Post Ablation Monitor Report is in..

[MeganMN]

Well, I,had an ablation on May 10th for Atrial Tachycardia and it was a 'success' in that they ablated the SVT. The downside is that 1) they weren't able to ablate the left sided ectopics, and 2) I have lingering inappropriate sinus tachycardia. So now I am stuck trying different meds again to lower my resting heart rate and also control the ectopics.

On the monitor, the PACs were anywhere from 20-30% daily burden, with a daytime burden ranging from 10%-15%, and a nighttime burden of 30%-50%. The tachycardia was also prominent, with my overall average heart rate at 90, and frequent high rates with minimal exertion. The EP doesn't want me that high for very long as it can certainly cause some Cardiomyopathy.

The doctor is trying a few things to get the rate down, but as before, nothing is really helping with the PACs/bigeminy. This very frustrating. I'm either worn out from the ectopics and tachycardia, or worn out from the meds.

Sometimes it feels like I am spinning in circles.

[CDreamer]

Devil and Blue. Commiserations. Has Pacemaker ever been discussed/considered?

[MeganMN in reply to CDreamer]

Its been discussed. It is kind of a last resort.... The EP has been optimistic that he could ablate the SVT, He is willing to try again to get the ectopics, but if the Inappropriate Sinus Tach doesn't resolve, I'm not so sure.. I see him in Mid-July for a follow-up. Until then we are just trying to control the rate....

[Ppiman]

You have a longer history of this than I have, so have struggled for longer. It is so tiring and stressful. You have my sympathies.

I saw my EP last week and am booked for an MRI next week to see if I can start on flecainide. A high ectopic burden is hard going as we both know. Mine has been daily for a while now and seems persistent, with less overnight and is easily exercise induced. I'm trying to halve the bisoprolol to 1.25mg from today just to see if that helps. I was told an ablation would likely help in my case, with a possible second needed so that is booked but it's a long wait in the UK.

Steve

[MeganMN in reply to Ppiman]

Well, I spoke with my EPs office today. They have one last med to try, Verapamil, and then I have to go back to the EP lab to ablate the PACs. Ugh.

[Ppiman in reply to MeganMN]

It’s surprising when it comes to it, how relatively few drugs there are to try. Best of luck, Megan.

Steve

[MeganMN in reply to Ppiman]

I feel like my list of things that I HAVE tried is pretty long 😂. I can't even remember them all.... I could make a song: (sing to a country theme)

Propranolol, Metoprolol, and some Flecainide..

These are some of the early meds,

That we have tried.....

Norpace, Rhythmol, then some Multaq...

Side effects and arrhythmias,

Doctor, you can take them back...

Bisoprolol, Sotolol, now Verapamil...

Oh, doctor can you help me please,

I have had my fill.....

I forgot about Diltiazem,

Oh, what a shame...

Dizzy, tired, oh so sick,

they all seem the same...

Doctor, doctor, can you help me please.

Take this mess away.

Ablation? Sedation? A beach vacation?

Thanks and have a nice day!

[Ppiman]

Very good. I'll be frank and say I refer Robert Frost, but you run him a close second! You haven't go digoxin on your list. That was the only one that helped slow my fast atrial flutter. And then there's amiodarone, now given in low dose only, that seems relatively safe,

Steve

[MeganMN in reply to Ppiman]

In was always an Emily Dickinson fan! Dark, but meaningful.

[Ppiman in reply to MeganMN]

She can be wonderful; but can often be obscure and too open to unlikely interpretation. I suspect she might have a quiet giggle in the quietness of her heavenly room at the interpretations some of her poems are given, knowing them herself to be something other than wonderful!

But I might be wrong. This one I like!

"Faith" is a fine invention

When Gentlemen can see –

But Microscopes are prudent

In an Emergency

Emily Dickinson

[MeganMN]

I have had one dose of Verapamil, and as such, am extremely cautiously optimistic. But this is quite literally the first evening of Normal Sinus Rhythm that I have enjoyed since Mid-December of 2022. It feels amazing...

[FibChick in reply to MeganMN]

What was the dosage, and did it continue to work for you? I've been cycled through a long list and this is the next one cued up by EP.