Can ablation make arrhythmia worse? Being wise in selecting the options.

[nano-science]

Apparently yes - just learned from EP - the ablation is not a perfect solution, in particular that ABLATION CAN GET THINGS (MEANS ARRHYTHMIA) WORSE! The usually mentioned complications like groin bruising (I had my leg swollen for 4 weeks) and puncture of the heart (thanks God did not have this one) are not the only ones, and not the main I guess as these both will heal. The scars created by the ablation can become a NEW SOURCE of arrhythmia. I hoped it would have been made clear to me BEFORE the ablation. It apparently happened to me so I am in persistent PVC bigeminies for hours now after slight load like walking down the corridor, that I can not shake off by lying in bed, any exercise etc. I am 58 yo, moderately fit, used to swim, hike, cycle regularly, had second ablation 11 weeks ago for frequent (10-12,000 in 24 h) PVC, NSVT, things get worse by day about two weeks back. I still pray that these are transients and healing will take care of this, but most cardiologists and my EP think that this is it. The EP suggests strong antiarrhythmics now (propafenone, amiodarone etc) that could well be taken before the ablation, with better outcome, when I had just plenty of PVC's. One of the reasons was perhaps that my PVC subsided before the ablation and EP had to trigger them with lots of drugs - but may be triggered a different one. So - DO NOT go to the ablation if you have low PVC load or they strongly reduced - do not be shy to call it off! Hope my experience will help the other sufferers to make right decision!

Please share your opinion and experience on the potential long term worsening of Arrhythmia post ablation. Good luck to All of you!

[chevidaniels]

Hi It was very interesting to read your post, I have been thinking about my scheduled ablation for my SVT. I have one cardiologist pushing for me to have it and the other suggesting I could be on bisoprolol for life seen as my arrhythmia is not life threatening. Sorry to hear you had such a hard time, We often only hear of the positive experiences on this site so the other side is not often heard.

[nano-science in reply to chevidaniels]

Dear Chevidaniels,

For SVT it might be different - usually only 4% have ectopics afterwards, and in some cases they go away. SVT ablation is usually more efficient as well. If it is controlled by beta-blockers you may want to stay with them. In my case they did not work, and the location was difficult.

So the main point - just research the case, and think about all consequences. Also - go for ablation ONLY if you have enough arrhythmias, they may not be able to trigger it during the procedure. Good luck in whatever you chose!

[MydogBrandy in reply to chevidaniels]

H, yes I have had one pushing for ablation and other suggesting pacemaker with loads of tablets

[nano-science in reply to MydogBrandy]

My EP said that both were the options but it does not sound appealing. My fault with the second ablation that seem to be not worked (not 100 % sure though as always there is a hope it worked - it is only 3rd months and I was completely arrhythmia free during weeks 3-7 after ablation that was a miracle note experienced for two decades) was that I went there when high loads of 10,000 PVC and bigeminies -a day dropped very strongly for week before ablation as perhaps I should have declined it. I think pacemaker with tablets is the last resort, while high quality well thought ablation as a much better option.

[Ninetyninepercent]

Thank you for sharing this. I am sorry to hear of your result with ablation. I have SVT AVNRT and PVCs and had a failed ablation in 2016. I am considering trying again. I'm 49, and the fear of episodes (over 220 bpm) is affecting me greatly.

[nano-science in reply to Ninetyninepercent]

Dear Ninetyninepercent,

I think for SVT you can have good chances - just make sure that the EP is experienced, low side effects, and can think laterally of complex conduction issues (essential for the procedure), and you have enough arrhythmia so they can find a focus(es) and ablate them correctly (that is where lateral thinking is essential as ablation is more than zapping the place but rather interrupting the wrong excitation patterns and pathways). Good luck and hope you will be cured!