Ablation

[Jm_heart]

ablation or no ablation? After seeing my cardiologist he referred me to a specialist that said ablation could benefit me
I have SVT. I'm 62 yrs old. This just started about 9 months ago. At first stomach bloating acid reflux stress gastritis vertigo.When resting my heart is 62-70 bpm waking up 58 bpm as soon as I start moving around it will go into the
90 to 100 bpm. 1 mile dog walk 100-114 bpm. It does go down fast after I sit down to rest to 65-75 bpm after a minute of resting. I did have a atrial septal defect surgery at age 18 cardiologist says it looks fine he did put me on a beta blocker after I failed the stress test on the treadmill my heart rate went to 170 bpm after a couple of minutes. He then wanted to do a angiogram which I had two months ago results less than 20% build up which he said was good for my age. A zio patch was put on in the hospital after the angiogram 2 week period results heart stopped for 3.2 seconds around 10:00am the morning after the angiogram. The cardiologist referred me to
the electrophysiologist who told me to stop metropolol cold turkey he thinks it was the reason for the 3 second pause.
So he suggest the Ablation would be the best thing to do. It seems like a no brainer but since I had the open heart surgery at 18 anything to do with my heart scares the heck out of me. I. Keep thinking could this be happening because of a Vegas nerve or infection of some kind. I do have back pain left side that shoots into my neck and base on skull. I'm a contractor so do a lot of heavy lifting so I thought maybe I pinched a nerve?
Thanks for reading.

[Jm_heart]

don't get me wrong about Doctors I have the highest respect, they saved my life this includes nurses and the whole medical field. At times when your not feeling well and panic I know myself I may not explain myself or symptoms correctly doctors are not mind readers they are human. Find one you trust listen to your body don't forget your children,family and friends.

[Jm_heart]

Yes, I do have a missed beat sometime one a minute that I notice sometime not at all.when sitting or lying down its a good pace 65-75 bpm no fluttering just a relaxed beat. When I stand it starts to race quickly to 80- 90-100-110 within 20 seconds. But still at a steady beat just fast. The rolling or super fast heart beat of 170-220 bpm has not happened again. I try to stay calm and keep up a slow pace of exercise.i still have a lot of questions about the Ablation the more info I get the less it sounds like I have SVT. Very confusing when the Dr. Tells you you need to do this, well they could be wrong try to ,listen to your on body it will tell you I find staying calm easier said than done is the best way. Go on with your day by day routine listen,relax, rest, have trust, like Tom said be careful as you proceed.ask a lot of questions trust yourself.

[Anxious4ever]

Does you heart rate feel normal though?

I know its a jump in heart rate but does it happen while sitting in one place doing nothing?

[Jm_heart]

Thanks , I think exercise is important I have always been active this quick rise in heart rate scares me from sitting to standing 40-50 beats within 20 sec.
65-70 sitting to 110 standing,that's crazy

[Anxious4ever]

I been hitting the treadmill 5 times a week for about a year now, depending on the incline and speed I can hit my target heart rate in about 3 minutes if I wanted to (157 BPM) for me.
If I take it easy it will take longer, I think it all matters on how hard you are working out and what kinda shape and your age is.

Being 60 your target heart rate is 220-your age x .85 = 136 BPM
That is at 85%

[Jm_heart]

Thank you Tom I do appreciate your input I'll give this more time and ask a lot more questions. When the electrophysiologist said the ablation could fix the problem I said it sounds like a no brainer to me. He said take a few days to think about it. That's when I found this site the input has been great. I just took my dog for a walk and decided to push it a little and do a short jog twice during the walk. I would get some skipped beats and a hollow feeling in the solar plex and heart area with pressure into my neck throat area I had no tumbling heart rate at one point my rate hit 190 -210 if my phone app is correct. Most the time the rate was around 124-140..before this happen it would take a good 20 minutes to get my rate to 130. I Will research pots and try to push myself a little more each day. Thanks again tom

[tom_h]

Of course you know I'm not a physician.  I had near life long SVT; 54 years and perhaps over a thousand episodes.  I CAN tell you that when I get up from the sofa, my heart jumps in rate.  A couple of minutes on a treadmill WILL cause your heart to increase in rate.  You COULD have perhaps POTS.  But based on what you're describing, this is not SVT unless it meets the criteria I stated in my previous post.

Look... electrophysiology procedures are big money; $100K and higher.  I hate to break it to you, but most physicians don't give a rat's hiney if you can afford it or not.  You and me and everyone else looks like a big $ sign. You can bet your life your bill will be the same if the electrophysiologist can or cannot find the problem.  

Please.. just be very careful as you proceed.....

[Jm_heart]

when I'm sitting or lying down heart rate in the 60s as soon as I stand and move around it jumps into the high 90s to 114 within a minute
During the angiogram my rate was at 100 the whole while under sedation. Dr. Said this is not normal .

[tom_h]

SVT is not a chaotic rhythm.  SVT is an exceptionally fast and steady rhythm.  That's what makes it mostly a benign condition.  Rates typically range from 160 to 260 beats per minute.  SVT starts and stops on a dime.  One may feel and initial PVC as the heart jumps into SVT.  A rate can go from 72 to 200 in literally an instant.  When SVT drops out to NSR, it does so witjin one beat.  The feeling as it start and stops is unmistakable.  That is the nature of SVT.  If your heart doesn't exhibit this characteristic I'm confident it isn't SVT.

