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Avatar universal

questions for those of you who've had an ablation

Hi, I have had AVNRT for apparently 11 years. I was 19 years old when I had my very first episode, that I actually felt. I can not say if I had any before turning 19, but I the first one I felt I was 19. I had them pretty infrequently, maybe twice a year. I had it checked out, and was brushed off early on. I again had it looked into back in 2000 and basically was told I was just having anxiety and I was making it up. He didn't say that in so many words, but said my heart was healthy, my ecg was normal, and it was anxiety and sent me away with an antianxiety (effexor). Ironically enough the year or two I was on effexor I don't think I had any more episodes! I eventually went off effexor and my episodes didn't bother me again until 2002-2003. They were only twice a year up until recently. I finally got the courage up to go see another doctor about this about 4-5 months ago. I am now a nurse and know doctors in the hospital I work with. The cardiologist said she believed me and was dedicated in finding out what I had. We tried 48 hour holter monitors and finally she implanted a medtronic cardiac monitor under the skin. They basically found out I had AVNRT. My heart rate was 220 beats and appeared self limiting. It lasted only 30 seconds. Lately my episodes are coming more frequently, so she asked me what I'd like to do. We decided on a referal to the elctrophysiologist. I have an appointment this Wednesday and I am set up for an ablation Thursday.
I have to admit I am scared to death! The nurse I talked to told me they use twilight sedation.
Can anybody tell me about what to expect? The nurse who reads my medtronic device said perhaps it will help my pvc/pac's. She said its possible it comes from the same hyperactive cells, but from reading on here, it sounds like it won't impact them at all.

I realize that the risk of death is low, but to me 1 in 1000 seems high enough to me. Is there certain situations that makes the risk more likely? What causes the death?

Does it hurt? What can I expect? If they say its in the AV node, will it knock out my AV node all together? I realize the SA node is the hearts natural pace maker.
Any advice or offerings to sooth my nerves will be much appreciated!
Thanks
16 Responses
251395 tn?1434494286
Hello...Since Oct 06' I have had 5 trips to the EP lab which resulted in 4 ablations. 3 for recurrent AVNRT and 1 for RVOT. As for what to expect...You will be brought to the EP lab, upon arrival the nurses and techs will place tons of electrodes all over your torso, pacing pads will be placed front and back. If you didn't have an IV before hand one will be started and you will be given light sedation (probably versed) you will receive Fentanyl for pain. At this point a small incision is made in the right and sometimes left groin, catheters will be inserted to make access to the hearts chambers. Based on what kind of information they are able to gain will determine if they ablate on the right side or if they have to make a small hole in the septum and do a left sided ablation. During the EP study, they will be pacing your heart up and down. This can get scary and can be somewhat uncomfortable. Be assertive, don't be afraid to ask for more sedation or pain medication. When they determine where they will be ablating, most often they will completely sedate you and you will only remember waking up in recovery. At that point you will have to be flat, no bending of the legs for about 4-6 hours.

As far as helping reduce your pvc's/pac's...it may reduce your pac's but reducing pvc's is a completey seperate procedure. Concerning the risk of the procedure. The risk is pretty low 1% of heart attack, stroke or death, and I have made it through 5 times (I'm still kicking and screaming) I can't say exactly what would cause death. I would imagine it would be complications from the risk I mentioned above and certainly the risk is a bit higher if they have to do a left sided ablation which is not common. I think that the benifit of being cured from this problem far outweighs the risks. The only way they would knock out the AV Node is if they mistakingly ablate it. The focal point for AVNRT is usually in close proximety but not directly in the Node itself.

