Hi everyone,
I wanted to share my recent ablation experience as I know there are others who have upcoming procedures and still others who are deciding whether or not to go the ablation route to address their arrhythmias. Since I found the experiences of others helpful in my own decision making and coping process, I wanted to share mine as well.
To start, my arrhythmias were svt and frequent ventricular ectopics. I was diagnosed fairly recently, in August of last year (2018). However, my svt was not definitively diagnosed until after my EP study, as atypical AVNRT.
I was started on Metoprolol but due to having baseline low blood pressure, I could not tolerate even a low 12.5 mg dose. I was then started on Diltiazem 30 mg quick release, which I took 3 times a day, but it only helped for about an hour after taking it, after which my forceful ectopics would return and it did little at all to manage my svt.
I had svt that occurred throughout the day - very short runs, for the most part, anywhere from a few seconds to 10 minutes or so. I found them less troublesome than the constant ectopics that occurred in a bigeminal or trigeminal pattern and would be so forceful that if you were sitting in the sofa with me, you could feel the reverberations through the back cushions.
I decided to have the EP study to determine exactly what kind of svt I had and, if possible, to ablate it. I also made the decision to ablate the PVCs, as they bothered me so much. My EP warned me that because the PVCs were on the left side of my heart, he may not be able to reach them. He also warned that because svt can be hard to catch, he may not see it during the EP study; therefore, there were no guarantees going in that he’d be able to ablate anything. I was not having much relief with medication and at age 52 with an active lifestyle, I did not want to start down the road of medication after medication, knowing full well that the medications typically stop being effective after a period of time and the arrhythmias become more refractive to ablation the longer they continue. I did not enter my decision lightly - I am terribly anxious about any surgery and certainly any kind of heart procedure was very difficult to come to terms with. However, my EP assured me that if I changed my mind, I could cancel right up to the last minute and that if I did go forward with it, my safety was his utmost priority and he would not ablate anything without being absolutely certain he could do so safely and successfully.
I had to wait almost 3 months for the scheduled ablation. I made the appointment in December and it was set for February 15. I did my best to put it out of my mind and just tried to enjoy this time as much as I could, knowing that the week leading up to it would be time enough to fret and worry.
But then, I had a follow up with my regular cardiologist who suggested giving the medication more time, maybe a few months, and if I wasn’t better, then I could reschedule the procedure later in 2019. This seemed reasonable so I called my EP and told him I was going to stay on the medication a bit longer and see how it went . I only did this because my cardiologist indicated that he would try to wean me off in a few months and that maybe I’d be improved enough that the procedure would not be necessary. I wasn’t really sure about this, as I knew that svt tends to progress rather than go away, but anything that allowed me to avoid surgery was worth it to me.
Well, it was as if the heavens intervened and sent me a sign - just a week after deciding to forego the procedure, I had the worst svt episode of my life and was rushed by ambulance to the emergency room where they tried for several hours to bring my heart rate down. It was the most terrifying experience of my life. The paramedics that brought me to the hospital were all very caring and comforting, but they all said, “unless you want to live like this, never knowing when svt will hit, you might want to reconsider having the procedure.” I agreed. If I could’ve had it that day, I would’ve gladly walked straight into the operating room without hesitation. So I called my EP and was back on for a February 15 EP study and attempted ablation.
I was quite anxious the night before and took 1/2 mg Ativan to help calm my nerves. We woke at 4 am, and I arrived at 6am for preparation of my 8 am procedure. I was allowed to have clear liquids up until 6 am so I took another 1/2 mg Ativan (with the prior permission of my EP), and this helped as well. They prepped me - (bloodwork, groin shaving, IV placement) and then the team stopped by to chat with me. I had my EP, an EP Fellow who would be assisting, a nurse and two anesthesiologists. Although I would be under conscious sedation and not GA, they had anesthesiologists present in case they needed to convert to GA.
