Terrified of having catheter ablation for SVT

[Chocolateyclaire76]

I’ve suffered from SVT for many years and although my episodes are very infrequent, they are horrible and completely debilitating when they appear, out of the blue.

I really don’t want to be on medication for them so have opted for an ablation but am now slightly terrified in case something goes wrong.

I’ve got a 6 and 3 year old and the thought of a terrible complication just fills me with dread, especially as I’ve chosen to have it done!

There’s only a less than 1% of serious complications but my brain is focusing on that!!

Has anyone else had one?

[sashh]

Not had one but I was a clinical physiologist.

Have you had a cardiac cath at all before? Maybe an EPS study?

Depending on the type of SVT there is a quirk in the electrical system of your heart. The depolarisation (the electrical activity that initiates the beat) should begin with the SA node and disperse evenly through the atria.

You have a bit of 'extra wiring' if that makes sense so some of the depolorisation takes a short cut and this sets up a cycle of SVT.

In some cases it is a well known pathway, ie you have Wolfe-Parkinson-White syndrome then the extra tissue is a 'bundle of Kent' and that is what the Cardiologist will try to destroy or atleast stop the conduction.

If it isn't WPW then it can be tricky to identify and the consultant will attempt to find the source.

OK so complications. Well the most common is that you may need a pacemaker, sometimes pacemakers are implanted alongside the ablation as part of a planned procedure.

People lead completely normal lives with pacemakers, they need a check up every year and the pacemaker replacing every few years.

I know it is worrying because it is your heart but it is a procedure carried out commonly all over the country.

It is zapping a tiny piece of tissue in your heart, a bit like having a mole removed.

[Sunlov]

What is an SVT?

[Chocolateyclaire76]

Thank you so much sashh! I wore a holster monitor for 7 days last December and thankfully I had an episode and they diagnosed SVT, which is what they suspected. I’m 43, in good health but could do with losing a few pounds - hopefully there won’t be any complications.

What i’m struggling with is the guilt in case something does go wrong as this is all my choice, over medication.

[dreamingofsunshineeee]

Hi there. I had a catheter ablation 5 years ago. I was very anxious at the time and on reflection wish I had got some help in talking to someone about my anxieties prior to the surgery. I think anything to do with your heart can be very scary.

In saying that, while the procedure was uncomfortable, I have since had 5 years without SVT which has been life changing. I'm really glad I had it done.

[IrenetheQuaint]

I've had one. It was a bit unpleasant at the time (I was offered sedation but refused, which was a mistake - take the sedation!) but totally successful and I recovered quickly. As you say, the risk of complications is very low.

[KTD27]

My son is due to have one because of WPW and our consultant explained it’s a very straightforward procedure.
It helps that my husband has had two himself due to unrelated issues - he said it’s unpleasant a bit like the PP but had no issues (other than they couldn’t stop his weird heart episodes but then they went away on their own...)

[Chocolateyclaire76]

Thank you everyone! I just keep reading the ‘1% chance of stroke or death’ and I start panicking!

[Chwaraeteg]

I remember freaking out badly when I had mine done. Anything involving your heart just makes you feel vulnerable!

It is a very quick and routine procedure though, don't worry. My quality of life and energy levels have improved 100% since I had mine done. It's worth the risk.

[YonWeeLassie]

Sunlov It's an extreme form of palpitations caused by an electrical fault in the heart. The heart rate can go up to 250 beats per minute.

Chocolateyclaire76 How often do you have SVT? Can you stop them or do you always end up in A&E? What drugs are you on and why do you not want to take them?
I have SVT and had a horrific episode last year so was put down for ablation. I had an EP study recently but they failed to do the ablation.

If you have had SVT then the process of having electrical currents run through your heart will not phase you. It's kind of interesting actually. The worst bit was the local anaesthetic in the groin. Then a bit of tugging while the place the tubes in. I was not given any sedation although they would have sedated me if they had found a site to ablate.
Afterwards you have to lie flat for 4/5 hours minimum then a gradual sitting up. No driving or lifting for a week and my groin was very tender for several days.

[Chocolateyclaire76]

YonWeeLassie, I get them really sporadically but when I have they’ve been completely out of the blue and i’ve verged on blacking out. Last time I had an attack it was terrifying as my 2 young children were with me. Thankfully friends were there too and able to help - I managed to make them stop after 40 mins. I could then go weeks, or months until another attack. No hospital admission yet but they have caught it on a holster monitor.

As for drugs, I don’t want to start taking something, with potential side effects, that may or may not continue working, for the rest of my life. I’ve chosen the ablation and I know it’s the right thing but it doesn’t stop me worrying about the what ifs.

[YonWeeLassie]

Are they really out of the blue or can you find a common event leading up to the episode?
It took me a while but eventually I worked out what the triggers were for my SVT. Number one is infection. Also injury, shock, stress and bizarrely bending over for any length of time.

