Triggers for SVT / Tom's Ablation

[sma5]

Last year (Feb) I experienced my first SVT episode and then again a couple of months ago I had another episode - both sent me to ER where they stopped after about 45 min.  Have any of you found that there were "triggers" that brought on your episodes, i.e., being under major stress, hurrying, lifting something, body positioning, electrolyte deficiencies, caffeine or alcohol, etc.  I also have been dealing with PVC's (premature ventricular contractions) for some years.  Do any of you also experience those?  My cardiologist has talked about ablation, however, the risks involved petrify me and also I have a panic disorder.  I honestly do not think I could be in a situation where I cannot move for hours and I may freak. I've read the posts today and I'm happy that Tom has had a successful ablation.  You must feel so much freedom and relief.  Do you remember anything else about the procedure?  Could you feel anything like the catheter in your heart?  I always feel SVT "lurking" and honestly my life has not been the same since it first happened.

[VCJohnson]

My ablation procedure, for SVT/AVNRT, was in March 2014.  Prior to that procedure, I never felt PVCs, only felt a single ectopic beat, then a sudden, heart rate drop, with that only happening during strenuous exercise.  My HR drop was due to my 2nd degree, Mobitz 2, previously diagnosed heart block.  I had a pacemaker implant for the diagnosed heart block in 1/2013.  My SVT/AVNRT was diagnosed about one year after the PM implant.   Since the 3/2014 ablation for SVT/AVNRT, the SVT has stopped for now, but that took over a year to completely stop.  But, since the 3/2014 ablation, I'm much more aware of what I guess are PVCs.  I'm only aware of these during very strenuous exercise- either running or cycling.  I get the same feeling which used to immediately precede an SVT event (sudden, prolonged high heart rate).  But, now the SVT doesn't happen.  I think that the PVCs have become much more frequent, though still only happening  during extreme exercise, when compared to my experience prior to the 3/2014 ablation.  My Cardio Electro Physiologist only recommends several drugs for me to take for the PVC.  I don't take them.  I'd rather live with the PVCs, at least that's my preference for now.  Good luck to you!

[tom_h]

Glad to hear from you along with the update regarding your troubles.  I'm sorry to hear that you continue to experience PVC's.  They are a pain and from reports here are hard to get rid of with an electrophysiology procedure.  I continue to do very well.  I can't say that I'm arrhythmia free as I continue to experience an occasional short run of something, either SVT or perhaps NSVT, but it drops out after 8-12 beats.  This occurs every few days.  But it doesn't worry me, and I continue on with what I was doing.

I don't think that you're alone here.  I can't say for sure, but I believe there are other who have reported the development of PVC's following their ablation for SVT.  I hope you can get control of them, and don't give up.  Perhaps a new thread with an appropriate title would get some responses.  Good luck!

[esjaydee]

Hey Tom.  It's been a while.  Just checking in to see how you're feeling, and if your heart has continued to calm down.  Mine has not unfortunately.  I still experience about 5000+ PVCs in a 24/hr period.  Although I was very against it, I caved finally and started a course of medications (separately), all of which have not really calmed the PVCs.  I've seen some other EPs, but I get the strong sense that since my case has been evaluated previously, they really don't want to get involved.  I had one top-notch EP in NYC practically yell at me during a consultation, saying that I have to stop thinking that the SVT ablation has anything to do with my PVCs since then.  So meds don't help, the medical community has been a constant disappointment, and the PVCs continue.  Hate 'em.  Hope you're well.  Would love to hear from you.  And of course, if you know of anyone who's experienced similar issues as I have, and their PVCs have gone away, I would welcome that input as well!

[tom_h]

Yes, what are the chances that your EP will say that his work is the caused the PVC's!  Perhaps a whole new team, cardiologists to electrophysiologist will offer you some new ideas and direction.  Hope it gets better!

[esjaydee]

Thanks Tom.  I appreciate your message.  I think what is most frustrating is that pre-SVT ablation, I had virtually no PVCs, and now post-SVT ablation (literally right after!), I am experiencing 2000-5000+ daily (and of course, concerned they will get worse as time goes on).  So, I have to conclude that something happened during the ablation which is now causing these PVCs.  Equally frustrating is that my EP never mentioned any such potential after-effect.  And worse, he keeps saying that I'm just more sensitive to them now.  I point to the fact that monitors pre and post ablation say otherwise.  Ugh.  So now, I'm left with these pesky PVCs night and day, and the only advice I am getting is go on anti-arrhythmic meds or get another ablation.  Neither is a great choice.  No one in the med community will come out and say that my PVCs are caused by the ablation, which is very frustrating and concerning.  So, I wait and hope that over time, they will get better, but they are not unfortunately.  And I am now thinking of meds or another ablation.  Not a great place to be.  I would strongly recommend anyone having an ablation for SVT to discuss after-effects such as PVCs with their EPs and Cardios.  There's plenty of posts on this site, and others, which mirror my story.  Had I known it would be like this, I likely would have not opted to have the ablation.  Hope you continue to feel better.  

