Ablation next Wednesday

[Christmaspie]

Hi, Apologies, I’m dreadful at remembering terminology .. I’ve had racing and irregular heart beat intermittently for a decade of more. I have a resting heart rate of 50 and low blood pressure. My afib tends to be aggressive and I usually end up in hospital. ( rate of 240 not unusual) Last time had the electric shock which worked. Docs previously said they thought 2 different things going on each relating to a different atrium. One was SVT I think but I’m not sure of the other. Was advised by doc that if I had ablation the svt was straightforward to do but the other condition had a much highr risk and they couldn’t predict how successful it would be. They felt they couldn’t treat one without the other as they thought they were linked. Then a year ago young doc in hosp said he thought I just had fast heart rate and not irregular based on last ecg. Couldn’t find the ecg from previously. So now I’m having ablation on Wednesday . When they make my heart do it’s thing will they be able to see if I have 2 causes or will it be limited and only give them a partial picture if they’re not looking for the second condition? I’m just concerned the young doc was a bit hung Ho and so confident he’d worked out my condition was simpler than the consultant had said it was before. I’m hoping they will finally confirm all that is going on…. Please can you advise if they’ll be able to see everything not just what they think they’ll see and what the second condition might be. Sorry for the long message.

[pip_pip]

Was he a cardiologist. ?

The Electrophysiologist who does the ablation will be sure as to what he is doing, looking at your ecg and other testing beforehand. Be sureof it

Phil

[Christmaspie in reply to pip_pip]

Thanks for replying Phil, that’s reassuring.

[JaneFinn]

Good luck for the ablation, Christmaspie (great name btw!).

Are you in the UK, or elsewhere? Certainly here in the UK you’d get a chance before the ablation (Eg a pre med chat a few days before the ablation with an arrhythmia nurse) to raise any queries and concerns you have. And they’d be passed on to the EP (specialist cardiologist) doing the ablation even if you didn’t get to see him/her in person.

But in any case, as pip_pip says, the EP will know what they are doing. I understand they trigger the arrhythmia and then address what they find. And they often find things that haven’t been recorded on an ECG in advance. So don’t worry about that.

It sounds like you’ve had a dreadful time with fast arrhythmia, so fingers crossed this ablation will make things loads better. Jx

[Christmaspie in reply to JaneFinn]

Thankyou Jane, you’ve put my mind at rest. Particularly about them dealing with things they didn’t expect. 😊

[bassets]

Best wishes for a good outcome and good luck too!

[Ppiman]

You should email the specialist's secretary beforehand to ask this question as it is important one.

I am guessing that they will ablate all of the potential areas to try to stop both issues. Atrial fibrillation generally is a fault with the cells around the pulmonary veins in the left atrium and these are usually completely ablated but leaving a safety margin to prevent damage to the vein entrances. SVT is a general term covering a racing heart caused by atrial issues, so this includes AF as well as atrial flutter, but I gather that it can also occur from various sites within the cardiac muscle of the atrium.

Steve

[Christmaspie in reply to Ppiman]

Thankyou Steve, that helps me understand more.

[Ppiman in reply to Christmaspie]

The most common cause of tachycardia (i.e. a resting heart rate above 100bpm), which is an issue with the bottom chambers (i.e. the ventricles), is that something is happening in the top chambers, the atria, that stops the heart's natural pacemaker working properly. This is usually atrial fibrillation, which is an irregular twitching of the top left chamber, or atrial flutter, a highly regular twitching of the top right chamber, or it is "SVT" (i.e. "supra-ventricular tachycardia"), which can be either of those or some other cluster(s) of misbehaving heart cells within the left or right chamber walls, firing off randomly. Finding these is the problem and this is done using special "mapping" techniques before or during the ablation.

One problem with all heart cells, I gather, is that they don’t only healthily contract as a result of an impulse coming into them (i.e. from the right place: the heart's natural pacemaker in the left atrium), but they can also generate their very own unhealthy impulses, sending the heart muscle into disarray. Luckily, the ventricles are much better protected from this issue as when it happens to them, it is life threatening. The effect of the atrium misbehaving is often tachycardia as the ventricles do their best to remain as effective and life-supporting as they can.

Steve

[Christmaspie in reply to Ppiman]

Really clear explanation. Thankyou Steve. In a way I’m intrigued to find out what is actually happening.

[Ppiman in reply to Christmaspie]

I think you’ll not likely find out as getting to the root cause isn’t easy and the NHS especially just doesn’t have the time and resources often to bother. Probably it’s not all that helpful either in the sense that the originating cause is likely lost in history, such as genetics, weight, lethargy, blood pressure - so many things that take years to manifest as AF (and that is likely a small part of a much wider health aspect, even just getting older!).

Steve

[Magson]

You will have a consultation with your EP before the procedure where he will explain the procedure and you can ask anything that is a concern for you. This happened to me when I had an ablation in 2018. You will be in good hands rest assured.

[Afibflipper]

Wish you all the best on the day, hope all goes well for you

[Christmaspie in reply to Afibflipper]

Thank you so much for remembering! Procedure went ok ( see response to Jane Finn pls as it’s long and I type with one finger!) 🙂

[JaneFinn]

Thinking of you, Christmaspie, and hoping you’re doing ok, if your ablation went ahead yesterday as planned? Don’t exert yourself to reply- rest up!

Just thought this post- ablation fact sheet could be helpful, if they haven’t given you it from the hospital:

api.heartrhythmalliance.org...

[Christmaspie in reply to JaneFinn]

You are so kind to have remembered! Yes it went ahead. Before the op they had hoped to resolve my issues with a simpler heart flutter ablation. Unfortunately there was no svt activity and the surgeon said they found a lot of afib. He didn’t do the procedure for this because I am overweight. It took him two cardioversions to shock my heart back into sinus rhythm. ( is that usual?) So I will be working heard to lose weight before I go back in 4 months time. I am glad the procedure clarified what’s going on so the way ahead is clear.

I do have another question though.. they did do some ablation , something to do with withstanding the flecanide I am taking???(100mg per day)

For those about to go through the procedure my experience was that I was so out of it I only felt when they actually ablated and as soon as I moaned they increased the sedation. It was honestly ok.

In terms of coming off flecanide and bisoprolol cold Turkey for 5 days before the op… on day 3/4 I felt more awake than I have been for ages and slept so well. . It made me realise that the meds really do have side effects for me.

Thanks everyone, this chat really has made a big difference to me. So good to listen to others who know from first hand experience.

[JaneFinn in reply to Christmaspie]

Oh wow, thanks so much for letting us know, Christmaspie. I’m sorry you couldn’t get it all fixed now, but as you say, it’s good you’ve had things clarified, and the way ahead too. Very good to hear about the sedation - and interesting that you found out the impact the meds are having on you too - I imagine this is extra incentive to have the AF ablation at some point, in the hopes you can come off them?

I’m intrigued they wouldn’t continue with the AF ablation because of weight, when they would have done it for the flutter. I wonder why that is!

I’m so sorry I don’t have a clue about what they might have done about withstanding the flecainide … If I were you, I’d post a totally new post, explaining about your ablation, like you’ve said here - if it’s a new post people will see it and you’ll hopefully get some group wisdom! Also, people will be interested in finding out what happened Jx

[JeanetteH]

I have AFib but recently fast regular heart rate too which they said in hospital was flutter.I have had 3 ablations and had to havd a cardioversion recently.I still get flutter and was told by one cardio that its very difficult to 'capture' the flutter.