I take calcium channel blockers and they work very well now I have the dosage right but I understand the dislike of long term medication. Also the reluctance to take a risk with such young children.

They have to tell you the worst case scenario ( and will again before you sign the consent) but my cardiologist was very reassuring about the routine nature of ablation.

[Chocolateyclaire76]

YonWeeLassie well there are definitely things that don’t help, like caffeine, but I only have decaf now. Bending over can trigger a flutter sometimes and it can be a delayed reaction to stress but there has been times when I can literally think of no reason, such as lying on the sofa watching TV. It’s like being hit by an unsuspecting sledgehammer!

Do your meds work for you YonWeeLassie and have they been more successful than the ablation?

[sashh]

YonWeeLassie and Chocolateyclaire76

Id depends on the type of SVT and the part (or parts) of the atrium that start and continue the SVT, if the atria are more 'excitable' generally then beta blockers or calcium channel blockers can work. If it is a particular group of cells then ablation is a better choice.

I remember in my early training the only way to 'cure' WPW was open heart surgery so it was only done for people with severe symptoms.

Chocolate

What are your chances of death or a stroke in your everyday life? You don't think about it do you?

KTD27

Your son's ECG will change shape after the ablation. WPW causes a delta wave making the qRS slightly wider and with an extra, er,sort of kink. I can't think how to explain it but ask the cardiologist to show you, or the physiologist.

Sunlov

Supra ventricular tachycardia.
It's an abnormally high heart rate originating above the ventricles, our HR raises for things like exercise but in SVT it starts for no apparent reason and can be debilitating.

I've only had it a couple of times, I get it when my thyroxine needs adjusting.

When I had the palpitations the first time I was in work so just did a rhythm strip,and thought, "SVT, interesting"

An ablation kills the cells causing or contributing to the the SVT, if the cardiologist can find them.

[KTD27]

@sashh yes it’s got like a swoop in it. Sort of a Nike tick thing going on.

[KTD27]

Only when he isn’t on his meds though. With the flecainide and atenolol he has no pre-exitation

[sashh]

KTD27


Nike symbol - yes, good description.

How old is ds? Clinical Physiology is a great career, I had to leave due to disability but if he wants a job for life and he is interested I'd recommend it.

[KTD27]

@sashh he’s three

[greyspottedgoose]

When I was 18 my partner at the time had it, I remember sitting in the hospital waiting room with his mum being terrified and not much else, he always said it wasn't as bad as he had worked it up to be, and said it was much less traumatic than the palpitations he would sometimes get that made him think he would die there and then. Good luck you will be fine

[Chocolateyclaire76]

Thank you everyone! Well D day is tomorrow so i’m crossing my fingers!

[sashh]

KTD

A bit young for career advice then.

OP

Good luck ad if they offer you sedation take it, it's like a stiff drink.

[YonWeeLassie]

Chocolateyclaire76
A couple of tips for hospital tomorrow.
I was told to arrive at 7am but there were several others all given that time. We had to go onto the ward and get into hospital gowns then the Dr came round to get consent signed. I was first on the list and went down at 9.30 am so lots of waiting even before they start.

If the procedure is successful they will probably keep you in overnight, if they can't ablate you will probably go home about 6 hours after the procedure.

Take big loose pants or pyjama shorts - you will have a very tender spot in your groin and don't want elastic around it. Wear loose trousers or joggers.
My feet were frozen in the lab as I was wearing only a hospital gown. The woman in the next bed had kept on some fluffy socks .
Take headphones and download audio book or podcast as five hours flat on your back is a looong time.
If you are staying overnight have eye mask and ear plugs in your bag.

Let us know how you get on!

[Chocolateyclaire76]

Thank you so much YonWeeLassie! Someone at school just told me their doctor refused to send them for an ablation for SVT in case they ended up with a pacemaker - just what you want to hear the day before!!

[YonWeeLassie]

Well it's highly unlikely to happen, but a pacemaker isn't the end of the world actually. I think in the US they often fit pacemakers routinely in ablation cases.

[sashh]

Well it's highly unlikely to happen, but a pacemaker isn't the end of the world actually. I think in the US they often fit pacemakers routinely in ablation cases.

Ablate and pace is a strategy when certain parts of the atria are targeted.

The idea is to get to as near as normal for the patient so for KTD's son the aim will be to destroy the bundle of Kent.Most people do not have his and it causes SVT so getting rid of it returns the electrical system to 'normal'.

If there is a lot to ablate or you are ablating the AV node then you do need to implant a pacemaker.

Obviously sometimes it becomes apparent that a pacemaker is necessary so it's implanted.

[KTD27]

Good luck chocolatey let us know how you get on