New pacer and more ablation.

I went for a pacemaker checkup two weeks ago. The cardiologist eyes got real big and he said you are going back to see the EP. (Well over 1000 high rate episodes with it set at 160bpm).
So my wife and I go to see my EP this morning, and he says that it is not Afib this time, rather he is thinking it is ventricular tachycardia basically all the time. He set a date to remove my single lead Medtronic Sensia SR, and replace it with a dual lead Medtronic Advisa MRI pacer and more ablation. This will be my fourth ablation in a year and a half. What are your thoughts on this?

10 Comments

Don't know if my opinion counts for much

by NiceNiecey - 2014-07-30 10:07:04

because I've never had an ablation. HOWEVER, I do know that ventricular tachycardia is more dangerous than Afib. I wouldn't hesitate to have another ablation and the dual-lead PM in your circumstances.

I am praying that you have peace about your decision(s) and that your doctors will know how best to treat you and your constant episodes of Vtach.


Re:

by billylittle - 2014-07-30 10:07:58

Thank you.

ablation

by Alma Annie - 2014-07-30 11:07:00

Go for it. I have had two, no big deal and the 2nd one cleared up many problems.
The EP's know their stuff, and if this is the advice, take it.
All the best
Alma Annie.

Ventricular tachy?

by golden_snitch - 2014-07-31 01:07:11

Hi!

Something can't be right here: If you were indeed having ventricular tachycardia, as you put it, basically all the time, you would now be in the ICU unit. Also, if you had more than 1000 episodes of ventricular tachycardia, you'd need something to happen right NOW, there would be no time to wait and set an appointment. Ventricular tachycardia is no benign arrhythmia, it's dangerous.

Also, never ever fully rely on the pacemaker report alone, always get a holter monitor to confirm what the pacemaker is detecting. It sounds like you were not aware of all these episodes. From those people I know, who had ventricular tachycardia, it doesn't go unnoticed; and with having had a lot of supraventricular tachycardia myself, I can add that this doesn't go unnoticed, either. If you did not feel anything, it could be that the pacemaker is detecting artefacts and not real VT episodes. With VT episodes nobody would send you home with a holter monitor, you'd rather be monitored in the hospital to get these episodes confirmed with an ECG.

If it is indeed ventricular tachycardia, I'd get the ablation, if I were you. And then maybe also get an upgrade to a ICD/pacer device, not just a dual-chamber pacemaker. That's what ICDs treat: ventricular tachy.

Inga

Now,...

by golden_snitch - 2014-07-31 01:07:32

that makes sense then. However, SVT/atrial tachy is nothing dangerous, so if you do not even notice it, you could as well do nothing about it. And as I said, if this is all based solely on what the pacemaker detected, and not what an ECG has shown, get a holter monitor to confirm it.

Inga

VT

by Sylvia1 - 2014-07-31 02:07:09

I have icd which has give me two shocks since implanted in July 2013 due to VT I was told.I was awaiting VT ablation but went to see different EP and was put on amiodorane and he said it was the a fib causing the icd to shock me,so he has decide to do av node ablation.I was surprised that on device check I was told it was VT and on further investigation by icd tech was told it a fib causing problem.

Afib causing the ICD to shock

by golden_snitch - 2014-07-31 02:07:18

Hi Sylvia!

Do you have a single-chamber ICD? Afib is often the cause of inappropriate shocks, especially in single-lead ICDs, because they cannot sense what's really going on in the atria, they only sense the ventricles. So, sometimes a fast and irregular rate caused by Afib is interpreted wrongly by those ICDs, and then they start shocking. You can usually resolve this problem by adding a lead for the atria. An AV-node ablation for Afib is a last resort therapy when all other treament options have been exhausted (drugs, cardioversion, ablation).

Inga

Corretion

by billylittle - 2014-07-31 11:07:24

I just checked the Doctors notes from the visit and was not VT, it was supraventricular tach, and atrial tach.

Shocks

by Sylvia1 - 2014-08-01 02:08:12

Hi Inga

I post on behalf of my husband he has 3 lead ICD implanted due to congestive heart failure,af and LBBB.When he has av node ablation.will it stop the shocks if af is causing them?We hoping he will be taken off amiodorane also.

Tks

Sylvia

svt and atacky

by skaggsoak - 2014-08-12 02:08:20

I had svt and atrial tacky also. I had a Medtronic 2wire. Was since march having numerous episodes of out of rhythm but my readouts were not showing anything out of the ordinary. I had a bad spell about a month ago and recored time and when they ran printout of that time and day there it was. My natural heartbeat on the left was going chaotic and the pacemaker on the right side was trying to correct it. My heartbeat was at 200 beats per minute. But pacemaker didn't record it. I had times then found were it had been at 300bpm. These were not long but long enough to slam by bodily system. Last week aug 7 I underwent a 6hr surgery for av node ablation and a Medtronic 3 wire crt. 100% paced. Have no natural heartbeat now. Heartbeat smooth as silk since. I could not be corrected with another ablation. Tried every rhythm medicine on market. Nothing worked. Big step but was my only step left. Ep told me av node ablation and 2 wire would not guarantee a fix but 3 wire would. Pacemaker reports dont show everything especially palpitations.

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