Anyone know about esophageal fistula post ablation?

[Timsywhimsy]

Hi all, I had an ablation two weeks ago. It was for SVT, not A-fin.

Question is, am I at risk of developing a fistula or is that only a complication seen after an A fib ablation?

Nurse seems incapable of answering this. I just started PPIs today—15 days after procedure! They ‘forgot’ to prescribe them at discharge and told me to start today because I left a message 10 days ago complaining of heartburn. So unimpressed.

I thought I’d read everything, but never saw that antacids should be used as a prophylactic???? Is this common for SVT patients?

Recovery has been more difficult than I thought and now I have to worry about a fistula for two months!!!!!! Ugh.

[Ceelos81]

Hi

I have a question for you. I’ve had a few SVT episodes witch my dr said I should not worry about and says I don’t even need to be put on meds. I’ve had 3 this year and my longest episode was 10 seconds (9 beat run), how often and for how long would they last before you were a candidate for an ablation. I’ve brought up if I need a ablation and she laughed and said I’m nowhere near to be a candidate.

You said recovery has been unpleasant can you please explain and how was the experience with the procedure. Where you awake?

Thank you

[Timsywhimsy in reply to Ceelos81]

So, I had two major episodes (first that I was aware of) 2.5 weeks apart. That was back in June. Each episode lasted 20-30 minutes before ambulance arrived and I was given adenosine. I have two small children and couldn’t live with the constant fear of it happening again. I was given toprol for three months before the ablation. It worked but I didn’t want to be on it for life.

Ablation was scary for me—procedure itself wasn’t painful per se. I was given a relaxant then put out more deeply at the end. I recovered for four hours but then as I stood up to get ready to leave, one of my groin incisions started bleeding a lot and I had to stay longer. For about a week I felt like I was hit by a truck then a lot of fatigue. I’m having some abdominal pain now and getting that checked out. It’s just been a lot to deal with. Recovering with little kids around is challenging.

So, I’d say your doc is right. 10 seconds of a SVT isn’t a big deal. Though I will say a lot of people on here say it gets worse as time goes on. There is a new drug in phase three clinical trials that works like adenosine but is a nasal spray you can administer yourself. That could be a good option for you in the future. Best of luck!

[perkman]

Very rare occurrence especially with the technology today. It is common to prescribe PPI after ablation as a precaution to keep acid lower. You'll be okay. The worst is over.

[Timsywhimsy in reply to perkman]

Thanks. I think I’m a bit traumatized by everything that’s happened. Many ER visits and scary things in just a few months time. I’m 43 with a 3 and 5 year old so I think that’s made it extra hard.

[CDreamer]

Acid reflux after ablation is quite normal and can take many months to disappear completely, if you had either GA or TOE then the tubes can cause irritating cough which can also last - but they do go away eventually. I didn’t take PPI’s for the horrible side effects and if you do take them, don’t take for more than a few weeks as they can be really hard to come off them as when you do, you can have something called ‘rebound affect’.

webmd.com/heartburn-gerd/ne...

You may also find the Pinned Post - Recovering from Ablation of use.

Chance of a fistula developing is so rare that your nurse will never have seen or known of one. EPs know the riskier areas to ablate and steer well clear - that is why the Hybrid ablation was developed.

Hope you feel better soon.

[Buffafly]

My info on esophageal fistula is that the main symptom of it is very high temperature so unless you develop one you don't need to worry, it is very rare.

[BobD Volunteer]

Recovery is ALWAYS more difficult than expected which is why we wrote the fact sheets on ablation but don't beat yourself up as you are not alone.

Why are you worried about fistula? I think it is a very rare problem and had you got it you would be much worse and likely back in hospital. Indigestion problems are not uncommon post ablation of any kind. (The process is the same whatever it is for.) There is, however, no reason to expect everybody to suffer such issues so why prescribe unless needed I would have said. No it is not common protocol. One treats what needs treating.

I know the first few months post ablation can be trying and often disappointing but you will start to feel much better soon I am sure.

[Timsywhimsy]

Thanks to all of you for writing. I’m a worrier so my mind always goes to worst case scenario—hence worrying about the fistula. I sort of thought/was led to believe everything would be great in three days. Pain in my groin is a lot better but still there and fatigue persists. And I didn’t realize I’d have to worry about complications for so long afterwards. I think it’s all been a bit depressing too. I love fall and I’ve missed a couple weeks of it lying low inside. It’s hard to get beyond the inertia of all the resting!