PVC's after ablation

[LovedOneSuffers]

My husband recently went through a cardiac catheter ablation...his 2nd attempt finally produced arrhythmia's in the lab, and the dr was able to ablate 2 locations.  Within 2 hours after the completion of his procedure, the PVC's began...and became very frequent.  Sometimes as close together as every other beat.  This has continued and remained at this frequency and we are now about 31 hours post ablation.  His dr prescribed metoprolol XL, which did nothing to help the situation today, so has changed to Rythmol.  My husband has the misfortune of being able to feel every flutter, PVC, pause,  everything--which we've been told is rare, most people who experience them don't even know they're happening--makes me wonder if many patients have this post-ablation and just do not know it.  I've read that some people after ablations do experience palpitations or PVC's or abnormal rhythms that eventually decrease over a few weeks, that sometimes meds are needed then tapered off and all is well....but I've also read that sometimes these things persist despite a "successful" ablation procedure.  At this point, we're looking for how common is it to experience this?
What time frame can the PVC's persist?  How often is medication needed temporarily then taper?  Can they be occurring because of needing to heal after the ablation?  Are they only occurring because there is an un-ablated area causing disturbance?  Does anyone know a good resource to locate more info on the subject?  (Many places I've searched only comment on the wound site and chest discomfort post-op, not the rhythm after affects).    

[ptadvoc8]

I had a "successful" cryoablation for WPW in 2010 at a top notch facility by an experienced Dr. I like and have faith in. The delta wave disappeared and I was pronounced "cured". However, post-ablation I began experiencing PVCs that significantly interfered with my life in such a way as to be worse than the occasional WPW induced PSVT episodes, most of which lasted a few minutes and stopped when I lay down and valsalvaed, none of which ever lasted longer than an hour and for which I never needed to be cardioverted via meds or paddles. My PVCs are currently 5,000 to about 12,000 per day and leave me fatigued, light headed, short of breath and extremely frustrated.

While PVCs are generally benign in those with functional hearts, no heart disease and no other health problems, they are known to occasionally cause Cardiomyopathy, an enlarged heart and lowered Ejection Fractions, that can result in serious complications. Most PVCs WILL "calm" down after ablation, but I have seen several EP specialists who are aware that in some patients, PVCs continue to be a problem long after the procedure.

My EP says tests they ran suggest that my persistent PVCs are the result of a.) the procedure itself due a problem with the placement of the catheter in a susceptible spot below the valve or b.) possibly due to "unmasking", where the WPW bypass tract that once blocked or "masked" the route the PVC impulses took is no longer there and the impulses go straight to the foci in my ventricle. So, either way, had I NOT had the ablation, I would presumably NOT be having so much trouble with PVCs.

I don't blame the EP specialists (not even the fine doc who did my procedure) as working in the medical field I was actually aware of this as a possibility. I'm also not saying people should not have ablations, because many people have benefited greatly from them, but I do think that too many patients don't have all the information they should have before making these types of health care decisions and I absolutely think that the medical community has a lot more learning and research to do in re this issue. It is becoming obvious that there is a subset of patients who have "post ablation syndrome", which is a general term that can include persistent PVCs, Sick Sinus Syndrome, A-Fib, Heart Block and chronic chest pain of unknown etiology. I would like to know what the actual numbers for this are, but ufortunately there have not been very many longitudinal studies looking at patients long-term after their "successful" ablations.

Because I am on the border line of having 10% - 15% of my total beats as PVCs, which is where research suggests the problems with heart enlargement often begin, I am now trying Verapamil to see if I can lessen the PVC load. Prior to that, I tried everything else I could find or think of, from supplements to dietary changes to exercise to meditation, and while I am grateful that my situation is not worse, as I know many people's are, it is still difficult to deal with. If medications don't work and there is ever PVC caused heart enlargement, then I am looking at having to go through another ablation — not something I feel terribly sanguine about at this point.

[Fitty4117]

They do ablations for PVCs, but they are less effective than SVT and more risky. I dont take the medacine anymore. It made me feel aweful and I decided if I could just live with them for now I was better off. I am getting better at it. I actually had a 5 day good stretch which was great, but the 3 days of them again. Today has been a good day again so I feel I am getting better now, but it has been almost 6 months.

[Fitty4117]

I have them as often as you and have actually had runs of bigeminy a lot lately. my EP says they are nothing to worry about and that I need to accept that they are harmless and learn to ignore them. They dont effect me as much as before, but some days they are constant.

[esjaydee]

Thanks Fitty.  I definitely never experienced PVCs at this rate, which for me are the sensation of skipped beats (I actually know it's a fast beat, and then a pause for about 2 seconds before the next), or an acute awareness that my heart is beating hard.  Mine are probably every 3-10 beats.  I do feel lightheaded at times, or sometimes feel my heart rate speed up and then subside.  Although I've been recorded on monitors, my EP thinks there is no real issue, other than I happen to be someone who feels them quite often.  With all the knowledge about the heart out there, I can't imagine there is no "cure", besides just prescription drugs to make you feel them less.  But that is what it seems.  I'm now 3 months post-ablation for AVNRT/SVT, and am hopeful that the PVCs will subside.  Still really concerned about exercising, which is something I miss dearly.

[Fitty4117]

I had my ablation 5 months ago and still get tons of PVCs. My doctor seems to think I will have them I guess always and I will become desensatized to them eventually. I have gotten much better. They do seem to be weaker ones now. The ones I used to have were very forceful. The Stanford University website says many people experience them for several months after an ablation. I hope they do go away all together some day, but not so far.

[achillea]

Although I have had PVCs and other minor arrhythmias for decades, I myself have not needed an ablation.  My understanding of cardiac function is based on years of studying anatomy and physiology.

However, a fair number of people on this board have actually had ablations and have described their experiences here.  Many of them describe PVCs for weeks afterward, so you are not alone.  You might find it helpful to run a search for "ablation for AVNRT" to read some of their experiences, and perhaps to communicate with them personally.  A member named Jannie411 has kindly mentioned that she would be happy to answer questions about her own ablation for AVNRT.