[tom_h]

.....sorry!  I'd give it a little more time and see how the PVCs do although unfortunately, I think most cardiologists would look at 2 to 5 PVC's per minute (what you're experiencing) as well within acceptable limits.  Keep. In touch on how your're progressing.

[tom_h]

Hi.  I got your message, but thought I'd respond here.  It took well over a year for my heart to settle down.  Even today, a full three years later, I still get short runs of SVT every now and then.  When I'm greatly fatigued, I start getting clusters of PVCs.  The thing to remember is that the path for you SVT is still there.  It was just interrupted with a small scar.  Tissue can heal over and begin conduction again, or there might be a small thread of conductive tissue remaining as what is suspected in my case.

I think your EP is trying his best to make it sound that what you're experiencing now just might be in your head.  The fact is, something could have changed in uour heart with the ablation.  I'

[esjaydee]

Hey fellow SVTers!  I'm wondering if any of you who have undergone an ablation for SVT have experienced any post-SVT issues (other than elation, of course)?  My story, the short of it, is that I underwent an ablation for SVT/AVNRT in March 2012, after having experienced about 7 or so SVT episodes prior to that.  It seems that the ablation procedure was an overall success (although I have had what feels like SVT episodes on two occasions since), however, just hours after my ablation I started experiencing very frequent PVCs.  And since that time, I have experienced PVCs on an almost daily basis, upwards of 2000+ per day (most recently in the 7000 range), when prior to the ablation, I rarely, if ever, experienced any PVCs.  My EP counsels that I'm just more aware of my heart, although the empirical data from monitors pre and post ablation beg to differ.  In addition, I've read several posts on this and other health boards of post-SVT ablation PVCs that get worse and never go away.  Some have reported initial PVCs, but then the heart "calms" after 3-6-9 months, and they go away.  Not my situation unfortunately.  Would love to hear your stories about this...

[tom_h]

Well thanks, Jannie!  .....and Suzanne, let me say that Jannie has an excellent account of of the entire procedure because she was conscious for hers, and gives blow by blow details! Glad to see you're hanging around Jannie.  Folks like you are needed here to ally the fears of potential "ablatees" who come here loking for answers.

[Jannie411]

The feeling of freedom and relief from SVT after ablation is indescribable.  Like Tom, I suffered from SVT for most of my life.  Since my ablation last month, I am also getting used to not constantly worrying about when and where an SVT attack would hit. I also experienced the weight problems that Tom speaks of - since the ablation, I have been able to exercise and have lost 5 pounds and also some of the weight of the emotional "millstone" as well.  

Tom has been an inspiration to me and many others.  Had he not taken me under his wing when I joined this group and eased my fears about the procedure, I don't know if I would have had the courage to go ahead with the ablation.  After reading his journal and hearing the story of his successful ablation made me think "If his ablation was successful, maybe there's hope for me too."  

If you would like to read my account of my ablation procedure, click on my MedHelp name and it will bring you to the page with my journal.   I wish you all the best!

Sincerely, Jannie411

[tom_h]

Hi Suzanne.  I got your message and replied directly to you.  All of those things you mentioned were my triggers.  However, what actually cased the SVT to initiate was a precisely timed PVC.  The things you mentioned caused the PVCs to fire.  I didn't feel it lurking actually, but with 4 episodes per month, I knoew when I was due for one.  Allergy season was allways a big time for me.  Sneezing and coughing we always  big triggers.

I told my electrophysiologist on a followup visit that he gave my life back to me.  He kind of brushed it aside, but he actually did.  The thought of when the SVT episode would hit was always in the back of my mind, no matter where I was.  I could be in a restaurant with my wife, 50 miles out in the ocean on our fishing boat, in an airliner, or just sitting at my desk in work.  After 6 months, I'm finally beginning to losing that aprehension of "when's is going to hit".  I've also begun to workout hard again without the concern of an episode starting.  As a former competitive short track speed skater, I use to be in tip top shape working around the SVT.  But after retiring, I started coaching, and put on weight as the episodes increased in frequency.  Now, in just 2 months, I've lost 15 lbs, and one waist size knowing that I can push it hard without starting up an episode.  He really did give me my life back, and I will be forever grateful to both my cardiologist for his gentle persuation and of course to my electrophysiologist who did the actual job.I hope you can find a resolution as well.   AT 60, I now realize what I've heard all the time.  Life is indeed all too short.  For most, they no longer have to carry this millstone as I did for 54 years.  Best of luck to you!