[Jm_heart]

tom_h
Thanks for the input. I first noticed the problem of what I've been told is SVT about 4 months ago.after a long day at word I felt 2 very hard beats of my heart when going to my truck. Thought my heart was going to stop. The next day on a walk going up a hill at the top my heart went into a chaotic flutter it didn't feel like a heart beat. I stood still after 10-25 sec I could feel it go back to a normal fast beat. Couple days later saw the cardiologist for a stress test. After a 2 minutes my heart did the same thing as the walk he took me of the treadmill had me on my left side for the sonogram my heart went down to Norman beating dr. Said my heat beat reached 170 bpm within a minute.
He put me on metropolol 25mg 2 times a day this made things worse. After angiogram which was fine and two weeks of zio patch he sent me to the electrophysiologist.

[tom_h]

" The incidents you referenced above are typical for SVT. Let's talk some more....."

I love this site, but the inability to edit posts drives me batty!  It should have said

 "The incidents you referenced above are NOT typical for SVT."

[tom_h]

Anot her question to ask is who will be doing the procedure.  In many hospitals, eecially teaching hospitals, an electrophysiology Fellow may do the procedure under the guide nice of the physician whom you've interviewed and selected.  I'm soort, but if I'm paying for the expertise of a particular, perhaps renowned electrophysiologist, I want his hands on the catheters, not those of a student.

I want to ask you about your comments in your post.  The events that you wrote about.  We're you referring to these as SVT events?  It sounds like you think they are.  In my opinion, these rate that you refer to are perfectly normal for the things that you were doing.  The last stress test I took was after my ablation when I was 60 years old.  I got my heart rate up to 198bpm, and I was in normal sinus rhythm the whole time.  I'd say 170 is not a problem.

My advice to you is be very careful that you do not get needlessly directed down the path of ablation without good reason.  The incidents you referenced above are typical for SVT. Let's talk some more.....

[Jm_heart]

thanks for the input, good questions to ask.
The treadmill felt more chaotic at which time he took me off and had me quickly lay on my left side for a sonogram
At which time quickly went back to normal pace, he said my heart is pumping very strong the ASD repair looks great.
Now the question is do I have the Right doctor to do the ablation .

[researcher09]

Like Michelle said, right atrial problems (SVT, WPW, etc) can be ablated relatively safely.  You would still want the EP that does it to have done many and that he does more than 100/yr.  If you have left sided issues (AF for example), then it takes a lot more experience and skill.  The average Medicare center (50 percentile) has major complication rates of 9%+ and they are mostly low volume centers.  So procedure volume is important in deciding whether the EPs are skilled.

The other important consideration for you is your ASD repair when you were 18.  If your EP finds AF (and there is a higher chance of that for people that have right sided SVT) and needs to go into the left side, he would not be able to do it with the conventional approach using a transeptal puncture.  He will need to do a retrograde approach to access the left atrium.  Under those circumstances, it would be important for him to have access to a magnetic navigation system (stereotaxis) in order to do retrograde access safely.  

I agree with your doctor that ablation is the way to go.  Finding the right EP with the skills and tools is the key to a successful outcome.

[MichelleP_3811]

Ablations are relatively safe all things considered.  They only have something like a 1-5% complication rate which is very low.  Did they say you had an accessory pathway svt or afib?   What did you feel on the treadmill. Did you sense a sudden increase in rate and a sudden stop back to a more normal rate or did it feel irregular and/or chaotic?  My svt felt like all of a sudden my heart was beating manic fast and would stop just as quickly.  For me I had episodes all my life but they were pretty rare until my 30s when it started to act up more.  There is a correlation between a rise in ectopic activity and an increase in svt episodes.  The mechanism of an ectopic beat can trigger an svt episode.  Things like acid reflux can trigger an ectopic beat so your gerd may be partly to blame.  That said, it is hard to completely stop ectopic activity once it gets initiated so you would likely always be vulnerable to having svt episodes get triggered.  I have heard of some whose svt was only triggered by exercise though mine would start and stop for no reason at all.  This said, I would ask to clarify if it was accessory pathway or afib.  Afib is a bit harder to ablate than run of the mill svt.  I would think they would say afib specifically since they don't generally call afib an svt but I would still want clarity before i went through with the ablation.  But in general ablations are pretty safe compared to invasive medical procedures.      

[Jm_heart]

Yes a treadmill stress test brought on svt to 170bpm
After about 2 min. I then had a angiogram to check for
Blockages which came out good less than 20% blockage
Had a zio patch (heart monitor) for 2 weeks which led
To the electrophysiologist who suggest the ablation.
This just came on out of the blue. I fill the same WTH
I've never taken any meds, I'm 62 yrs old.

[Anxious4ever]

Did you have a 24 hour monitor, did they catch the SVT in its act?
Maybe they seen it on the stress test?

From what I see is you have a normal heart beats, none of this shows tachycardia.

Sorry if I'm missing something.

Thanks for posting in my thread, I hope you ablation goes well.