Ablation for PVC's

[MuseRider]

Has anyone here had this done? Not the ablation for atrial fib but for episodes of ventricular tachycardia? I had no idea they even did this but after piddle farting around with my cardiologist and the supposed regulation of spending 3 months on clinical med trials I escaped with an ejection fraction of 20 and a PVC load of 20% with the danger zone in the 10% area. Thank goodness for Electrophysicists. He is unsure if he can get to the area to ablate it because it is high up in my right ventricle. If he can't they will implant a defibrillator to keep me from dropping over dead, lol, but the heart failure will remain. I am a bit upset by this. He said maybe a 3 or 4 hour procedure and I have to be awake through it all.

Just wondering. This cannot be a rare thing but I had never heard of it and I try to keep up somewhat as a retired Critical Care Nurse.

[luvs2sing]

1. Haven't had it done, but..

it was definitely on the table three years ago when I suddenly developed a PVC load of close to 20%. I was lucky. Between the time of my Holter and when I saw the cardiologist, I gave up caffeine, and the PVCs went away as quickly as they started. I still miss coffee a lot, but nothing is worth how terrible I felt when having the PVCs.

I hope your ticker gets reset in whatever way is quickest and easiest.

[MuseRider]

3. Wow that was really lucky!

It does feel just awful. Sometimes I think I could reach out and grab my heart as it pounds away in strange and very irregular rhythms. My husband took my B/P for all those "we have to follow the protocol of the American Heart Association" months while I took so many drugs I thought I would become one. I have about 2 1/2 hours that I can do anything right now and that is when I clean the barn and get the horses taken care of. After that there is nothing left. I rarely have caffeine anymore, gave that up some time ago so I am glad I do not have to deal with that. 20% PVC load is a trip isn't it?

Thanks for posting. It really helps to hear how this went for others. I am not really scared although there are a number of things that can go wrong but I am anxious. Waiting to hear tomorrow when to show up for the Tuesday festivities.

[lapfog_1]

2. Almost 25 years ago

I was one of the first patients to get ablation treatment for WPW or Wolfe-Parkinson-White syndrome.

5 catheters into my heart... and I drifted in and out while they did it. They had to seal off like 7 extra AV nodes... got 6 but had to give up on the seventh.

Since I was a teenager I have had episodes of tachycardia 300+ BPM and almost no blood pressure (60/40). At first I treated it with a pill (beta blocker)... but those quit working in the early 1990s and I would go to the ER... once for the paddles, and a few times for an intravenous drug called "endocard" or maybe "Indocard". This reboots your heart... kills you for a few seconds. I describe it like it was an elephant sitting on your chest. Then your heart rate is converted to normal.

The only problem with the ER visits is that a) the admitting nurse would never believe me when I told them my likely heart rate and BP... and then, once they checked for themselves... they would rush me into a bed and treat me for shock while calling for the on-call doctor. Treating me for shock involved sticking a large IV bag with a big needle (saline solution) into your arm... and opening it up to dump a LOT of saline into your veins... all of which has to go someplace in 30 min after. Dragging the IV cart to the bathroom to pee is never fun, but I refused to use the bedpan.

Anyway, 25 years later and no more episodes... although my heart often gives me that "skipped beat" pre-arrhythmia feeling.

Knock on wood. I was lucky to have the doctor that pioneered the microwave tip ablation surgery from inside the heart...

He told me it would likely be good for 20 years. So I guess I'm living on borrowed time now.

[MuseRider]

4. Oh thank you so much for being one of the first

making it possible for those of us now to get this done! The Electrophysiologist did not mention WPW but that must be what this is. He pointed out the node in my Right Ventricle. He had been on vacation and when he saw my referral and the passive way I was being moved through the process he got me in right away and minced no words with me. We are doing this or you will likely die and your heart failure now will look easy compared to where it is going.

The fact that you had 7 extra AV nodes blows my mind. I know how shitty I feel so I cannot even imagine how that felt. Those runs of tachycardia that you had are out of this world! My PVC's come in bigeminy or trigeminy but so far not a run like you have had. As an old ICU nurse I would have chased you down with the paddles a lot! My god.