They wheeled me into surgery at 8:15 am and started something in my iv just before I kissed my husband goodbye, they said it was like “truth serum” to which I replied, “ I hope I don’t say anything embarrassing!” I felt very calm, not drugged or “out of it.” They moved me onto the procedure table, I laid down, and then, I was out. I came to with no idea how long I’d been out, and they were in the middle of the mapping portion of the study. I chatted with them for a few minutes and felt absolutely no pain whatsoever. After a while, they told me I needed to be quiet so they could concentrate, which I thought was rather amusing. Then, I was out again. I came to at some point, looked around, and then could feel my heart beating a little fast (not scary fast, not like I had felt during previous episodes), and I said, “I can feel my heart beating fast.” They told me it was the adrenaline doing it’s job, the anesthesiologist came over and smiled at me, and I was out again.
I came to again and could feel some kind of sensation in my chest, not burning, not pain, just a little warm movement. I told them what I was feeling, and then I was back out. I was never afraid, uncomfortable, or in any distress whatsoever.
When I next woke up (I later learned it was a 5 hour procedure), they were removing the catheters and I remember saying “ow” when they removed the sheaths from my groin. They wheeled me to recovery where I laid flat for 6 hours, I slept for some of it, and complained that my back felt stiff but overall, it was easy. I mean EASY.
My EP eventually came by and told me then that I had atypical AVNRT with a 95-98% chance it would not recur. He also got the ectopics and there was about an 80% chance they’d not recur. I was elated. I could not believe how GOOD I felt. The constant sense of movement in my chest was gone. I stayed overnight, and other than my blood pressure dropping a little low (80/40), I felt fine. I cried tears of relief and gratitude. I was so glad that I overcame my fear and doubts, and had the procedure. Other than my back being a little stiff, I had not felt this good in a very long time.
It’s now 5 days later and I still feel great. I’ve taken two weeks off from work even though I know I could go back sooner. My work as a lawyer is stressful so I felt the extra time off would do my heart good. I’ve napped, watched movies, and read some books I’ve been meaning to get around to reading. I’ve said a lot of “Thank You’s” and even though I’m not religious, I’ve meditated quite a bit on how fortunate I am.
I have felt a few brief flutters, but very very brief, and I’ve had some achiness at times over the left chest but nothing I’ve needed to take ibuprofen for. My groin is a bit sore but nothing really bothersome. I’ve gone for a few short walks and tonight I made a big pot of black bean soup to enjoy tomorrow, as we are getting some snow tonight here in the northeast US.
I know how lucky I am. I know everyone’s situation is different. But I wanted to share my story because I really did not expect the procedure to be as pleasant as it was. I expected some degree of discomfort and I had none. I even had to be cardioverted on the table but did not even realize this until I asked about the horse shoe shaped burn on my chest! To be honest, that is the thing that made me a bit sad, to know that they “shocked” my heart at one point. But I was assured that it was a low voltage shock and was not the “violent” shock I envisioned in my mind. Rather, it was like a small “nudge” to get me back into rhythm.
I see my EP in a couple weeks for a follow up. I’m off all meds (yippee!) except aspirin.
Of course, I know either or both of my arrhythmias could come back, despite the favorable odds. But I know now that there is NOTHING to fear from the ablation. If I need it again, I will gladly do it. The expert care of every single person I encountered at the hospital and being in the hands of an experienced EP made this THE best decision I’ve ever made about my health.
I would urge anyone facing this decision to ask lots of questions and if you don’t feel you’re getting enough answers, seek a second, third or even fourth opinion. I had a second opinion and it definitely helped me to know I was taking the right path for me. Each person must travel their own path and not all will choose ablation. However, please take heart that if fear of the procedure itself is holding you back, you can rest assured that it is not difficult to endure AT ALL. Being able to set that fear aside will allow you to consider all the pro’s and con’s of your particular situation and make the choice that’s right for you, without fear driving you away from something that will likely improve both your heart function and the quality of your life.
I wish you all the best in your journeys.
With a happy and grateful heart.
Kelly
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