Ablation for AVNRT ok with existing first degree heart block?

[FLA467]

I was recently diagnosed with PSVT (specifically AVNRT based on the ECG) and I am considering radiofrequency ablation since I can't take the medication that can help as I already have a lower resting heart rate. (but ironically borderline high blood pressure.) My question is, I was found to have transient first degree heart block at various times, as well as 3.5 second pauses during sleep while on monitor. Is it any more likely that ablation of the slow pathway for AVNRT would increase the chance that I could develop higher degree heart block and need a pacemaker at some point after the surgery? I have read that heart block sometimes develops after ablation and can go away...since I already have first degree heart block I wonder if the procedure is more risky? (Btw, the heart block was detected on monitor after taking a calcium channel blocker for my bp...it seemed to go away when I quit the meds but the EP says the med didn't cause it...likely it was already there and just brought it out). Not sure if this helps but when I have a normal ECG sometimes I tend to have a slightly longer QRS complex (I think that's what its called). Mine registers on ECG at 202...so barely longer than normal. My EP seems to think that if this happens after ablation for AVNRT then I probably already needed a pacemaker then or would have eventually, but I am pretty young and so if avoiding the ablation longer could prolong needing one, so be it. (I should note that he is not referring to me needing a pacer because of over-ablation of my AV node...I know that is a very small risk of surgery. I am referring to any risk of progressive heart block due to my existing condition) Thanks!

[FLA467]

Now that I think about it...I assume I am not getting any responses since this is probably a question only an EP or cardiologist could answer.I shouldve probably posted in the doctors forum. I guess its not a common dilemma.....

[MichelleP_3811]

You definitely would want to discuss this with your EP.  I have no knowledge of heart block and do not want to mislead you.  I will say that I went all the way to my 40s before I got my avnrt fixed.  How often are your episodes?  How long do they last and can you get them to stop or do you have to go to the ER to get them to stop.  Do you know the tricks to get them to stop.  If well managed and you only have seldom episodes then you would likely be fine to wait to do the ablation.  As a matter of fact eps generally like a person to be fairly active before the attempt an ablation to increase the odds of success. Best of luck getting informed.  Sounds like you already know a lot about your condition and the heart and that is a good thing.