junctional rhythm after ablation

[hopeful 5]

I had my ablation performed 10 days ago and I have been experiencing accelerated junctional rhythms for several hours each day.  Can I expect these to decrease?  Can I do anything to remedy the situation?  The ablation for SVT was successful.  Thank you very much.

[Brooke_38]

What facility did you have your ablation done? Also, you had mentioned that you were going to have a consult about an AV node ablation...what did they tell you? I too get very down about how I am feeling. It's like there doesn't seem to be an end in sight! I have tried every medication under the sun and because of my many rhythm issues, what may treat one problem exacerbates another! It's like living on a double edged sword. I almost feel embarrased when I go into see my Dr. I think he walks in with the hope that I will tell him that I feel great. I cannot remember the last time I felt great. How sad is that? And if 1 more person tells me, "you look sooo tired." I think I might scream. Why do they find it neccesary to tell you how tired you look? I feel like saying, "yeah, I know but thanks for politely telling me I look like ****." What are the major symptoms that are troubling you? It's nice to have someone who can completely understand what it's like to walk a day in our lives:)

You are still early into your healing time, so try to be optimistic. It really takes a good 3-6 months for the tissues to completely heal. If at that time you still have the problem, then I would say that the problem will not resolve. You've got to try and stay positive. I'll tell you something funny....I was taking groceries out of my car and suddenly felt bigeminal pvc's followed by a run of afib....just as I was ready to pass out, I was stung in the foot by a bee! This bee kept me from hitting the concrete! I stood there and started to laugh and thought to myself that this bee just saved me a trip to the ER. This is how I make it through. I also know that there are many others that a far worse off than me. I hope this finds you having a better day.

[7deuceman]

Hi Hopeful 5:

Let me give you something to think about before you are talked into an AV node ablation..
My history; (previously) athletic man, 50, congenital heart defect--repaired coarctation aorta, replaced -valve, ICD, AVNRT ablation in early 2006. (failed ablation with over 4,500 junctional rhythm episodes since)..

1) Ablations should be done by the absolute best doctors.  You need to find that doctor based on where you live and where youre willing to travel.

2)  Find a medical center with the 3D CTA Mapping for Electrophysiological Procedures  
A 3D electroanatomic and non-fluoroscopic system (CARTOMERGE, Biosense Webster, Inc)-- SOME-- not all Med centers have this equipment.  You must research which med ctrs have this equipt based on where you live!!  The most advanced med ctrs should have this equipment!

3) Find and consult the most proficient doctor which uses this equipment!   Like I said, not every hospital or doctor uses this equipment!  Research by website the top hospitals near where you live
then call them to get specific details.
doctor has/uses this equipment.

4) The best method to deal with JET (Junctional Escape Tachy) for some people is to let the heart heal.  Over time my episodes have slowed down a bit.  Also, I do things to stop my JET:

-take several deep breaths and then HOLD my breath as I lean forward, sitting in a chair.  
-lie down in the prone position (on your tummy) one arm stretched out, one folded under your head-- and just relax and do deep breathing, exhailing ALL the way out..
-drink cold water and try the 'vagus maneuver'.  (check google)

5) The best advice comes from an EP nurse friend of mine... Wait for your heart to heal before you do an AV node ablation-- give your body the chance to heal!!!!

It will be difficult but if I can do it, hopeful, (decrease my episodes over time) perhpas you can do it as well!
Hang in there!
7Deuceman

[Michael J. McWilliams, M.D.]

Hello,
The accelerated junctional rhythm is caused by tissue injury.  It should calm down soon but there is no way to know for sure when.  There isn't much you can do to change it.

If you don't mind, drop another post to let us know when it stops.  It is helpful for me to hear about things like this and possible other people in the forum as well.

[hopeful 5]

I think I have given up on my doctors.  I canceled my six week follow up because I am tired of hearing there is nothing we can do for you.  I went to the Mayo clinic for a second opinion and they said the same thing too.  I am really depressed over this, I am sure you have gone thorugh the same thing.  Sorry to hear you have new symptoms.  Keep me posted, I hope your doc has answers for you.

[Brooke_38]

I am sorry to hear that you're having such a rough time. I don't find any connection between sugar intake and my symptoms. However, I do find that drinking anything very cold does make it worse. I can certainly empathize with what you're going through. It is really hard to go about your every day life with this issue. I am seeing my cardio in 3 weeks, in the mean time he wants me to have another 30 days with the event monitor. I have been experiencing new symptoms for the past couple of weeks. I have been awakend from sound sleep with shortness of breath and a rapid, irregular heartbeat. He thinks it may be bouts of the afib but needs to have the event strip to capture the "beast" I do hope that you will be persistant with your Dr and explain that this problem is affecting your quality of life and that you will not accept, "this is it, there is nothing that we can do for you"  That is absolutely unacceptable. Let me know what happens and I will do the same.

