Stress Test Before Ablation?

[BlueINR]

I am scheduled for an ablation at the end of the month. Cardiologist's office called me yesterday to tell me he wants a chemical stress test done, which I assume is to determine what my coronary arteries are like. I'm also assuming, if he's not pleased with the results he will cancel the ablation. It is scheduled for the week after next.

Had an ablation two years ago in a different city, no test of coronary arteries done before that, so this is new to me. And, no, I cannot go back there. It's too far from where I live now and because of insurance, I'm with a different medical group.

Didn't know a stress test was needed before an ablation to see how well coronary arteries are doing. Has anyone here had this?

[fairyfeathers]

I recently had an Ablation for Flutter. I asked the EP prior to this procedure whether I needed any preliminary tests on my heart like a stress test and he stated not at this time. He had an uptodate ECG. So all went ahead. I wish you well with your Ablation.

[secondtry]

I would ask why. I am not a fan of these unless absolutely necessary.

[BlueINR in reply to secondtry]

I did ask why. It's because the doctor needs it, was the response.

[secondtry in reply to BlueINR]

You have to be so diplomatic but I would request the reason, so I can assess the need myself - you are part of the medical decision team and I hope most doctors still respect that, despite or because of time pressures.

[BlueINR in reply to secondtry]

I know how to be diplomatic. This is how he's managing me. I have to like it or lump it. I've been dealing with medical stuff for decades, none of this, nor how to communicate with doctors is new to me. He is the EP in the cardiology group, as my cardiologist is not an EP, the EP is doing the ablation.

I'm sure I have the right to decline, which most likely will have him refuse to do the ablation. I dearly need it. I have had 17 bouts of afib in 2 years.

[Nugger]

if your active & reasonably fit,then no

[2learn]

Hi, I had to have a stress test, on a bike and with heart scan before open heart surgery to check my ejection fraction rate as if too low would influence my heart recovery after op, it would be pumping too slowly. Now if we are talking about same thing, chemical test is usual only if you cannot do exercise for some reason. Determining what your arteries are like is I think usually done with angiogram not stress test. I've had 3 ablations and no stress tests before.

[BlueINR in reply to 2learn]

I'm not having open heart surgery. I am having a cardiac ablation due to 17 bouts of afib in the past 2 years.

[2learn in reply to BlueINR]

did you actually read what I said. the implication is that the stress test may not be needed for an ablation and you may be charged for an unnecessary procedure.

[BlueINR in reply to 2learn]

Yes, I read your response. The MD says it's needed, Sounds more like you're not reading what I post.

[SeanJax]

if your cardiologist needs it then follow his recommendations. I did not see any differences between your Afib episode and the chemical stress test. They inject some drug to increase your heart rate and some contrast product to see the myocardial perfusion to see if any blockages in your coronary arteries. It is a good reason to have a stress test as baseline since above 50 we start having comorbidities as high blood pressure, diabetes , high cholesterol, high BMI. All these comorbidities are the root cause of heart attacks.

During the ablation procedure they will use drugs to provoke the Afib and the heart rate will be high and might cause some cardiac ischemia if you already have blockages in your coronary arteries.

It sounds scary but no big deal. If you can tolerate your Afib episodes you will be ok with the stress test.

[MrJD]

I had a stress test and CTCA prior to my ablation.

My ejection fraction was reduced when I initially had AF, but was in Sinus post cardioversion when I had the above tests.

Useful to know that there was not a coronary artery factor in my AF or reduced EF.

Both tests satisfactory for me and subsequent ablation. Reassuring.

Maybe your cardiologist wants to see if your AF is due to coronary artery disease, a stress echo is one way to identify territories of the heart not working so well due to reduced coronary blood flow. Also see if there are arterial or ventricular shunts or defects

IIRC it is a step up from the old exercise ECG test but not as invasive as an angiogram or involving radiation as per CTCA

[Mugsy15]

Personally I would be pleased to be tested!

All tests carry a cost so consider yourself lucky to be subjected to a little extra surveillance that will give peace of mind by showing normal function. If it shows an abnormality then even more reason to welcome it!

The closer they look at your heart the better in my opinion. One hears of so many people having life-changing ischaemic events due to an 'undiagnosed underlying heart condition'. I'll take all the tests they can give me, any time!!