Great Article

[Mom2four85]

When is ablation appropriate?

Many people have abnormal heart rhythms (arrhythmias) that cannot be controlled with lifestyle changes or medications. Some patients cannot or do not wish to take life-long antiarrhythmic medications and other drugs because of side effects that interfere with their quality of life.

Most often, cardiac ablation is used to treat rapid heartbeats that begin in the upper chambers, or atria, of the heart. As a group, these are know as supraventricular tachycardias, or SVTs.

Types of SVTs are:
Atrial Fibrillation

Atrial Flutter

AV Nodal Reentrant Tachycardia

AV Reentrant Tachycardia

Atrial Tachycardia

Less frequently, ablation can treat heart rhythm disorders that begin in the heart’s lower chambers, known as the ventricles. The most common, ventricular tachycardia, may also be the most dangerous type of arrhythmia because it can cause sudden cardiac death.

For patients at risk for sudden cardiac death, ablation often is used along with an implantable cardioverter device (ICD). The ablation decreases the frequency of abnormal heart rhythms in the ventricles and therefore reduces the number of ICD shocks a patient may experience.

For many types of arrhythmias, catheter ablation is successful in 90-98 percent of cases – thus eliminating the need for open-heart surgeries or long-term drug therapies.

[Mom2four85]

"Recent data suggests that VF, in certain patients, may be initiated by a trigger that can be identified and ablated"  

I'm wondering if that's what happened with me during surgery and why they had to use the paddles on me.

[Mom2four85]

Some other info: A healthy heart beats in a predictable and smooth rhythm. This rhythm is stimulated by electrical impulses generated within the heart muscle. When the heartbeat becomes abnormal, the rhythms it produces are called arrhythmias.

When the heart is beating more than 100 times per minute, this type of arrhythmia is called tachycardia, a potentially dangerous condition. It is caused when the electrical impulses in the heart’s electrical network travel along irregular pathways or repeat the same pathways over and over.

Ablation is a procedure to restore normal rhythm by destroying very small, carefully selected parts of the heart that cause tachycardia. In most cases, ablation refers to the use of catheters to destroy the selected areas of heart tissue. However, ablation can also be performed during open-heart surgery

Ablation has become the preferred technique for treating many forms of tachycardia, and the American Heart Association estimates that radiofrequency ablation (the most common type) is used successfully over 90 percent of the time.

Depending on the cause of the underlying arrhythmia, there still may be a need for antiarrhythmic medications or an implantable cardioverter defibrillator (ICD). Patients with atrial fibrillation or ventricular tachycardia, for example, may require continued use of antiarrhythmic medications. The type and severity of an arrhythmia may also require more invasive surgery in order to correct the problem.

Ablation is a procedure to destroy very small, carefully selected parts of the heart that are causing tachycardia – an abnormally fast heartbeat. Ablation enables the heart to beat more slowly and normally again.

Catheter ablation has become the preferred technique for treating tachycardia. It has replaced direct-current shock ablation, and is more frequently taking the place of some open-heart surgeries and long-term use of antiarrhythmic medications. Although there are several forms of catheter ablation, the two most common are radiofrequency ablation and cryoablation.

Ablation may be used to treat any of the following conditions:

•AV nodal reentrant tachycardia. A condition in which the heart's electrical system “short circuits” due to an extra pathway in, or adjacent to, the AV node.


•Wolff-Parkinson-White syndrome. A condition in which the normal electrical signals in the heart travel along an extra, abnormal electrical pathway. This can cause an abnormal heart rhythm (arrhythmia). The condition is believed to be present from birth (a congenital heart defect). In certain cases, physicians might recommend ablation for young adults who have Wolff-Parkinson-White, but do not experience symptoms. Ablation has been shown to lower the risk of developing serious heart-rhythm abnormalities later in life.


•AV junctional tachycardia. Abnormally fast heart rhythms that result from electrical impulses originating in the AV junction, the area of the heart that includes the AV node.

•Atrial fibrillation. The extremely rapid and uncoordinated contraction of the upper chambers of the heart (atria).

•Atrial flutter. A condition similar to atrial fibrillation except that the rapid firing of impulses occurs in a regular pattern, rather than uncoordinated.


•Atrial tachycardia. Abnormally fast heart rhythms that result from electrical impulses originating in one of the two upper chambers of the heart (atrium).


•Ventricular tachycardia. Abnormally fast heart rhythms that result from electrical impulses originating in one of the two lower chambers of the heart (ventricle).


•Ventricular fibrillation. Recent data suggests that VF, in certain patients, may be initiated by a trigger that can be identified and ablated. However, this procedure is used as a preventive measure. Once ventricular fibrillation has begun, it is an extremely dangerous condition that requires immediate intervention to prevent sudden cardiac death.

Patients with atrial fibrillation or ventricular tachycardia may need to continue antiarrhythmic therapy after ablation. Patients undergoing ablation of the AV node typically require a pacemaker.

Also, some patients, especially those who are at higher risk of ventricular arrhythmias, may be required to have an implantable cardioverter defibrillator (ICD). These devices monitor the heart rhythm and interrupt dangerous and severe ventricular arrhythmias with a strong electrical shock. They can be combined with pacemakers

[Mom2four85]

Since I'm not a cardiologist or EP I can't say what is appropriate or not appropriate for anyone else but myself.  Even then it's so difficult to know what, when, why etc, decisions are difficult to make especially when it's with the heart.

That being said, even if doctors know and your case is cut & dry like mine was before surgery, while inside they may find other things or they may spark something that wasn't there before or hiding.

Each case is so different and there is no "cut & dry" case; only rules to go by and ones like me who throw them all out the window and have the doctors shaking their heads after lol

Have trust in your doctor and go with your gut instinct after being given decisions to make.

[Mom2four85]

Cleveland Clinic has a great 1 page article on Catheter Ablation:
  
http://my.clevelandclinic.org/heart/services/tests/procedures/ablation.aspx

[twinbee]

There are two different types of Ventricular Tachycardia, Non Sustained and Sustained. The Non Sustained or NSVT is relatively benign when not associated with other heart disease. Most people suffer from NSVT.
I on the other hand suffered from Sustained VT. This type of VT can be dangerous.I also suffered from a-fib and a-flutter. In 2007, when I started having episodes of the VT, it was decided that I had to have an ablation done. My ablation was done in January 08. I have been in NSR ever since.

[gb36]

I get so confused by all this.  Some people write on here (including doctors) that Non Sustained Ventricular Tachycardia is relatively benign as long as your don't have heart disease and your heart is structurally sound.  

This article you posted seems to suggest that ventricular Tachycardia is dangerous and deadly and that solution is ICD as well as ablation.  

Two very different takes on the same condition