Worries about ablation etc

Heart health and blood vessels
1

Hi all,

I've had infrequent SVT episodes for about 8 years. In that time, through fear of reoccurring episodes I have cut down on pretty much all forms of exercise, which is impacting my lifestyle.

I caught the SVT on an ambulance ECG about a year ago. Since then I’ve seen two cardiologists who have both, without hesitation, said I should have an ablation (even with the knowledge that my episodes aren’t that frequent). Both dismissed the use of drugs as they thought that the side effects would outweigh the benefits, and both downplayed the seriousness of an ablation (one says if he completed the procedure on Friday I should be back at work on Monday, the other compared it to a dental procedure).

I’m terribly scared of an ablation, but also live in fear of SVT episodes (which can be triggered by simple things like lifting heavy objects or bending down).

Are drugs really not worth it? Is an ablation now so safe that it’s the go-to option even if the episodes aren’t that bad?

Thanks in advance. I’d really like to talk to some people that have had ablations on the phone if possible... if anyone can think of a way to make that happen that would be great.

2

I did an EP study with possible ablation but the doc did not do the ablation because he couldn't trigger the episode long enough. I had sever anxiety before the procedure but it was so easy, I wondered why I was so worried after lol. Ablations are now so common, they are becoming first line treatments for SVT's. When I went to the hospital for mine, there were like 5 or 6 others scheduled. All though there are some inherent risks, the complication risk is low. If your sporadic SVT episodes are impacting your life, I would do the ablation if I were you. Since they could not ablate mine, I am now on beta blockers, which absolutely suck. Not only do they make me tired, they cause my PVC's to be worse I think. My EP doc doesn't want to give up on the beta's so he won't switch me to a calcium channel blocker until I've tried a few different ones. I'm on my second beta blocker, and think within the next few weeks, I'm gonna ask him to switch. He wants me to try at least two more before the calcium blockers, which sucks lol. And, calcium channel blockers have their own list of side effects. If you can take care of your problem and not be on meds for the rest of your life, that would probably benefit you in the long run. Of course, everyone responds to medication differently so if you want to try the meds first, you can do that and always fall back on getting the ablation done in the future.

3

Hi Chris, I have heard bad and good results for ablation. First, research your selection of surgeons. Please, PLEASE DO NOT TAKE THE WORD OF THOSE WHO CLAIM TO HAVE HAD SUCCESS OF ANY SURGEON. I just made this huge mistake in selection of a surgeon to perform an endoscopy carpal tunnel release. This maniac surgeon went nuts doing such an easy surgery. He took a cylinder shaped probe and continuously and violently jabbed it in and out of the home in my wrist. His nurse told me I wouldn't need any pain meds and sent me out to drive on the interstate a 2.5 hour drive to my home. Once on the interstate the analgesic wore off and my wrist light up like a torch. It was hell getting by home. Pain like I have never felt before. I am now getting an MRI to see what damage this guy did to me.

4

Our University Hospital electrophysiologist estimates chance of ablation error/failure at no more than one percent. Pharmacist Ben Fuhks of Critical Health News considers ablation an atrocity. You might be able to talk to him when he's on CoastToCoastAM (once a month). Ben says SVT is a back problem so instead of bending over, squat. See my other comments on topic. Get the CHNewsletter to find out when he's on C2C.

5

They tried an ablation on me but it did not work. They also tried me on a beta blocker, which made me nauseated. Then they switched me to a calcium blocker 240mg every morning. That worked a little, but still had some episodes so they added 120mg in the evening and it's keeping it all in check with no side affects . I have not curtailed my activities at all, but watch what those activities involve. I may have an episode if I bend over to pick something up or lift my hands too high. I also cannot have caffeine. Even Starbucks decaf has too much caffeine for me.

Start keeping tabs on what triggers you episodes. Try not to curtail your activity, since that will lead to a host of problems, especially weight gain.

I agree on the ablation. It really worried me and if I had it to do again, I wouldn't do it.

