Cat Scans and Ablations

[Eliza2]

Can those of you that have had more than one ablations please tell me if you get a cat scan as part of the protocol BEFORE any additional ablations???

[BobD Volunteer]

I did have a cat scan before one of my ablations actually the last one. I think it is very much up to the EP and equipment being used. I know that my scan was projected onto the screen in the cath lab to aid navigation but not sure how widespread this method is.

[Eliza2 in reply to BobD]

Hi bob

Just had procedure done to deal with my pulmonary vein stenosis. I was told that many EP routinely do cat scans before 2nd and 3rd etc ablations to rule out any stenosis of the veins. I went to a top EP at a top hospital for all three of my ablations and never got a cat scan prior to see the condition of my veins before doing the next ablation. Distressing news as it turned out had I had one prior it would have shown the stenosis before my third ablation which I have to believe made that condition worse. Between rock and a hard place the three ablations have definitely helped the afib but at what price?!! The procedure to stent the veins was promising however only time will tell how successful it is. Now I’ll be getting cat scans way too many since this diagnosis to track the condition of the stents and veins. Ablations are great when they work AND don’t leave another maybe even worse problem. Again I feel I had little choice since I cannot tolerate medications but still would have liked to have known ahead of time. Seems there are two different schools of thought as far as the pre ablation cat scans go as was explained to me. Those EP that do it as matter of course before all ablations and those that don’t unless some obvious reason to do so.

[pottypete1]

I have had scans on 2 or 3 occasions prior to ablations. Can’t remember if they were CT or MRI scans. I have had both over the years.

In addition I have had TOE scans on every occasion, once a few days prior and all the others on the table immediately before the ablation and after the GA had been administered.

Pete

[dedeottie]

I had a TOE done before my first but no scan. For my second one (that went wrong) i had no scan and no TOE. When I asked why not I was told that it was no longer hospital policy to do one on patients who were well anticoagulated. Cost cutting?

Well, if they had done a TOE they may not have pierced my aorta leading to the decision that I am unable to have another ablation. During the second ablation no burning was done as they had to come out quickly.

I would say that having a scan and a TOE before an ablation ,is a very good idea!

[Eliza2 in reply to dedeottie]

Dedeottie, As it turns out yes the scan is extremely important for every ablation after the first to see condition of veins. How did the aorta piercing effect you? Are meds helping your afib? I feel like I have been through the mill after 3 ablations then pulmonary vein stenosis procedure for that RARE side effect and still the beast show its ugly head.

[dedeottie in reply to Eliza2]

Hi Eliza. Yes , ablation is great if it works and all goes well but for me there are a LOT of buts!

The aorta piercing could have been fatal so I spent a couple of days in coronary care until they were sure there wasnt going to be a massive bleed out. Thankfully, the needle that they use to pierce the septum, must not have had enough force to actually pierce the aorta although on the screen it looked like it had. It was probably more scratched. Anyway it was enough to scare my E.P. who decided it may be my individual conformation that meant it wasnt quite in the place it should be and so he wont attempt it again and Im not keen myself! Of course a scan would have helped tremendously.

I think my first ablation must have worked to some extent and between that and flecanide I am AF free at present. I have a first degree heartblock and because flecanide can make this worse I cant have a higher dose so if the AF gets worse we will have to think again.

I didnt realise you had had such a hard time Eliza, I must have missed some of your posts. Please tell me more.....

I believe pulmonary stenosis is horrid. Has the procedure helped that at all?

It is good to hear from you.

Best wishes

Jane x

[dedeottie in reply to dedeottie]

Eliza I have just seen your reply to Bob which probably answers most of my questions. X

[Eliza2 in reply to dedeottie]

How are you doing these days? You on any meds? How is the afib?

[Luludean]

I did not. I had two unsuccessfully, done in the afternoon out in the early next morning. Quite scarey when you live alone.

[Eliza2 in reply to Luludean]

Yes it’s all very scary. Are you taking meds now luludean?

[Luludean in reply to Eliza2]

Yes Eliza, Rivaroxaban, Digoxin and Losartan potassium.

[jeanjeannie50]

Before my first ablation I had a scan to show the mapping of my heart and this was used during the procedure. I guess the same one would have been used for my 2nd and 3rd ablations.

Jean

[Eliza2 in reply to jeanjeannie50]

Thanks jean. Wish I knew then what I know now about how important it is to have the scans done before each new ablation. Btw how is your afib? Meds?

[jeanjeannie50 in reply to Eliza2]

Still no AF, over 6 months now!!!

[Eliza2 in reply to jeanjeannie50]

That’s great Jean Jeannie do you take any meds?

[jeanjeannie50 in reply to Eliza2]

Am very gradually weaning myself off them and I must admit it scares me! Now take 12.5mg Metoprolol and 12.5mg Flecainide. I've felt so well I dread that heart nonsense starting up again. It used to quite disable me.

[Luludean]

I did not. Had two unsuccessful NHS ablations in London, waiting list in Papworth was very very long.

[Eliza2 in reply to Luludean]

Will you go for a third luludean?

[Luludean in reply to Eliza2]

No way ! Others have had success though! My GP was scathing about my having it done , not helpful.

[Eliza2 in reply to Luludean]

Docs feel very differently about ablations. Where does that leave us the patient?! It’s a gamble and a crap shoot.

[Hidden]

I've had three ablations and have never had any sort of scan or TOE in advance. I've had a couple of routine echocardiograms. At the start of the last ablation though they made a 3D image of my heart - a procedure that involved applying a lot of freezing cold patches.

[Eliza2]

Hi Jean are you off the metropolol? I take 25mg every night was thinking about halving it. How is your afib? Wanted to clarify something you had said previously .....you said you had gotten CT scan before your first ablation. Did you get a second and third one before your next ablations or the first scan was used for all of them? Thanks