[hopeful 5]

Do you notice a connection between sugar intake and your symptoms.  After my ablation i am experiencing skipped beats, juncitonal rhythms throughout the day.  I am having a terrible week and am grasping at straws trying to figure this out.   The doctors have said this is it, there is nothing we can do for you.  The doctor on this site said it will go away but did not suggest a time frame.  I am six weeks from my ablation and have not had any relief.  I am going a little out of my mind because life goes on and I have to go thorugh my daily acitvities with this going on.

[hopeful 5]

Thank you for your posting.  I have had fewer Junctional rhythms this week so I do hope that I am healing.  Do you remember your approximate healing time?  I am almost 4 weeks form my ablation. I am going for a consultation tomorrow and they will advise me about an AV ablation.  I am very grateful for your details about this.   I really do not want to undergo another ablation and will try your suggestions instead.

[hopeful 5]

thanks for answering my questions.  Honestly, I am so sorry that you are having so many porblems, it doesn't give me much hope.  The doctors are now tlaking an ablation of the AV node.  I am having a really hard time coping with all of this.  The physical symptoms of the junctional rhythm are wearing me down mentally.  I wish I knew something to make me less symptomatic.  Good luck with dealing it.  I am thinking of you.

[Blax]

My son is only 12.  He was diagnosed with JET Tachycardia after an EP study and attempted ablation a week ago.  He was placed on 200 mg of Flecainide a day while in the hospital.  He's a large kid for his age (5'5 - 174 pounds).  His MD is talking pacemaker if this medicine does not work.  I am worried and have been searching the internet for all type of information I can find on this type of tachycardia and his medicines.  Any help or suggestions would be great.  

[Brooke_38]

I've been having trouble posting and had to create a new acct. This is heartofgld:)

[Brooke_38]

My experience from the get go has been pretty rare, according to my cardiologist. My Hist. in a nutshell...
38 yo F,Dx by holter 8 yrs ago with SVT. started on Diltiazem and did fine except for the daily PAC's&PVC's that I just dealt with. I have very severe asthma which makes BB's intolerable.
-Sept 06' developed Atrial Fib with rapid ventricular response and needed to be cardioverted. Bumped up the Dilt.from 240 to 360mg and started Coumadin.
-Oct 06' had EP study and failed ablation for AVNRT, did flutterline ablation and started taking 75mg of Flecainide 2x day.
-Nov 06' was sent to NEMC in Boston for another attempt to ablate the SVT.
EP felt that it was successful until I turned up in Atrial Flutter 6 weeks later.
-Dec 06' hospitalized again with Atrial flutter, heart rate was 440! Had Nadalol added, decided that asthma flare was worth the risk to keep heart rate down.
-Feb 06' was now referred to the BWH in Boston for yet another EP study which showed that my AVNRT was atypical. The EP felt that he was able to completely close down the slow pathway.
I have not been without an event monitor since Sept. I am at the end of my rope. So when I thought SVT was bad enough, the event monitor, Echo and countless EKG's have shown:
Accelerated Junctional Rhythm, Junctional Escape, intermittant LAFB, RBBB, 2nd degree AV block(type 1) wandering atrial pacemaker, IST, NSVT, loss of AV synchrony, left atrial enlargement, Atrial tach., Ventricular Bigeminy, Abberantly conducted atrial contractions and fusion complexes?.
I  spent 5 days at the BWH the beginning of June after having a few syncopal episodes. Went through another EP study, where Dr feels that I am now having what he termed, "pacemaker like syndrome" I was started on a low dose SSRI for the IST.
With the many different rhythm issues I have, I try and do the best I can. I live one day at a time. For me, I am worse by the end of the day and find it difficult to relax with my heart acting like a mexican jumping bean. I work full time as an RN and have 2 kids and a husband that have been to hell and back with me this past year. I am now at the point where my EP has done everything he can short of putting in a pacemaker. I will be talking to him next week and will keep you posted.

[hopeful 5]

I am sorry to hear you still have it 9 months out.  I have it most of the day off and on, it is at its worst in the morning and at its best in the evening.  I have trouble when I am standing and feel weak and short of breath with mild exertion.  I am 40 and I am going back to work next week and I am concerned.  What are your typical days like?  Were you able to return to normal activities?  Are your symptoms similar.  I am told this is extremely rare so I am interested to hear from someone who has similar symptoms.  

[heartofgld]

I had my first, failed, ablation last Oct after developing Afib, which required cardioversion. I then had another procedure done in Nov. I have had AJR since then. My EP had hoped that it would get better, but here I am 9 mo later and I still have it. I am in no way trying to discourage you. You are only 2 weeks out so there still is hope for you :) Are you very symptomatic?

[hopeful 5]

Thank you for your reply.  I have since seen my EP who informed me that out of the 5 patients he has seen with Accelerated Junctional Rhythm, none have gotten better.  He believes my condition is also permanent.   I am still hopeful that I will be the exception.  How long does it take in the cases that you have seen.  I am now 2 weeks out from my ablation.

[Momto3]

I am SOOO glad you were able to ask Dr. McWilliams about the junctional rhythm.  Sounds like it may resolve on its own.  Hang in there...brighter days are ahead : )

connie