6

Hi, I am scheduled for an ablation next week. I used to just have very infrequent episodes but then they became frequent so I was put onto daily Flecainide about 8 months ago and it has been great, but it does make me tired.Then the Health Board decided I should have ablation.

I live in a country that has a free national medical service, so I just go along with what the hospital experts say and don't have to worry as to whether someone is spinning me a line just to get my business. The two people I know who have had ablation have been really happy with it. My hospital does ablation every day. The risks are pretty low these days and the success rate is pretty high.

My ablation will be done as day surgery. I go in in the morning and then go home in the evening. I have been advised to take two days off work after the ablation, but some people in sedentary jobs can return to work earlier. I will work from home on my 2 days off if I feel up to it. I am looking forward to the interesting experience, and I hope, not having to take Flecainide every day.

My advice is try flecainide or metolprolol first if one of them is right for you, then if it doesn't work out for you, have an ablation. In the meantime,I would not advise limiting your physical activity. I exercise every day and have done so through all my heart's ups and downs. A strong cardiovascular system is important in limiting the effects of SVT.

7

I don't know where you are OP but I'm in the UK. I was diagnosed with SVT a couple of years ago and like you I curtailed my activity. I was put on calcium channel blockers which do have some side effects. After a very bad episode of SVT involving A&E and an overnight stay my dosage was increased and I was referred to electrophysiology. The NHS moves slowly but when I was eventually seen the electrophysiologist was immensely reassuring and I went for the procedure. It was unsuccessful as they failed to trigger an even but I am on the waiting list for a repeat attempt. The process was treated as very routine and if you have had SVT you would feel familiar with the sensations. In addition the Doctor told me not to restrict activity out of fear. He advised me to build up exercise and warm up but that fitness could only be beneficial. I followed his advice and am now much fitter and less fearful of triggering an attack.

I found this helpful thread on MN https://www.mumsnet.com/Talk/general_health/3567051-Terrified-of-having-catheter-ablation-for-SVT?msgid=86674694

8

Hi! I have infrequent episodes, too, and I have an appointment at the EP next week. I was offered ablation in January, and I'm not on meds, either. Today on Facebook Dr. Gupta (cardiologist in the UK) had a live Q&A, asked his opinion about an ablation with infrequent episodes, and his answer was to undergo the procedure so I wouldn't worry about SVT again. So I think ablation is a very common treatment for this condition.

9

Thanks for this response, it's really helpful. Hope your switch goes well and works out for you.

10

... but if it would have worked you probably would be saying it was the right thing to do? I don't blame you for saying you wouldn't do it again if it failed.

11

Thanks for the advice. I don't really fancy taking the medication - it seems to be the case that doctors are so confidence these days about abation that it's their number one option.

I'm guessing you're English (either that or your english is great). I am too, and I trust the NHS, of course.

12

Thanks for all this. I generally am a bit scared of exercise right after a bad episode, then after a while I gain in confidence until I have another bad episode. I just can't play football or run though, they are far more likely to set it off. Cycling works for me but it still happens sometimes. I'm still not a tiny bit fit, and not particularly overweight or anything. I'm pretty set on getting an ablation but it just scares me... on the NHS too.

13

Thanks for this - I think this is the way that the NHS is going. They didn't really even want to know how frequent it was. Something like this with both cardiologists:

'Is it affecting you? Does it make you think twice about doing things like swimming when you're on holiday or running after your kids?'

'Yep'

'Get it done'.

Their confidence was surprising and a little unnerving... but ultimately I guess it's just the huge gap between it being their 9-5 job (no big deal) and me getting poked in the heart (big deal).

