post sinus node ablation

I am a couple weeks post sinus node "modification". The doctor ablated some 36 different spots but did not completely ablate my sinus node. I was reading my discharge summary and read a comment by the nurse practitioner mentioning that most patients only benefit from this for about a year before having problems again. Has anyone that has had a partial sinus node ablation experienced improvement for longer period of time? If so, how long. I'm curious, so far I have had a great response to this and surely hope it lasts longer than a year. Also they put me back on all of my medication and actually added Digoxin (im on flecainide and pindolol). I did very well off of all of my medications the first day after ablation but they said they wanted me back on my meds for a while before coming off of them. Have you been able to decrease the amount of meds after having the SA node ablation? Thanks for your help in advance!

PS hey everyone.. Pookie, frank, Tracey ...pacergals!! sorry I havent been on, health has been terrible so been in the hospital a lot.

4 Comments

Question

by golden_snitch - 2012-09-10 02:09:51

Just read your profile and am wondering: Why did you have an ablation for sinus tachycardia when you already had AV-node ablation? You have a complete block, and either your pacer switches the mode (DDD -> VVI) when the atrium gets inappropriately fast or it's programmed into VVIR mode all the time, so that it "ignores" the atriums and all the arrhythmias in there, and just steadily paces the ventricles. Maybe you can shed some light on why that doesn't work for you as it seems like we have a somewhat similar story.
Inga

My experience...

by golden_snitch - 2012-09-10 11:09:02

Hi Sam!

What the comment by the nurse says is exactly what I can echo: I do not know a single sinus node modification patient who did not need several modifications; who did not end up with other forms of tachycardia; who did not need a pacemaker. I have had four sinus node ablations, but it still recovers. They ablated around 120 different spots in the sinus node area in my case. I ended up with lots of scar tissue that blocked my superior vena cava, so that it had to be reconstructed via open-heart surgery.
The sinus node is not really a "node", but rather an area of increased electrical activity and cells that can produce a rhythm, and because it's not a defined structure but an area, one can hardly ablate it completely.

Actually, I just got home from having my AV-node ablated. It was my 8th ablation. Spoke to several EPs while in the hospital, and they all said - regarding my sinus node story - that they HATE sinus node ablations, because they never really help; because the long-term outcome is so bad.

Sorry, this is probably not very encouraging for you, but I thought I'd better be honest.

Good luck for you!
Inga

P.S. No, I always got off the meds after ablations. I know that in atrial fibrillation ablations the patients need to continue their meds for several months, but haven't heard that for other arrhythmias.

follow up

by sam78 - 2012-09-11 01:09:07

Hi Inga, yes we have talked before. I had an A-V node ablation 3 years ago. I have no underlying rhythm (as nothing conducts) however I still have both inappropriate sinus tach as well as an atrial tach. My pacer is set to DDDR (yes the R has been hotly debated amongst many) with a rate of 60-130. At a rate of 140 I mode switch to VVIR as you talked about. The problem I have been having is multifactual. I also have POTS (postural orthostatic tachycardia syndrome). I recently passed out a couple of times. One of the times was associated with a atrial tach of 190. They tried changing my pacer settings around and it put me into "pacemaker syndrome" as they called it because I would then have missed and skipped beats. I felt horrible with this. I am EXTREMELY sensitive to changes in my heart rate (totally unconsciously and totally SUCKS). When they changed the rate around it would then go from a rate of 130 (max rate) to 60s or 70's. This caused me to pass out when I dropped rates so fast. I have so much tachycardia that I was frequently in the mode switch which makes me beat in dysynchrony (spelling?) which makes me feel HORRIBLE! It has been a very frustrating process for both my EP doc (several of them actually) and myself. So since I have been symptomatic, they went ahead and fired at the SA area. Even with the pacer set as it is, prior to this ablation I was short of breath with any exertion, since then I have felt great. In the hospital prior to the ablation I was 130 walking the halls, after the ablation my max was 110 with brisk walking. I also wasnt having the tachycardia with standing. We are yet to find anything that substantially helps with the POTS, they were going to send me to a specialty clinic but I think they might have ruined that with this ablation. Will be interesting to see how this all turns out. Sorry this is long and probably confusing. But thanks for the input.

It doesn't last

by mereiriz - 2012-09-12 09:09:47

I've had 7 ablations (3 of them were SA node modifications). One was through open surgery. Most were performed at the Cleveland Clinic with the best specialists. They always lasted less than a year. I ended up with complete SA/AV node ablation and the PM.

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