Here is my situation. I have Atrial Tachycardia/SVT. I had a 14 day Holter that showed a 20% average burden of Supra ventricular Ectopy. I had an 11% burden of SVT. I had, on average, 20-30,000 ectopic beats every day, and 6-700 runs of SVT per day. Most of my episodes occur at night. From 10pm to 6am, my hourly burden of PACs/SVTwas 30-80%. It starts in the evening and then keeps me awake constantly. The meds have all been a disaster. I have had two ablation attempts with failure to induce.
Had my follow up today for the post-procedure Pericarditis. The EP wanted another 3 day Holter while on the Metoprolol, not sure why, maybe just to confirm my claim that the Metoprolol wasn't working. It was confirmed.... Still have 20% burden of SVT/Ectopics, with an additional 11% burden of tachycardia, and 500 or so episodes of SVT per day. The runs were shorter on the Metoprolol, but that is about all that changed. So he said I could just stop the Metoprolol. The only plan for now is to try the TENS vagal stimulation (which he was fine with), take Propranolol for sleeping, and call him if it gets worse. The next med to try is Sotolol. For now I am just going to wait and see. I'm tired of the meds. He thinks it could be from increased vagal tone but the Norpace doubled my SVT.
I honestly don't know what to do. The meds are all worse than the heart issue. The ablations have been a failure. Unless I can get someone to do an ablation at night, when I am actually having the SVT. I am hesitant to try that again. But the massive amount of PACs/SVT are super terrible too. Any suggestions? Thoughts? I know that SVT won't kill me, but it sure feels like poo.....
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MeganMN
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Just to put your mind at rest re ablation, the EP uses special techniques to stimulate the arrhythmia so it makes no difference whether you have it going on at the time or not. My EP found four different sites firing when I had my A tach ablation.
Bob, I have had two failed ablations because they couldn't induce. The last one caused terrible pericarditis. They said they couldn't fix anything if they can't see it to fix.
Anything is possible but I wouldn't put a lot of faith in the Tens machine.
You did mention pericarditis. Perhaps there is a link? Are you fully recovered? If not, are you resting? Being active during pericarditis could be contributing to the ectopics.
Pericarditis aside, Daily Flecainide has stopped my ectopics dead in their tracks. Something you might consider with your EP.
As to another ablation, I'd look into second opinions from other EP's, preferably at a top 10 cardiac teaching hospital. They don't all work the same way and they don't necessarily have to induce.
I had a similar diagnosis a couple of years ago. The EP decided not to even attempt an ablation but put me on Diltiazem and Flecainide. Things seem to have been under control, more or less, since then, although the Diltiazem did cause dreadful fluid retention so we played with the dosage until it was managed together with diuretics. Hope you get some improvement soon
Megan, you could consider a Mini-Maze. Some people consider that a last resort, I don't know its effectiveness with SVT/Etopics. I plan to get it as a first line treatment. The Cardiologist creates a Maze on the outside of the heart, as well as ablating the Ganglionic Plexi, and often times clamps or eliminates the LAA (which reduces your stroke risk 97%, and also can contribute to 20% of the AFib)
Some doctors also call this a Convergent Ablation.
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Don't know what to do anymore