I should have known. I have not been able to bend over without rising all out of breath and faint for a very long time. Walking in to rehearsals would leave me so winded I could hardly be ready to play. I had to give up my almost 50 years with my symphony because you cannot be a wind player without the wind. Not a great time in my life but I am glad to hear other stories. It will calm me some.

I hope your borrowed time lasts much much longer. Thank you so much.

[lapfog_1]

5. When the beta blockers stopped working

I would drive myself to the ER... get of the car, and very slowly walk to the ER door.

My cardiologist told me later that I could have easily died on the spot. But I was young and in reasonably good health... so I was lucky.

Today, if I survive another arrhythmia, I am definitely calling the ambulance.

Fortunately that only happened maybe 3 times before I got the corrective surgery. I don't think I ever want the paddles again... even at the lowest setting. I was wide awake for that.

[MuseRider]

6. God no with the paddles

I am used to being on the other side of the paddles. I would not wish that on anyone.

I was told that there were likely to be one of two outcomes. #1) He can reach the node and microwave it (I love that thought it makes me kinda chuckle but that is what it is) and my PVCs will be gone and my heart failure will be better as I work to make my heart stronger or #2) he cannot reach it and I will need a defibrillator. In that case I can at least stop worrying that I will drop dead, that has been the concern all along and not fun to live with. The heart failure will likely remain and that is not something I want to happen. I am not sure there is any amount of exercise that will bring it back in that case but at least I will get the kick if my heart gets wacky. I was told it feels like a cow kicking you in the chest.....but at least it is not the paddles. I hear they hurt a bit, lol.

Tomorrow I check in and should be a go for 10 AM. A bit nervous but glad to finally be at this point.

[MuseRider]

7. Leaving to go to the Med Center

about 60 miles from here. I have to stay overnight but I have my tablet. Thank you two for your help, I am more relaxed than I was. See you on the other side of the microwave!

[MuseRider]

8. Failure.

[lapfog_1]

9. pacemaker?

that was option #2.

oh well... I'm sure they tried their best.

[MuseRider]

10. Still out of it lol

When the doc talked to my family I was away in my head. Lol I will be better tomorrow. That ET tube has made me sound just awful. Such a nice nursing staff here.

[MuseRider]

11. I am home and in better shape to be posting.

My doctor had told my husband that he did not think he did enough but could not do more. The node was on one of my left ventricular arteries. He called in 4 of his other doctors and they all agreed that to get closer was a huge risk. He told me he was within 2 mm of my artery and if he had hit it it would have been "Game Over" for me. He was sad and sorry when I saw him before he left that night. I was in there around 6 hours I think and they ended up intubating me so I was way out. My husband told me he had said that he hoped the parts he did get would help me.

He came into my room the yesterday morning with this big grin on his face, I had had not one PVC all night long and that after carrying a 20% + load before. I am home, on some new meds for now. EKG today showed no PVC's.

Still a lot of follow up to do but I am happy. Tired but happy. Next to get rid of the heart failure, much of that caused by my arrhythmia. Boy was this close.

[lapfog_1]

12. That is GREAT news

so happy that you are doing better.

Yeah, too bad about the placement.... I have the same sort of issue.

[MuseRider]

13. Hopefully the two of us

can live the rest of our earned long life with only a PVC now and then.

It is funny, every now and then I look around wondering why I feel so odd. It is because my heart is not pounding and kicking me in the chest all the time!

[MuseRider]

14. I ended up having a little stroke after all this.

I had to spend most of 2 days and a night in the hospital while they all discussed it and pictured it. I am just fine. It was tiny and all it did was make me walk to the left, no matter where I was headed I went left and then fell. All better and AND 10 DAYS WITHOUT A SINGLE PVC! As long as that area on the aortic cusp does not act up I am good.

I have not felt this good in a very long time, years. I am no longer considered a walking time bomb! When the failure starts to get better, look out world. This old lady is going to be out and about.

Had an ECHO while in for the stroke. It isn't a formal reading but the tech told me it looked like my EF went up from the low 20's to around 40 and for women that is considered the low end of normal IIRC.