cryoablation

[diagnoseme]

I am a 32 year old female and had cryoablation a few days ago to correct SVT.  I have also have sinus tachycardia and irregular heartbeats but the dr did not go in to correct this because he said there was more of a risk that I would have to get a pacemaker because the "electrical" problem is located around the AV node.  Not sure of all the technical terms.  Anyway, prior to and since the ablation, I have had irregular heart beats every day, all day long.  They might stop for several minutes but then return with a thud sound in my chest.  It bothers me to the point that I have a hard time sleeping at night.  Anyway, my dr called me the day after my procedure to check on me and I told him about the irregular heartbeats.  He said that because I told him I didn't want to risk getting a pacemaker he didn't try to fix this problem, only the SVT, which he said was a success.  Only time will see if the SVT is cured because it only happened a few times a year anyway.  He said that if I wanted to risk it, he could always go back in for another ablation in the future to try and fix the irregular problem and now I'm wondering if I should have done that in the first place.  Has anyone experienced frequent irregular heartbeats prior to and since having an ablation procedure and are there any suggestions on what I should do?  My dr doesn't want to put me on meds because I told him I wanted to get pregnant soon but I'm kind of afraid to get pregnant with all these irregular heartbeats also.  Not sure what to do?  Please help?

[ptadvoc8]

I know how tough it is to make a decision about his -- and how frustrating to have to be concerned with these epsiodes, especially at your age. I am really keeping my fingers crossed that you will be one of the majority of SVT ablations who DOES get better after your heart has had time to recover. While I know it's not much to offer, one thing that has really helped me is to do daily meditation and guided imagery for about 20 minutes a day with another 15 - 20 minutes of yoga. Not completely sure WHY this helps (and there are several theories) but while it did not cure my arrhythmia, it did cut my episodes down quite a bit. Thanks for the info about Piedmont -- I'm always interested to know who's doing what type of ablations and where. Hang in there, give it a little time and try to stay positive (I know that is not always easy!) -- and remember, the statistics for you to be feeling better in the next month or so, with fewer episodes and palpitations, are good.

[diagnoseme]

Thanks for your advice.  I have tried meds in the past about 4-5 years ago for irregular heartbeats (through another cardiologist while living in another state) but he couldn't really find the correct medicine to put me on.  I bet he tried 4-6 different kinds but they either didn't work or made me too tired.  He ended up referring me to an EP specialist who suggested ablation but at that point, I was too scared to do it, so I just gave up and decided to live with it.

I continued to have episodes of SVT and irregular heartbeats and would just go to the ER whenever I couldn't get the SVT to stop by myself.  Earlier this year I had to go to the ER again and they referred me to another cardiologist who I have seen since then.  He didn't want to put me on meds due to my age and wanting to become preganant and he said the only other thing to do was ablation.  At that piont I was tired of having these episodes and since wanting to get pregnant, he suggested ablation.  With hesitation I agreed and he performed the cryoablation at Piedmont Hospital in Atlanta.  And that was a week ago now.

I have my follow-up appointment with my dr in a couple of weeks but this is just so frustrating.  I didn't want to risk getting a pacemaker by him going closer to the AV node but sometimes I wish I had, although I'm not sure that I would be able to live with a pacemaker at my age, as I am an otherwise healthy person.  Hopefully the SVT won't come back, at least to the extreme as it was before.  Maybe I will give it another go at taking medication for my PVC's and IST, not sure....

[ptadvoc8]

I also have daily bouts of short runs of SVT (with occasional episodes lasting for as long as an hour or more) along with daily episodes of frequent PVCs and PACs and have been told that the pathway for the SVT would probably be easy to ablate, but the rest of the palpitations would not be cured by ablating that pathway so while some symptoms would be gone, I would still have palpitations. I have read many other similar cases on this site, as well as in the research literature, so you are definitely not the only one experiencing this.

Cryoablation is considered to be the safest methodology for ablating areas near the nodes and septum because they can "try it it out" by freezing for a few minutes to see if the abnormal rhythm stops and then usually thaw the area out if it causes heart block, but it is a very delicate and complicated process so there is always some risk of needing a pacemaker with ablation in those areas. Not that many facilities are doing cryo and I would be curious to know what facility you went to if you care to share that information?

Ectopic beats, which can cause PVCs, PACs and that "thumping" feeling can originate in many different areas in the heart as well as the vessels and are much more difficult to ablate than a recognized accessory pathway that causes SVT, but there are cases of good success. Inappropriate sinus tachycardia seems to be a condition that is often not helped by ablation. There are certainly some cases where it is improved, but there are also a number of patients who have this procedure who do end up with pacemakers or who have no relief from symptoms post-ablation.

Before deciding about a repeat procedure with possible risk to the node, you might want to do some reading and research on life with pacemakers. Many people owe their lives to these devices, but they do take a little adjustment so the bottom line is what are the risks and benefits to your life situation. Can you learn to live with it like it is, or try diet and exercise to see if your symptoms improve? Can you try meds for a trial period, say 3 months, before getting pregnant to see if they help then quit taking during pregnancy? If the ectopics don't improve and are driving you crazy, you can always try ablation again. Some people have 2 or 3 or even more ablation before getting things all straightened out. Also, some facilities have better mapping equipment and more experience in ablations near the nodes and have higher success rates, so you might want to check around -- although if you had cryo, it is likely that you already found someone highly skilled in those types of ablation as most docs and facilities currently use RF to create the lesions.

Do bear in mind that has been noted many, many times both here on this site and in the literature, that after an ablation patients may have an increase in symptoms as the heart heals -- and it can take several months to heal and "learn" it's way around the altered circuits after ablation. So while they may not have been able to ablate all your palpitations and you are having episodes now, it is possible that in several weeks you may notice fewer and fewer symptoms. I certainly hope this is so in your case.

Good luck and best wishes!