Ablation or not?

[Dpc2019]

So due ablation in October for ectopic beats mix of pvcs snd supra ventricular ectopics about 8000 a day was getting more snd felt terrible when cardioligist tried me on beta blocker and calcium blocker. But when he stopped them for me they started to im prove slightly and I've kind of got use to them, and most people I speak to are like ablation is very invasive and not without risks, I mean im just looking for some feedback really

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This information sheet may be of use to you: uhb.nhs.uk/Downloads/pdf/Pi...

I’m sure others with direct experience will be along before long, but the consensus view from medics is that a burden of around 10% ectopic beats a day or more definitely requires intervention, and particularly if it’s predominantly PVCs: whilst ectopics as a phenomenon are generally considered benign in most cases, a high frequency can lead to more serious cardiac problems. If you were/are close to or above the 10% threshold, I would personally go with the ablation. I was never offered one (but probably should have been for SVT, which is an arrhythmia triggered by ectopics, due to the frequency of episodes I was having at that time), and the outcome isn’t quite so good for stopping idiopathic SVT versus SVT caused by Wolff Parkinson White syndrome, but it’s generally very effective for many people that have it done for any reason: not always successful, or permanently successful in some cases (recurrence rate of about 1 in 20 people), but it’s said to work for around 95% of patients with ectopics, with a low rate of complications otherwise. It’s classed as a minimally invasive procedure. Have the people you’ve been talking to had an ablation themselves, or are they just parroting back stories they’ve heard elsewhere?

[Loveswimmimg]

Hi, I don’t know much about your specific condition but I can totally relate to your last minute doubts. I had an ablation for AF in April, and by the time the date rolled round I had not had an episode for two months. I was thinking, why am I doing this, perhaps the AF has gone away, why am I risking it? But looking at it rationally, I knew the AF would come back eventually. I’d had periods when I was AF free before but it always came back. So I went ahead with the ablation. Yes there are risks, like everything in life, but it’s normally a very straightforward procedure these days. Touch wood it seems to have worked for me so far! In the end, only you can make the decision, in conjunction with your consultant. Good luck!

[Dpc2019 in reply to Loveswimmimg]

Aww so you had done, how was recovery? Did they put you to sleep? Also any new arrhythmias or anything since? Fast heart rate after during recovery is what I'm worried about

[Loveswimmimg in reply to Dpc2019]

Hi, no I just had sedation. There was a bit of pain during the procedure, I won’t lie, but tolerable and recovery is much quicker than with general anaesthetic. Yes, my HR did go up after the procedure for a few weeks but it was very low before. It’s now gone back down to 55 resting ( at night)and about 60 during the day just sitting. It’s normal for HR to increase temporarily while the heart recovers. You will have a bruise in the groin area where they put the catheter in, and a good rule of thumb is when the bruise has totally healed then so has the heart. I was back to walking in a few days, slowly, and swimming after a couple of weeks. It probably took me about eight weeks overall to get back to my usual fitness. Odd ectopics and short fast heartbeat runs were common in the first few weeks, and I still get them occasionally but no further episodes of AF and that’s the main goal for me.

[Dpc2019 in reply to Loveswimmimg]

Amazing well mines for ectopics so if I go for it hopefully they can rid me of these things 🙄

[Milosmom98]

Hi! I’m also scheduled for an ablation in October for PVCs (about 25k per day). I really don’t know if I’m going to go through with it - I’m very scared and don’t know if it’s the best decision. So I don’t have much advice, but I understand what you are going through.

[Dpc2019 in reply to Milosmom98]

Wow 25k a day, yeah see my cardiologist said he's only doing mine be aude effecting my mental health, above 10%can cause pumping dysfunction, but anything above 15 and definitely 25 % can cause cardiomyopathy (weakened heart) but i know how you feel ablation is not to be taken lightly, im at 8000 a day currently my last holter this week, jmwhen was your last holter? And did it show 25k?

[Milosmom98]

My last holter was several months ago and it showed 35,000 PVCs in 24 hrs - I was on verapamil at that time which obviously didn’t work. I had a 2 week monitor before that which showed the average of 25,000 per day. I’ve also tried a beta blocker, which reduced them somewhat, and flecainide, which helped a lot - but I don’t want to take it long term. My EP said that there is no way to know if I will develop cardiomyopathy so if i don’t want the ablation we could just closely monitor things. I definitely feel like this is affecting my mental health also, but I’m very worried that I will end up worse off after an ablation. I don’t know how I’m going to make this decision!

[Dpc2019 in reply to Milosmom98]

It's very hard decision to make but whatever you Dr ide I hope it works out so do you feel every single pvc you get?

[Milosmom98 in reply to Dpc2019]

I definitely don’t feel them all, but I do feel palpitations several times per day. I also think I am more aware now - until about a year ago I didn’t even know I had them (they were first discovered by my GP as she was listening to my heart during a routine exam).

I think I am leaning toward not doing the ablation at this time. I just don’t feel ready and I’ve seen some stories on this site that concern me. How are you feeling about it? Do you have a lot of symptoms with yours?

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I have hypertrophic cardiomyopathy and FA. I had an ICD implanted a few moths ago, and I'm on Bisoprorol and Apixiban. I recently saw a specialist electrophysiologist, who discussed several aspects of my condition, and said there were two possible procedures that might help me - ablation, or alcohol septal ablation. He explained the procedures, and explained the risks, and I decided against either as the success rate for people with hypertrophic cardiomyopathy is relatively low. If my condition deteriorates in future, I may reconsider, but for the moment, I feel the risks outweigh the possible benefits. I will carry on with regular monitoring and see this consultant again in 12 months, unless anything changes. At least I now know there are options available to me. Your circumstances are different, but if you're unsure, maybe delay making any decision for the time being. Find out all you can, and don't let yourself be rushed into anything. Good luck.