish you the best at getting a handle on this at some point in the near future.  Hang in there.  I am sending good thoughts your way.

[hiker73]

Sometimes I would go a couple weeks without having the tachycardia, but most of the time it was 3-4 times per week.  The tachycardia in itself isn't going to make me drop dead, I know.  But, it makes my blood pressure bottom out, and if it sustains for more than 10 seconds, I become in danger of passing out.  The doc said my body wouldn't be able to handle more than 15-20 seconds before I would pass out.  I've had several episodes right around the 15 second mark, and was barely conscious by the time it converted back to normal sinus.  So, for me, it is too dangerous to be left untreated.  The pvc's & pac's were what was so annoying for me.  Most days, I'd have hundreds (at least the ones I could feel), and I'd get SOB when they came together (anywhere from 3-8 in a row).  
My first EP study in Jan, I wasn't sedated at all.  No meds whatsoever - not even anything to relax.  I was on the table for over 8 hours while they tried to induce it.  I had been on flecainide up until 4 days before the study, and as soon as I stopped the flecainide, I had the tachycardia about 5-6 times per day.  Then, I woke up the morning of the study, and felt absolutely nothing.  The doc tried every medication available, multiple times, to induce the tachycardia, but it wouldn't come out.  So that time, it definitely wasn't suppressed by any meds. I went to one of the top EP docs on the east coast for the one I had done on Monday.  He has so much experience, and his belief is that he starts out with sedation, and if he can't induce, he wakes you up, and tries again.  He tried for 4 hours to induce it, with no luck.  But he also told me before the procedure that this type of atrial arrhythmia is extremely difficult to induce.

Luckily, the flecainide controls almost all of my symptoms.  I've only felt 1 or 2 pvc's per day, and no tachycardia at all.  That's a HUGE improvement for me.  Now, I just have to finish healing from this surgery, and then I'm hoping to get back to normal life.

I'm glad your svt was cured!  From what I hear, it seems like most people go through multiple EP studies before theirs can be pinpointed.  You are lucky!  Take care.....

[MichelleP_3811]

I am sorry to hear about your troubles.  I assume that since they put a loop in and they also have trouble inducing the svt that you don't get it too often?  Regardless stressing about the whole thing could be causing your pacs/pvcs to be worse so do your best to try and breath deeply when you feel them starting up.  I can't say for certain that the fluid is nothing but if you don't have any redness or fever it is likely just your body doing it's thing to heal itself.  As for your svt hiding I wonder a bit if the medicine is preventing it from being induced.  Were you heavily sedated during the procedure?  My EP pretty much just gave me relaxing medication since they feel that anything more would hinder activating the svt.  But I was lucky, they were able to induce on the first try.  Well if it is any consolation be safe in the knowledge that most svts are not life threatening.  Maybe if you can find a bit of peace about the condition it will settle down a bit to a more manageable state for you and you can try and ablation a bit down the road again when your extra fibers have had a chance to mature some more.  Best of luck and keep us posted on how you are feeling.

[hiker73]

No fever at all, and I feel fine, other than pain, but even that is getting better slowly but surely.  I've had an abcess before, when they put in the loop monitor in January, and this feels totally different.  It's not red or abnormally painful.  It's very strange because the pocket of fluid is in the exact shape of the heart monitor, and in the exact same place as where the heart monitor was.  The nurse asked me if I had a fever, or if there was any redness or swelling, but the answer is no to all of that.  Well, I guess the fluid is kind of like swelling, but there is no swelling right at the incision site.  I had swelling the morning after the surgery (tuesday), but that has gone away, with exception of the fluid.  I can tell it's fluid, because if I put two fingers on it, spaced a little apart, and press down with one finger, it bulges where the other finger is...kind of like pressing on a balloon or something.  It really grosses me out!  I can see the pocket of fluid, too, but it doesn't protrude nearly as much as the loop monitor did.  I guess my biggest fear is that it will always be like this.  

Yes, it is so miserable to feel the pvc's & pac's.  I had them every couple minutes, all day, every day.  Plus, I would go into runs of tachycardia that would nearly make me pass out.  I was SO hopeful for the cure of the ablation, but this was the 2nd attempt in less than a year, with no success.  I really hate taking medication - I'm not on any medication other than the flecainide now.  I don't want to take medication for the rest of my life, but living in misery every day from the arrhythmia is much worse.  After they put in my loop monitor in January, they took me off the anti-arrhythmic meds because they needed to get several recordings of the arrhythmia in order to pinpoint it.  The past 7-8 months were horrible.  I never could predict when I would go into tachycardia - it would happen when I least expected it to.  The loop monitor was also miserable, mainly because I'm thin (5'4" and 125 lbs...not as thin as you, though!).  I'm a group fitness instructor at a health club (my part time job in addition to being an insurance agent), so it was especially annoying when I worked out.  I'm also a single mom of 3 kids, so thoughts of me passing out in front of them was just plain scary.  So, when I think of all I've went through this past year, I guess medication isn't the end of the world.  

Were your skipped beats worse when you were sick?  I was really sick with a sinus infection & ear infection about 3 weeks ago, too, and my pvc's & pac's were a lot worse.  My arrhythmia was so active the past month, that I thought there was no way they wouldn't be able to induce it during the EP study this past Monday.  But, no....it went into hiding that day, and wouldn't come out for nothing!  Ugh....

Anyway, thanks for your response.  If the fluid is still there Monday, I'm going to go see my family doc and see what he says.  
Are you being treated with meds?  Have you had an EP study yet?

[rilesnic]

I would definetly go in for a check-up before the 18th. You said there is no redness or swelling other than the fluid? Do you have a fever? Did the nurse say it could it be an abcess? You may need on antibiotics just to be safe if you're not already. Maybe a family doctor in your area could just check it to be sure? I feel every skipped beat too, and I'm miserable. I too am very thin, 5'2" 98 lbs.  I got sick with strep about 3 weeks ago and couldn't eat for about 3 days...I lost 3 pounds in 3 days...it stinks. I'm glad they were able to find your arrythmia origination. Let us know if you get an answer on that fluid. I can imagine how uncomfortable the swelling feels. Best to you!

[hiker73]

I forgot to mention that I'm now on 50mg flecainide twice per day, which does control a majority of the irregular beats & tachycardia.