SVT Ablation, should I get it?

[kcolly32]

I'm a 28y/o female that's pretty active. I've had what I assumed was SVT on and off for the past 9yrs, up until a few months ago it was never caught on a monitor. It mainly came out with exercise, I would feel a PAC then feel my HR increase to very high rate. I finally had a 30 day holter monitor to wear and caught an episode, my HR went up to 260bpm! I got light headed and just sat down and let it ride out, lasted about 5 mins or so. I usually vagal out of the episodes but I let that one go since I had the monitor on. My Dr. referred me to a cardiologist and he wants to do an ablation. I work as a cardiac RN so I've taken care of many patient with this procedure but never thought I would need one. My question is, is it worth it? I get occasional PACs with anxiety or exercise but that's about it. I've read that many ppl suffer PACs and PVCs pretty extensively after the ablation. I understand that these are benign but ppl end up on meds to control them, which I don't want and was the main appeal to getting the ablation. I'm a very active person and love to run so having SVT has definitely stopped me from doing this. Anyone have any advice??

[MichelleP_3811]

If your svt has a history of stopping on its own within a certain amount of time you can feel pretty comfortable doing just about anything or going just about anywhere.  Atrial issues are rarely life threatening.  I understand a certain amount of caution being out in the wilderness but in general svt is not rated by the medical community as a health threat and as such ablations are considered optional.  I rather wish this wasn't the case but the point is svts are rarely if ever the cause of sudden death.  I respect the idea of not straying out to where help cannot be found but I would not stop living your life because of your svt.  It isn't anything to fear but rather just to be managed.  If your body is stopping it on its own odds are it will continue to do that.  There is usually a progression to the syndrome as opposed to a sudden change.  I would highly suggest consulting on this with the EP finding out if there is any activity you should restrict yourself from but I suspect they would tell you to continue to live your life.  As well learn vasovagal maneuvers to help you manage your svt on your own.  If you can take control of your svt instead of it controlling you then there isn't a thing you can't do.   Stay strong and fear not.  

[tom_h]

Your comment could have been written by me prior to my EP procedure.  I too would never do anything that put me out of reach of a hospital, even while knowing that in the 54 years that I had it, I never set foot in one as I was able to slow it with Valsalva maneuvers.  Still it was always back in my mind, and I took up sports that kept me closely to where I started,  Yes, something like rafting in the Colorado would be out.  That would put me in a remote area.  Instead I took up speed skating, and track cycling.  I was never far from where I started.  My family had a big sailboat, and I'd often sailed with them offshore or in the Chesapeake Bay.  But when they sailed to Bermuda, I declined to go much to the disappointment of my late dad,  That was out of the question for me. This was long before they had the technology that they do today. So while I definitely challenged my SVT, daring it to happen participating in sports that required every ounce of whatever I had in me, there was this particular limit that I had that I wouldn't cross.

We've had a few people here in the 4 years that I've been associated with the forum that had failed procedures due to the inability to get their heart to go into SVT.  That is key to finding it.  Unfortunately, the hospital bill is nearly the same as a successful procedure.  So unless you have a very low co-pay, or have money to burn, it['s good to make your procedure count.  Being somewhat of a cynic, I would imagine that an electrophysiologist doesn't think about that when he's encouraging a prospective patient to commit to the procedure.  It's another payday for him regardless of success or failure.

[kcolly32]

That is also another concern for me, what if they can't make SVT happen and fix it the day of?! Mine seems trigger by stress and high HR so I'm hoping the adrenaline they give will set it off. While I'm worried about the procedure, I'm also nervous to do any exercise that requires my HR to get too high. I used to run a lot and haven't been able to this year. I know someone that had that the procedure done but they couldn't get it to go in SVT so they stopped it. Can't do anything if they can't find the area. She was disappointed so she's back on metoprolol at this time. I've read how a lot of ppl feel so much knowing their SVT is fixed afterwards so I understand having to worry about going on trips. Like tom_h said he has a much better life without it. Our situation isn't as severe most so in that case we are lucky. I'm leaning towards getting it done just so I won't have to worry about it getting worse... Still gonna read more about it tho before I make my final decision.

[tom_h]

Michelle and I had it most of our lives.  For me, it was always manageable.  That technique you are using is called a Valsalva.  It was what I used for 54 years until I got it fixed.

Again, speaking from my experience I was back to normal within a month.  My heart was not immediately still.  But it was a lot less than what I was experiencing prior.  Over the next year, the short runs of SVT I was experiencing after the procedure began to diminish.

An electrophysiology procedure while safe does carry some risk.  Again, it is my opinion that 2 episodes per year does not warrant this procedure, especially since you can control it with what you're doing.  Regardless of your decision, best of luck to you!

[kcolly32]

Thanks for your input guys, as far as cost, I was told my insurance is covering the procedure, thank goodness! When I was saying i vagal, I just bare down like I'm trying to have a bowel movement. That usually kicks my SVT back into normal rhythm. I have PACs while working out and that is what usually kicks my SVT in, I'll start feeling them then one hits just right and my HR takes off. I've never had this happen at rest though. Like I said my Dr is concerned it will progress and become unmanageable. I just read how most ppl don't feel normal for about yr which is really discouraging. My main concern is starting a family, I'm sure pregnancy will cause my SVT to become worse. But I being able to workout with out the fear of SVT would be nice to have...