14

Hi I had an ablation 18 months ago and it was the best thing i did. I had had sporadic episodes of SVT for probably 3-4 years but these had never been captured on ecg despite lots of tests. When they began to become a bit more frequent and lasted long enough to be captured on ecg, my consultant immediately suggested the ablation. He did mention taking tablets but once i realised that would be for the rest of my life, I chose the ablation. I am not saying I wasn't nervous but I trusted my consultant and it worked out well for me. He managed to deal with it during that first procedure and (touch wood) I have had no SVT since. Some people do need more than one attempt to deal with it and others find that they are not suitable for ablation. My ablation took approx. one hour thirty minutes from start to finish and i opted for an overnight stay in hospital. The next day, I felt a little tired but after a few days rest, was fully recovered. I had a good experience and take no medications. Talk to your consultant, they should be able to help with any fears/nerves. I totally understand that it is scary! Like you, I came on this forum to ask others for their advice before making my decision. Its good to get other people's experiences and views but only you can decide. I hope it all goes well for you and that you find a way to get rid of the SVT. Best wishes

15

I was diagnosed with SVT in 1992 and used medication.. an older style (Proprananol). It worked well for years although I did still have episodes requiring medical reversal of the rhythm. In 2015 I started to have very frequent episodes landing me in ED. These were occurring everywhere doing the most benign things.. like bending over and even laughing. I work as a midwife so the last straw for me was two episodes in one week at work and having to be taken to ED. I saw a cardiologist who said i could change meds or have an ablation. I had put off having a ablation because I was terrified of the procedure. I finally had it done in January of 2016.. it was the best thing I did. No more meds. Occassionally I still get a thump here and there which would signal the start of an episode but now the pathway is no more it cant start. Recovery was good. I took a week off work to rest and haven't looked back.. where are you located. I can highly recommend Dr Chan who works out of RPA hospital. He specializes in electrophysiology of the heart, has written numerous papers and is on various boards. Very well credentialed. I finally got a name for my SVT of AVNRT. I saw him a week later and haven't had to see him again.

16

Was awakened by SVT at 8:55a-m. Weather forecast was 60% rain. Got control with corotid pressure in 5 minutes to about 80 beats/min. Back to 60 after few hours, return of sunshine.

17

A further note; pharmacist Ben Fuhks in an article in Critical Health News on meditation being the best medication notes: ""vagus nerve", which activates the parasympathetic nervous system." The vagus nerve in the neck is where I apply firm finger pressure as soon as I have ventrical "stoppage" in order to return to a normal pulse. So there may be a connection between SVT and the parasympathetic and meditation may be something worth trying.

18

Hi, I had my ablation yesterday. The surgery was done in my local hospital (I live in New Zealand) as day surgery. It is very routine, they do several a week, and the surgeon is world-class.

I found the surgery quite fun, watching on the screen the instruments moving round in me and conversing with the 6 staff involved (senior surgeon, junior surgeon, and I think 2 techies for the x-ray and whatever else, 2 nurses to administer the cocktail of drugs to rev me up, slow me down, etc. at different parts of the op). There is a huge amount technology involved, demonstrating the pinnacles of human mental, scientific and technological abilities. Something to be truly grateful for.

The worst part of the day was lying completely still for 4 hours after the op, a small price to pay.

The surgery barely deserves the term because it is quite a minor operation. I was awake throughout most of the procedure. (I dropped off at some point when the mild sedation they use to keep you calm overcame me.) I went to hospital at 7 am and was home by 7 pm. And now, after a good night's sleep the only thing to show for it is a plaster on the groin.

I intend to log into work and have a normal working day (at home) soon. Enjoy your day. I know I will enjoy mine!

Katherine

19

Hi Katherine,

So wonderful to hear your ablation went well. Enjoy some down time and rest.

Did you find out what type of SVT you had?

Unfortunately, My experience has not been as successful as your. I have had 3 attempted ablations but never ablated.

I have AT, and do not take any meds. I did take Bisoprolol for about 3 months when this first started Feb 2016, but could not handle the side affects. I am 64 years old.

Congratulations on your success and enjoy a SVT free life

20

Hi Katherine, how's it feeling today? May I ask whether you were on any medication - CCBs or BBs? If so have they stopped these immediately or will they be phased out? I think I have SVT and AT and I'm taking Diltiazem. I am having a repeated attempt next week and while I wouldn't call it fun I did find it fascinating. I had no sedation last time.