Going in to unknown territory can be scary, but there are lots of us here that have lived to tell. We're here to help you in any way we can. Don't hesitate to ask anything and everything you want. I am sure that you will be reading further posts from members here who have been through this. Just sit back and read the stories...they can get interesting

Avatar universal
Why did it take 3 time for your AVNRT? They told me they won't be using versed, she told me over the phone they use something else now that works much better. When I had my medtronic device inserted they gave me versed and it didn't do anything for me. Infact I remember the whole thing, and I know with some enough versed will give you amnesia.
So do you remember everything then? I am glad to know they put you completely under when they go to ablate. I know they want you awake when they speed the heart up.
I've talk to some one online that said the first time they were not able to recreate the AVNRT for her, and they had to try another time. I am hoping they are able to do so with me!
Thanks for the info. I am sure it will be okay, but I am a nervous nellie as it is over anything! Which doesn't help the PVC's and PAC's and ofcourse the tachy stuff.
Avatar universal
I HAD AN ABLATION IN APRIL OF THIS YEAR AND IT WASNT BAD EXCEPT FOR LAYING STILL FOR THE 4-6 HOURS AND UNFORTUNATELY FOR ME IT DIDNT COMPLETELY WORK I NOW NEED ANOTHER AND I WANT TO GET IT I AM IN AFIB AS I WRITE THIS THIS IS JUST WAY TO NRERVE RACKING NOT TO TRY AGAIN FOR ABOUT 4 MONTHS I THOUGHT WE HAD GOTTEN IT AND THEN IT STARTED AGAIN BUT THEY PUT ME TO SLEEP COMPLETELY I JUST REMEMBER GETTING THE PADS PUT ON AND THE IV IN AND THEN THEY TOOK ME TO THE CATH LAB LIFTED ME ON TO THE OTHER BED AND THEN I WENT OUT TILL I WOKE UP IN RECOVERY. BUT MINE WAS FOR A FIB. GWANDA
288089 tn?1232736136
I'm 34 and I, too, just had an ablation last Wednesday for AVNRT.  My 4th, actually.  It's not quite as bad as it sounds.  They are pretty good about keeping you sedated enough so you won't really know what's going on.  I have had to tell them to give me more pain meds because I could feel what they were doing.  I think maybe it just scared me more than it hurt.  Just remember, they've done this thousands of times.  You will be safe.

Unfortunately for me, it didn't work this time either.  My heart was pounding before I even left the hospital the next day.  Not sure what's in store for me now.  I hope that yours is successful.  Good luck!!  :)  
Avatar universal
I had an ablation on Aug. 4th for AVNRT and it went very well.  I was in the lab only about 2 and a half hours from start to finish.  I was up for the whole procedure and I felt no pain at all. I, like you, was so scared and I  honestly have to say that it's not as scary as you think it's going to be.  If I had to go through it again tomorrow, I'd do it a heartbeat (no pun intended!!) When it was all over, I couldn't believe I had put myself through all that anxiety.
An experienced Dr. is not going to ablate too close to your AV node so don't worry about that.  My Dr. who has done thousands of ablations has never lost a patient or had to put in a pacemaker.
It is so normal to worry about the complications but these pros do this day in and day out and they know exactly what they're doing.  You'll be so happy you had this done.  I am so happy I am now SVT free. After 36 years of dealing with AVNRT, all I can say is I am so thankful it is a thing of the past!!  Good luck!
Betty
Avatar universal
Relzx.
I had an ablation in 1999 for PAT.  My heart rate would go from normal to 225 and stay there for 20 munites. This started when I was 21 years old and lasted till I was 58.  I would get very week and some times dizzy durring and folling the palputations. I learned how to make it stop to some degree but my Dr told me they could fix it. I The procedure was not at all painfull and it worked perfectly and I have never had another problem.  Just relax and it will be fine.  
Avatar universal
Thanks for answering my questions. I wonder why some work and some don't? Some must have more pathways and excitable cells than others?

That was my big question, how much of it do you remember?
569980 tn?1228329485
Hi.  The weird thing for me is that immediately following I could have told you everything that happened - because I was talking out of my head to my wife in recovery.  But then I really started forgetting things.  I think I was on fentanyl and versed.

If I had my way about it I would have had them just knock me out so I would feel or remember a thing.  I told them this but they said that if you are too relaxed they could have a hard time inducing the tachycardia.  So its a balance between the two.

You'll be fine.  Good luck!
246577 tn?1202737776
I had a successful ablation for AVNRT in Sept. '07.  I have been episode free, since that day.  
My procedure took 7.5 hours because they said my pathway was very close to the AV node and it just took a long time to try to ablate the bad areas.  I remember a lot.  I can remember hearing the nurses talking, hearing the phone ringing and feeling my heart race back & forth.  If you had told me that ahead of the procedure, I would have run for the hills.  I thought I'd be totally out of it.  Having said that, it wasn't bad because I never felt an instance of pain or discomfort.  I don't know now what they gave me, but it didn't knock me out, but it didn't let any pain get to me either.  It's natural to be scared to death...I think all of us were that way.  Don't let the worrying get to you.  It's not a bad procedure at all.  I'd go tomorrow and have it done again, if I had to.

