AVNRT - Post Ablation Symptoms

[JasonW]

I'll keep this question simple...

I had an RF ablation for AVNRT in late September.  For the most part, the healing process has been fine.  There are some days, however, when I have so many PACs that I border on going insane.  The problem is that they are frequent and forceful...not the light ones that we can all ignore, the ones that really thump.  These days of incessant PACs might be tracking with exercise - happening one to two days after a good run.

How long do post-ablation symptoms last?  A lot of us hear 4-6 weeks, but I'm hoping the period is longer because I want these days to fade away eventually.

Any insight is appreciated.

[JasonW]

I think we're on to something here...

The heart block thing was just a result of the burn site being so close to the AV Node...once the swelling went down I was okay.  The doctor had me on Carvedilol before the procedure but took me off of them afterward.

I'm not having any issues with tachycardia.  I just get these three day stints with PACs.  Day one is the ramp up, day two is all day misery, and day three is the ramp down.  So far, there's no rhyme or reason to the bouts...the correlation to exercise is my best theory.  Maybe be a little lazy for a couple of weeks and see if they stay away?

Something you wrote, Michelle, really struck me.  The idea that the premature beats are much worse than dealing with the SVT really hits home.  The tachycardia might hit me twice a month and ONLY when I was exercising so I seemed to have some control over it.  The PACs defy reason and are miserably 'in your face' when they are at their worst.

I appreciate your story.

[MichelleP_3811]

I struggle a little with wondering if I made the right choice doing the ablation.  The pvcs didn't bug me that much prior to the ablation.  But in the long run I kind of think having the two problems isn't healthy for us.  Though I did not know what they were and that they weren't related to the avnrt I was starting to get quite a few flutters prior to the ablation.  I guess it kind of seemed as though they calmed down after a run of svt but to be honest I can't say that for certain.  I know I felt the flutters quite a bit so I can't say for certain that correcting the svt created a bigger problem with the pvcs.  It may have but then again the pvcs getting a bad as they were may have put me in more danger of falling into VT.  The medical community doesn't consider either condition life threatening in a healthy heart but if I am going to be honest I rather think not doing the ablation sooner has left me with the pvc problem.  The two problems obviously feed into each other but I kind of wonder if I had been a little more on top of the svt problem I wouldn't have developed the pvc problem.  But it is kind of the chicken and the egg riddle.  Which came first.  I guess in the whole scheme of things we can't go back.  I am down to little bouts of pvcs a day, some days almost none and they aren't that troubling.  I have faith that you will reach that day as well.  

[JasonW]

I don't second guess  having the ablation.  I hate SVT and became really sick of holding my breath and waiting for it to happen.

Are you sure that you are having PVCs and not PACs?  From what I read, they feel similar.  Did you catch them on a holter, EKG, or event monitor?  I ask because usually ablation for AVNRT consists of work and burns in the atrium.  Hard for me to see how that would irritate the ventricle.  But...I'm no EP so it's entirely possible that I don't know what I'm talking about.

It's concerning me somewhat that no one else is jumping in here to say 'Oh yeah!  I had to deal with daylong episodes of premature beats, too!'

If you're out there speak up.  It helps people like Michelle and I to know that the specific symptoms that we're dealing with are common.  It gives us hope that we're not special cases and that we can look forward to the symptoms going away.

[MichelleP_3811]

I actually had the pvcs before the ablation.  The ablation didn't cause the pvcs.  I am not sure how I got the pvcs.  If they were caused by the svt initially maybe one of my longer episodes that I didn't do anything about or if something else happened in my past to cause the pvcs to begin in the first place and then having the pvcs gave the svt opportunity to go off.  Essentially when I am having a pvc the heart adds an extra beat from the ventricles and in doing so confuses the SA node causing the heart to pause a beat.  I can feel the pause, it kind of feels like my heart is fizzling out.  If I have a few in a row I have trouble catching my breath.  Pacs are less likely to be felt because you don't have a pause and then hard restart.  I know they are pvcs because they were caught on an ekg in my doctors office.  I may possibly have pacs as well but don't know that for certain.  In any event, more of a concern for me is the statement they don't get worse but mine did.  I never did notice them before up until the last couple of years.  And right before the ablation they were flaring up a lot.  And because they were flaring so much I had at least 7 svt episodes that week.  If I had not had the ablation with the pvcs flaring so much I likely would have started to have daily episodes.  But on the other hand it almost seemed as though the svt would calm the pvcs down once the episode stopped.  But since I didn't know I had pvcs it is hard for me to judge that for certain.  I wasn't consciously trying to understand them at that time.  So I have to go with the notion that the svt stresses the heart enough to allow the pvcs and pacs to get a bit out of hand but after the heart has healed they will settle down.  If not I guess we will just need to figure out how to deal with them.  I only had a couple of weeks were I felt really really sick with them.  Now they come and go and are more of a nuisance than anything else.  

[MichelleP_3811]

It is the pause after the pvc that allows the secondary pathway signal to make it to the center of the avnode thus giving it the opportunity to get caught in the loop going out the entry and back in the secondary pathway in cases of avnrt.  There may be other triggers for causing one to fall into an avnrt svt but I think mine most likely got trigger by the pvcs.

[esjaydee]

I had an ablation done in March for svt (AVNRT).  Since then I have had very frequent PVCs.  I experienced some prior to the ablation but nothing close to post ablation.  Sometimes they are every 3 beats.  It's very disturbing to have them so frequently.  I too am curious about others who have experienced PVCs post ablation, and if they subsided at any point after.  Thanks.