Ablation after second cardiac arrest in 6 weeks

[Alice_Ro]

Hi everyone

Does anyone have experience of ablation treatment, particularly after cardiac arrests?

I had a cardiac arrest out of the blue on 3 April (I'm 29 and was healthy). 3 week stay in hospital included loads of tests. All inconclusive and so i had an ICD fitted on 20 April (shocking and pacing).

I've since been at home recovering, but had some dizzy spells earlier this week, so my post implantation check up was brought forward to yesterday.

They found ongoing arrhythmia and some worrying episodes on various days. And most worryingly, I actually had another cardiac arrest on 5 may. I apparently must have lost consciousness in my sleep and s so didn't feel the arrest or the successful (thank god) shock therapy. Good ICD is working well , scary it is working so hard. I now have the monitoring box at home so the medics will pick up such activity sooner and they've doubled my betablocker dosage

Consultants yesterday advised that this level of arrhythmia and frequency of cardiac arrest "wasn't sustainable" (frightening!) So they are going to try some investigation and ablation.

Does anyone have experience of this? Particularly hoping there is someone who can tell me it sorted out their arrythmia and meant no more cardiac arrests? I just felt the tone of the consultants yesterday was more like we need to try this, rather than we think this is going to sort it, but I may be projecting.

I am feeling pretty low and scared today.

I really wanted the check up to be 'you've recovered remarkably well because you are so young and fit, and everything is now functioning normally. There is nothing that suggests you will have a second cardiac arrest, just keep in the icd as a safety net" but that wasn't to be.

Sorry to rant/ramble. Thanks in advance for any advice

Alice xx

[sturon]

Hi Alice and welcome to the forum.

What a horrible time for you. It is very natural for you to feel confused and worried, anyone would be. My best advise is to question, question, question - make a list of anything you don't understand or are worried about and ask your GP and consultant to explain things to you. You can also ring the BHF nurse helpline, they can offer you help and advise.

Cardiac ablation is a common procedure now and is very safe with very few people having any complications. You didn't say what the arrhythmias have been if they are leading to a VF cardiac arrest and your ICD is shocking you they are probably supra-ventricular tachycardia. These can be as a result of Wolff-Parkinson-White syndrome again ask for a definitive diagnosis. With WP-W ablation is very successful.

One great thing is that your ICD is working as it should, and you have your very own paramedic with you all the time.

Please let everyone know how things go and take care.

Regards Ron.

[Alice_Ro]

Hi Ron

Thank you very much for your reply. The news of the second cardiac arrest has now sunk in and I am thinking more clearly than when I wrote the post.

I am taking your advice and compiling a list of questions to work through methodically with medical professionals, as well as a tailored glossary for all the new vocab.

My current understanding (steep learning curve!) is that while my usual resting heart rate is low, I have frequent ventricular ectopics; extra beats originating from the lower heart . The current hypothesis that this activity may be coming from some cells in the outflow tract. These extra beats sometimes knock my heart into unsafe rhythms. In two recent cases the rhythm has not rectified and rather progressed into a cardiac arrest. I am not sure if the frequency/persistence of the ectopic activity is changing/has changed over time.

As such, (from a quick Google; I will ask the experts) I don't believe I have supra-ventricular tachycardia, as I believe the medics' view is that the issue stems from the lower rather than the upper heart.

I have been referred for screening of inherited cardiac conditions. I think this is likely to include an ajmaline challenge, testing for Brugada Syndrome.

Thank you again. I will keep you posted.

Best wishes,

Alice

[sturon in reply to Alice_Ro]

Hi again Alice.

It sounds like you are starting to take control, which is great. Remember it's your heart not the cardiologists.

My partner has the genetic condition of long QT syndrome, which caused two cardiac arrests in December last year. He had an S-ICD implanted. He has recovered well but is still fragile and for the first time yesterday I left him in the house on his own. It takes time to adjust and get your life back but slowly it does happen.

Supra-ventricular tachycardia just means a very fast heart rate originating from the ventricles (the two lower chambers). Usually caused by an ectopic beat which happens as the heart is repolarising. A so-called R on T ectopic. This can trigger the heart into SVT, this may rectify itself or need intervention like cardioversion. As you know it can also lead to ventricular fibrillation which needs defibrillation.

The great thing is you know you have a problem and you now have the ICD implanted. It is better to know that you have it and get it sorted. My partner was unaware he had long QT until he collapsed. Fortunately, I was with him and gave him CPR until the rapid responder arrived. After a spell in ITU and then CCU he spent 3 weeks in the cardiology unit before they implanted the devise. As I say it take time to adjust but together we are finally planning for the future.

Good luck and keep us posted on how things go.

Ron.

[Alice_Ro in reply to sturon]

Hi again Ron

I am glad to hear you and your partner are gradually getting back to normal

Our experiences sound very similar as my first cardiac arrest was out of the blue (i had never had any known problems with my heart) and my partner also had to give CPR until the ambulance came, and he then spent 3 weeks visiting me in hospital before the ICD went in. Mine is in my chest as I need the pacing function for if my heart goesctoo slow.

I hope you are finding time to look after yourself while looking after your partner. You have done something truly amazing!

Thank you,

Alice