Take care & good luck.  Don't worry....Pam
621803 tn?1302888341
I've had two ablations now, one in 2002, and one in 2007 for IST.  Unfortunately, neither of mine worked as I'm still having episodes, and as a result of the first one, I had to had a pacemaker implanted. However, that was a result of my problem being in the SA node, not the AV node.  

As for the actual procedure, the most annoying part is not being allowed to move for 5-7 hours after the procedure!  I remember them setting up all of the electrodes during both ablations, and turning my pacer off for the 2nd, but other than that...nothing!  And my second ablation took over 10 hours!
Avatar universal
I had a successful ablation for a fib almost two years ago.  My EP prefers to do the procedure using general anesthetic.  He said they have done thousands of ablations at their center and have had one death.  That patient was at high risk going in.  
   Being anxious is very normal and we all go through it.  Given your age and general health, it is probable that your risks are as near zero as it can get.  
   I chose ablation because I wanted to be free of the meds that tended to slow me down, and have an opportunity to cure the problem.  And it is true, this is one procedure where "cure" is often used.
Avatar universal
Thanks again for the reassurance. They told me they will use twilight sedation. They said they don't use versed, but something that they said works better! They said I shouldn't remember a thing! I sure hope so!
799882 tn?1238067515
I had AV node ablation w/pacemaker 81/2 yrs ago. It really isn't that bad. I just had a regenerator put in 2 yrs ago. Each time I have had Versed and it went well. Try not to worry too  much. It does make your symptoms worse. I am 100% pacemaker dependent. I don't really recommend it, if it can be helped. I do ok, I just live with daily fear of having to rely on a battery to survive. I know it is scarry, but you will be fine. Technology has come so far just in the time I had my procedure done. Good luck and God bless!!!
Avatar universal
Hello-I guess I forgot to come back and post. I had my ablation Oct. 23 and it was successful. Last night I had a "rev-up" where in the past the feeling that i got would have resulted in the AVNRT coming on, but last night it was a split second rev up and it passed with out going into AVNRT. Since the ablation I have had no episodes.

The procedure itself sucked! I remember every minute of it and the versed did not do a darn thing for me. It was very uncomfortable and I felt a lot of pressure in my chest. I got anxiety during the procedure and the Doc ended up getting upset with me and basically yelled at me to calm down and let him do his job. (yeah even us nurses get nervous during stuff).

But all in all it was worth the discomfort and money to be cured.
Avatar universal
Hi,

I am so happy you had a successful ablation even though you had a bit of a hard time going through it. Being cured of SVT was worth it though, right?!!  I wish you the best of luck!
Avatar universal
I am just so glad I am being able to read other people's stories about their ablation. I am 24 years old female from Cyprus and had my ablation last August. I just needed to lak to other people who went through this but unfortunately we are not as organised as you! I had been having symptoms for quite a few years now and I just got used to not being able to walk with out being dizzy and short of breath. Last summer though I was diagnosed with RVOT and I had to go through an ablation. I was just told that it wasn't going to be painful and that it would work.

So i was sent to Greece and had my ablation there...and i am proud to say-after reading these posts- that guys I went all through the procedure with out any medications!!! It was sooo painful but I was just laying there praying to God to help me. And He did help me. The procedure lasted only an hour the found the source of the arrythmias and now 8 months after I am feeling fine. And it just feels soo weird now that i am able to do so many things, dance, run, even get angry without having arrythmias and dizziness at the same time!!

I am just so grateful I am feeling all right now and I just hope I will still be ok for the rest of my life and grow old...I feel a little scared at times because I really want to live and because I am engaged to be married soon, I don't know if anyone knows if after going this procedure and after having RVOT I can have a family? My doctor says I can but i would like to know if someone actually did it? It would make my life so much peacful...

Thank you and may God be with everyone of you
xx
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